PBL discussion of PD Flashcards
Alternating or synchronous contraction of antagonist and agonist muscles is the result of a ….
Tremor
Describing the tremor involves 4 things
- Distribution/topography
- Relation to movement (rest or action?)
- Frequency (slow or fast?)
- Amplitude
Action tremors are subdivided into two classes. what are they?
- Kinetic tremor
2. Postural tremor
Intention tremors are a subtype of which class of tremor?
Action - Kinetic tremor
Physiologic tremor occurs at low or high frequency?
high 8-12 Hz
Cerebellar tremors occur at low or high frequency?
Intention tremor - low frequency - 3-4Hz
Describe the frequency of essential tremors
Initially high frequency, later low frequency
Parkinsonian tremors are high or low frequency?
Can be 3-6Hz
Physiologic tremors are a subtype of which class of tremors?
Postural
Describe a key feature of physiologic tremor
“Invisible” so fine amplitude
Is Enhanced physiologic tremor a neurological condition?
NO
Describe 3 key features of a cerebellar tremor
- Alcoholic degeneration
- Posterior circulation stroke
- MS
Cerebellar tremors are a subtype of which class of tremor?
Intention tremor - kinetic
How do you treat Essential tremor? (1st line)
- Propanolol
2. primidone - adverse effect: can cause vertigo, nausea
How do you treat Essential tremor? (2nd line)
- Gabapentin, topiramate, benzos
- Botox locally
- Deep brain stimulation
Akinesia or bradykinesia is described as
slowed movement
reduced amplitude brought on by continued movement
Do you need postural instability to diagnose Parkinson’s?
NO, often absent until later in disease state - EARLY FALLS ARE ATYPICAL!
What are the three predictors of idiopathic PD
- presence of rest tremor
- Asymmetry of signs in onset and progression
- Good response to L-dOPA
In young onset PD what’s first line?
D agonist
How does COMT work?
Prevents breakdown of both L-Dopa and Dopamine
