Parkinson's Disease Flashcards
What it Parkinsonism Syndrome; Parkinson’s Disease?
Primary degenerative disorders
Characterized by:
The decrease in production of dopamine within the substantia nigra.
What structures are involved in Parkinson’s Disease? What is this structures role in movement?
Basal Ganglia; Substantia Nigra, responsible for the modulation and control of voluntary movement.
What is the most likely cause for the production of Parkinson’s?
Unknown Etiology
Possibly:
- Carbon Monoxide Toxicity
- Excess Manganese or Copper?
Typical age range for Parkinson’s
50-79 y/o
The majority of patient will most likely develop what symptom first? Conditions in which tremor decreases?
Resting Tremor, “Pill-Rolling Tremor”
Disappears with voluntary movement (momentarily)
Disappears with sleep
What type of “affect” symptoms are prevalent with Parkinson’s?
Flat affect. Become very apathetic; decrease in goal directed behaviors
What type of rigidity is commonly found?
Lead-Pipe or Cogwheel Rigidity
(One of the Clinical Hallmarks)
Signs and Symptoms
- Hypokinesia (small movement; decreased amplitude)
- Akinesia (Difficulty with Initiating movement)
- Bradykinesia (slowness of movement)
- Stooped Posture
- Resting Tremor
What information is needed to confirm diagnosis?
Diagnosis is made from:
- Patient history; History of Symptoms
- Clinical Examination
What findings may present with progression of the disease? (Non-Motor Symptoms)
- Dysphagia (impaired swallowing)
- Difficulty with Speech
- Pulmonary impairments
- Depression; apathy; reduction in goal-directed behavior
What is the most effective management of Parkinson’s
Pharmacological:
- Dopamine replacement therapy: (Levodopa. Sinemet)
Reduces symptoms of bradykinesia, rigidity and tremor.
What gait disturbances are present?
- Festinating and Shuffling Gait
- Freezing episodes during ambulation (Freezing of Gait; FOG)
- Reduced arm swing
- Increased double limb support time.
What can trigger freezing episodes during gait?
- Narrowed spaces
- Obstacles
- Visual barriers: hallways, doorway, changing of floor pattern.
- Dual-tasking; Increased cognitive demands
What symptoms are needed for a clinical diagnosis of parkinson’s disease?
Parkinsonism; bradykinesia plus resting tremor or rigidity.
What is the most widely used scale for staging Parkinson’s Disease?
Hoehn and Yahr Classification
Stages 1 - 5, with increasing disability with higher stages.
What is TRAP (Cardinal Clinical Signs)
T: Tremor (rest)
R: Rigidity
A: Akinesia
P: Posture and Balance
