Flashcards in Parksinsons Deck (68)
Age of presentation of Parkinson’s ?
Bradykinesia, tremor, rigidity. Usually bilateral but can start unilateral
What happens to tremor in Parkinson’s ?
Disappears with activity
What is rigidity?
Increased resistance to passive movement
What is rigidity like throughout the range of movement ?
Gait in Parkinson’s ?
Show, shuffling gait
Arms and posture during walking ?
Stopped posture and reduced arm swing
What is speech like ?
may be slow and monotonous. In late stage disease may be slurred, or even lost
Power and sensory loss?
Power remains normal and there is no sensory loss
What other psychiatric conditions associated with Parkinson’s ?
Dementia and depression
Why do you get hallucinations.
A combination of the disease and the drugs used. Often they are not unpleasant
What are kayser fleisher rings seen in?
Wilson’s disease (copper)
Which drugs can cause Parkinsonism?
Drugs (usually dopamine antagonsists)–e.g. prochlorperazine, metoclopramide (antiemetics) phenozanthines, butyrophenones (neuroleptics)
pathological hallmark of parkinsons disease
prominent dopaminergic neurone loss in the substantial nigra with alphasyneuclein containing lewey bodies and lewey neurites
which part of the brain is the substantial nigra found?
what are upper motor neurone features?
pyramidal weakness and spasticity
triad of parkinsonianism?
bradykinesia, resting tremor and rigidity
Fragments of movements flow irregularly from one body segment to another causing a dance-like appearance?
what does PD present with?
PD presents with tremor, muscular rigidity, akinesia, rest tremor, and gait and postural impairment
which subtype has the slower rate of progression ?
non motor features of PD?
olfactory dysfunction, cognitive impairment, psychiatric symptoms, sleep disorders, autonomic dysfuncLon, pain, and faLgue.
when does diagnosis occur in PD?
with the onset of motor symptoms
what is progression of PD characterised by?
progression of motor symptoms
Neuronal loss in PD occurs in many other regions including?
ocus ceruleus, nucleus basalis Meynert, pedunculoponLne and raphe nuclei, dorsal motor nucleus of vagus, amygdala, hyopthalamus
how are lewey bodies formed?
Misfolded α-synuclein,which is insoluble and aggreagated, forms intracellular inclusions (Lewy bodies)
Prolonged muscle spasms and abnormal postures
Fragments of movements flow irregularly from one body segment to another causing a dance-like appearance
a parasomnia characterized by abnormal or disrupLve behaviours (such as talking, laughing, shouLng, gesturing, grabbing, punching, kicking,, sirng up in bed)
Rapid eye movement sleep behaviour
treatment of rapid eye movement sleep disorder?
clonazepam or malatonin