U14C3 Parkinsons

Question 1

What are the symptoms of Parkinson’s?

Answer 1

Question 2

What is the neuroanatomy of Parkinson’s?

Answer 2

Question 3

What is the pathology of Parkinson’s?

Answer 3

• Misfolding of alpha-synuclein associated with Lewy Bodies and neuronal cell death
• Likely interplay between genetic and environmental factors
• Neuroinflammation, problems clearing things out of cells (autophagy), mitochondrial dysfunction etc

Question 4

What are the clinical features of Parkinson’s?

Answer 4

• Anosmia
• REM-sleep behaviour disorder
• Constipation
• Mood changes

Question 5

What are the differential diagnoses of Parkinson’s?

Answer 5

-Essential tremor- bradykinesia, rest tremor and postural instability
- Vascular parkinsonism- repeated strokes and strictly unilateral features after 3 years
- Parkinson’s plus syndromes- supranuclear gaze palsy, cerebellar signs and early severe disautonomy
- Dementia with Lewy bodies- early severe dementia with disturbances of memory, language or praxis

Question 6

What is the direct pathway?

Answer 6

Question 7

What is the indirect pathway?

Answer 7

Question 8

What is the pathophysiology of Parkinson’s?

Answer 8

Question 9

What is the pathophysiology of the signs and symptoms of Parkinson’s?

Answer 9

Question 10

How do drugs induce Parkinson’s?

Answer 10

Question 11

What are the diagnostic tests?

Answer 11

• MRI
• DaTSCAN
• Olfactory testing

Question 12

What would Parkinson’s look like on a DaTSCAN?

Answer 12

Question 13

What is deep brain stimulation?

Answer 13