parkinsons disease W2 Flashcards
parkinsons motor symptoms?
bradykinesia (slowness of movement)
rigidity
tremor
postural instability
non-motor symptoms of parkinsons?
cognitive change
depression, anxiety
REM sleep behaviour disorder (vivid dreams, hallucinations)
constipation
pain
parkinsons clinical appearance
rigidity and trembling of head and extremities
forward tilt of trunk
reduced arm swing
shuffling gait with short steps
lead pipe rigidity?
increased tone throughout body
neuropathology of parkinsons?
lack of dopamine
pallor of substantia nigra due to degeneration
how do lewy bodies appear in histology
bright pink structures in cytoplasm of neuron, surrounded by pale halo
where do lewy bodies spread?
first appear in medulla and olfactory bulb, spread to pons, midbrain, limbic lobe, neocortex
basal ganglia structures?
thalamus
globus pallidus
subthalamic nucleus
what pathway is affected in parkinsons?
pathway between substantia nigra and basal ganglia:
nigrostriatal pathway
function of basal ganglia?
circuitry processes signals that flow from the cortex allowing the correct execution of voluntary movements
which neurons are destroyed in parkinsons? what does this cause?
dopamine producing neurons
other neurotransmitter pathways become overactive
where is dopamine produced and what does it inhibit?
substantial nigra
inhibits GABA
what does GABA do?
stimulates skeletal muscle
what does increased GABA cause
symptoms of parkinsons
difference in starting location of lewy bodies between DLB and parkinsons?
DLB - cortical
parkinsons - brain stem
how many people with parkinons develop dementia?
30%
what is development of dementia in those with parkinsons associated with?
age
disease duration
visual illusions/hallucinations
fluctuation in symptoms
paranoia/delusions
may be exacerbated by treatment, particularly dopamine agonists
what are parkinson-plus syndromes?
syndromes which look like parkinsons but have additional features
progressive supranuclear palsy symptoms?
type of atypical Parkinson’s
problems with balance
limited eye movements
appearing surprised in facial expression
multiple system atrophy symptoms?
autonomic disturbance
dizziness
falls
coordination
ataxia
slurred speech
corticobasal syndrome symptoms?
stiffness
slowness of movement (often asymmetrical)
difficulty solving problems
difficulty with coordination
general function of Parkinson’s drugs?
increase dopamine
(dopamine replacement therapies)
gold standard treatment for parkinsons?
levodopa (with carbidopa)
what happens if you take levodopa on its own? how is this fixed?
broken down in periphery. must be given with carbidopa which stops this breakdown allowing levodopa to cross blood brain barrier
