tremor Flashcards
which enzymes break down dopamine
COMT and MOA-B
what is the pathology of Parkinson’s
loss of dopaminergic in the substantia nigra
what are the characteristics of parkinsons
bradykinesia, cogwheel rigidity, resting tremor (pill rolling), micrographia, gait or postural instability.
how do we diagnose parkinsons
clinically
How do we intervene in parkinsons
1) acetylcholine inhibitors (benztropine) this is early first line treatment for mild disease
2) COMT-inhibitors (capones)
3) MOA-B inihbitors (salegeline)
4) L-Dopa and carbidopa are the best answers.
5) dopamine agonist (ropinerarole, pramiprexole)
what is the best question to ask about a person with parkinsons and what are the treatments?
if less than 70 and functional start off with dopamine agonists.
if over the age 70 or dysfunctional then start with levadopa or carbadopa.
as more and more neurons die add COMT-i and MAO-i
when everything begins to fail look to DBStimulation.
what are the characteristics of essential tremor
often familial disease. a tremor that occurs with movement. No tremor at rest. usually middle age man. clinical diagnosis.
what is the treatment for essential tremor
low dose beta blocker. propanolol
what is intention tremor
cerebellar dysfunction due to stroke or alcohol. gets worse when they approach a target. finger to nose test. the amplitude increases as they get closer to the target. clinical diagnosis
what is the difference between essential and intention tremors
essential occurs all the time and is the same amplitude. intention occurs when they are intending to do something and will get worse in amplitude when they approach their goal.
What is huntington’s chorea?
anticipation of tri-nucleotide repeats. chorea = purposeless, ballistic and uncontrolled movements. usually die by suicide. psychosis. no treatment
