Parkinsons disease Flashcards
define Parkinsons disease?
progressive neurodegenerative disease caused by the degeneration of the dopaminergic neurones in the substantia nigra, characterised by:
o Bradykinesia
o Rigidity
o Resting tremor
what is the pathophysiology of Parkinson’s disease?
o Degeneration of dopaminergic neurones projecting from the substantia nigra to the striatum
what are the two main types of Parkinson’s?
Idiopathic Parkinson’s Disease o Most COMMON
• Secondary Parkinson’s Disease
o Neuroleptic therapy (e.g. for schizophrenia)
o Vascular insults (e.g. in the basal ganglia)
o MPTP toxin from illicit drug contamination
o Post-encephalitis
o Repeated head injury
epidemiology of Parkinson’s disease?
- Very COMMON
- More common in men
- Mean age of diagnosis is 65 years
presenting symptoms of Parkinson’s?
- Resting tremor (mainly in hands)
- Stiffness and slowness of movements
- Difficulty initiating movements
- Frequent falls
- Smaller hand writing (micrographia)
- Insomnia
- Mental slowness (bradyphenia)
how do signs in Parkinson’s often present?
unilateral
what are the features of a Parkinson’s tremor?
o Pill rolling rest tremor
o 3-5 Hz
o Worse when stressed or tired
o Improves with voluntary movement
what are the features of Parkinson’s rigidity?
o Lead pipe rigidity of muscle tone
o Superimposed tremor can cause cogwheel rigidity
o Rigidity can be enhanced by distraction
what is a Parkinson’s gait?o Stooped
o Stooped o Shuffling o Small-stepped gait o Reduced arm swing o Difficulty initiating walking
other signs in a Parkinson’s patient?
o Frontalis overactivation (leads to furrowing of the brow) o Hypomimic face o Soft monotonous voice o Impaired olfaction o Tendency to drool o Mild impairment of up-gaze o Depression o Cognitive problems and dementia (in later stages) o REM sleep disturbance. • Postural Instability
how is Parkinson’s normally diagnosed?
• CLINICAL diagnosis
