11.13 Parkinson-Plus Syndromes Flashcards Preview

8501 Clin Med > 11.13 Parkinson-Plus Syndromes > Flashcards

Flashcards in 11.13 Parkinson-Plus Syndromes Deck (29)
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1

What are some red flags that indicate a dx other than PD?

- Early postural instability/abn postures
- rapid progression
- respiratory dysfunction
- labile
- signs of cerebellar, corticospinal, voluntary gaze dysfunction

2

What IS Parkinson-Plus?

Collective name for primary neurodegenerative dz that causes s/s similar to PD

3

What are the Parkinson-Plus syndromes?

- Progressive supranuclear palsy
- Dementia with Lewy bodies
- Multiple system atrophy
- CTE

4

Which of the Parkinson-plus syndromes is associated with accumulation of tau?

Progressive supranuclear palsy

5

CTE =

Chronic
Traumatic
Encephalopathy

6

What is CTE caused by?

Repetitive head injuries (concussions)

7

What are the common non-motor changes seen with CTE?

- Mood changes
- Depression
- Cognitive issues

8

What sort of physiological changes come about with CTE?

- atrophy of cerebral hemispheres with brain volume loss
- Eventually affects the amygdala and hippocampus

9

How does a diffuse axonal injury occur and what does it affect?

- Shockwave from head trauma goes through the brain (connection between cell bodies and axons)
- Affects all neurons in the cortex
- Get shearing of axons away from cell bodies

10

What happens when there is shearing of axons from cell bodies in the CNS? How does this kill neurons?

GLUTAMATE CASCADE
- kills neurons via excitotoxicity
- CNS white matter forms a scar

11

Why is a scar in the CNS white matter problematic?

- axons can't cross the scar
- get lots of inflammation

12

What does CTE cause the accumulation of?

Tau (hyperphosphorylation)

13

Dementia is a late presentation of this Parkinson-plus syndrome

Lewy body dementia

14

What is accumulated in Lewy body dementia?

Insoluble phosphorylated alpha-synuclein proteins all over the brain

15

Alpha-synuclein is (intracellular/extracellular)

Intracellular

16

What results from accumulation of alpha-synuclein protein with Lewy body dementia?

Neuron death

17

Symptoms of Lewy body dementia

First
- mood changes
- cognitive decline
- can have vivid/disturbing hallucinations

18

How is Lewy body dementia similar/distinct from PD?

- Lewy bodies occur FIRST (they like the SN)
- Dopaminergic cell death is SECONDARY to Lewy body formation

19

Why does a pt with Lewy body dementia have hallucinations?

It affects visual vortices

20

Can Lewy bodies occur in other disorders

- yes
- can occur in PD secondary to neuronal death

21

With Lewy body dementia, where is inflammation and neuronal death most significant?

- BG
- brainstem

22

What is frontotemporal dementia?

General term used to describe progressive neurodegenerative disorders that affect

- frontal lobe
- temporal lobe

23

Example of frontotemporal dementia

Pick's disease

24

What will an MRI show with Pick's disease?

Marked loss of frontal cortex volume

25

What causes Pick's disease?

- thought to be a problem of clearing misfolded proteins
- Ubiquitin
- Proteasome system

26

What s/s will be seen with Pick's disease?

- loss of executive function (FIRST)
- neurons swell in affected tissue area

27

Pick's disease: plaques/tangles

None seen in the disorder

28

Which is the most significant symptom of Pick's disease?

Loss of executive function (can overshadow memory disturbance)

29

Treatment for Pick's disease

- no tx to slow progression
- antidepressants and antipsychotics to treat six

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