Flashcards in Parksinsons Deck (68)
where are lewey bodies found in parkinsons?
not confined to the brain, they are also present in spinal cord and peripheral nervous system
what are lewey bodies?
misfolded alpha sinuclein, which is insoluble and aggregated. These form intracellular inclusions
what does pigment loss correlate with?
dopaminergic cell loss
greatest risk factor of parkinsons?
male to female?
more common in males
greatest genetic risk factor for PD
mutations in GBA
what is treatment in PD aimed at doing ?
enhancing intracerebral dopamine concentrations or stimulate dopamine receptors
which drug class associated with oedema?
which drug associated with dyskinesia? (writhing movements)
what is the "on-off effect" of levodopa
alterations between periods of good motor symptom control and periods of reduced motor symptom control
PsyChosis in PD is most efficiently managed with
motor symptoms in PD?
postural and gait impairment (stooped posture and show, shuffling gait with reduced arm swing)
Slowness of movement with progressive loss of amplitude or speed during aWempted rapid alternaLng movement of body segments
how can you assess bradykinesia?
can be assessed by asking the patient to perform some repetitive movements as quickly and wisely as possible
decreased facial expression and eye blinking ?
what happens to rhythmic oscillatory tremor on voluntary active movement
what is re emerging tremor?
tremor reappears after hands held out
is head tremor typical for PD?
what is cog wheel rigidity
"Cogwheel" rigidity occurs when there is also a tremor and is characterized by a "stop and go" effect during a range of motion maneuver. Felt especially at the wrist
why do you get a stooped posture?
impaired postural reflexes
what is the parkinsonian gait like ?
slow, shuffling gait with a narrow base
what is hyposmia?
reduced ability to smell (hypnosemia)
what are premotor symptoms to ask about?
REM sleep behaviour, loss of smell, constipation
exposure to what can be a risk factor for parkinsons?
do you get dementia early in the disease course?
investigations for parkinsons?
structural brain imaging
possibly structural brain imaging
dopamine functional imaging is unable to distnguish PD from other causes of degeneratve Parkinsonism, but should be normal in essenLal tremor, dystonic tremor, psychogenic parkinsonism.
positive levodopa challenge
genetic testing where appropriate
what is vascular parkinsonism?
parkinsonism affects mainly the lower limbs. rest tremor is uncommon. get a poor levodopa response
does parkinsonism tend to be symmetrical or assymetrical?
symmetrical, although can start unilateral
what drugs can cause parkinsonism?
any drugs that block the action of dopamine (especially neuroleptic drugs)