Parkinson's Disease Flashcards

1
Q

What is the definition of Parkinson’s disease?

A

Movement disorder characterised by resting tremor, rigidity, bradykinesia.

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2
Q

What are some risk factors for Parkinson’s disease?

A

Age
Family history
Male gender
Environmental exposure (pesticides, head injury, rural living, beta blocker use)
Genetic (LRRK2 and PARKIN)

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3
Q

What is the pathophysiology of Parkinson’s disease?

A

Accumulation of Lewy bodies (intracellular inclusions composed of misfolded alpha synuclein)
Neuronal death in dopaminergic cells of substantia nigra of basal ganglia

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4
Q

What are the subtypes of Parkinson’s disease?

A

Tremor dominant
- With relative absence of other motor symptoms
- Slower rate of progression and less functional disability

Non-tremor dominant
- Akinestic-rigid syndrome and postural instability gait disorder

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5
Q

What are some motor symptoms of Parkinson’s disease?

A

Bradykinesia
Resting tremor
Rigidity
Postural stooping
Shuffling gait

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6
Q

What are some non-motor symptoms of Parkinson’s disease?

A

Sleep disorders
Hallucinations
GI dysfunction
Depression
Cognitive impairment/dementia
Anosmia
Quiet, indistinct and flat speech
Drooling
Swallowing difficulty in late stages

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7
Q

What are some investigations for Parkinson’s disease?

A

Primarily clinical diagnosis supported by positive response to treatment trials
Rule out treatable conditions of asthenia (hypothyroidism, anaemia)
Structural brain involvement and SPECT can be helpful

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8
Q

What is symptomatic treatment for Parkinson’s disease?

A

Levadopa
Dopamine agonists
MAO type B inhibitors
Amantadine

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9
Q

What can tremor in Parkinson’s disease be treated with?

A

Anticholinergic agents
Trihexyphenidyl
Clozapine

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10
Q

What can non-motor symptoms in Parkinson’s disease be treated with?

A

Depression- SSRIs
Constipation- laxatives

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11
Q

What can happen if Parkinson’s drugs are withdrawn or allowed to fail suddenly due to poor absorption?

A

Neuroleptic malignant syndrome

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12
Q

What are some side effects of Parkinson’s drugs?

A

Dopamine agonists:
- Impulse control disorders
- Excessive sleepiness
- Psychotic symptoms

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