Atypical Parkinsonism Flashcards by VB VB

what is Atypical Parkinsonism

primary motor degenerative disease that cause sym similar to parkinsons

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what are the AP that we talked about

Progressive supranuclear palsy (PSP)

Dementia with Lewy bodies

Multiple-system atrophy (MSA)

Corticobasal degeneration

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how do we diagnosis atypical park

based on medical history and clinical examination

no specfic test

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early sym of AP

they present similar to park

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what are some red flags that what we are seeing is not park

early postural unsteadiness - abnormal posture

rapid progression

respiratory dys

emotional liability

signs of cerebellar and voluntary gaze dysfunction

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what is Progressive Supranuclear Palsy due to

an adnormal collection of protien struture tau in neurons that cause the cells to die

cause is unknown for this phenomonon

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what pop does PSP normally effect

60 -70

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what specific neurons are lost with PSP

corticobrainstem neurons

these control voluntary eye movements and this can result in gaze palsy

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other signs other then gaze palsy do we see with PSP

gait unsteady

tendancy to fall backwards

cog and phych issues - mood dys

speech and swallowing

lack of motivation

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what is dementia with lewy bodies caused by

abnormal tau protein collection and alpha-synuclein proteins within neurons

cause is unknown

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what is the second most common cause of neurodegenerative dementia

dementia with lewy bodies

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dementia with lewy bodies effects what population

individuals ages 50 and over,

slightly more prevalent in men

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with dementia with lewy bodies how much is the memory effects

memory is not disproportionately affected compared to other cognitive functions

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Characteristic signs of dementia with lewy bodies

early general cog decline

visual hallucinations

postural and gait instablity

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what are the other sym seen with dementia with lewy bodies

fluctuating attention/alertness,

mood changes,

sleep dysfunction,

behavioral changes,

loss of motivation,

blood pressure changes

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what is Multiple system atrophy (MSA) caused by

progressive degen disease that affects the
BG
cere
autonomic system
PNS
cerebral cortex

cause is unknown

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signs of Multiple system atrophy (MSA)

Akinetic/rigid syndrome

Cerebellar signs

Autonomic dysfunction

Corticospinal tract dysfunction

Decreased goal-directed cognition and difficulty with attention

Sleep dysfunction, breathing problems at night

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Akinetic/rigid syndrome - MSA

slow stiff walking and balance problems

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Cerebellar signs - MSA

uncoordinated speech and ataxia

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Autonomic dysfunction - MSA

postural hypotension

bladder and bowel changes

abnormal respiration

decreased secretions

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Corticospinal tract dysfunction - MSA

babinski

hyperreflexia

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what is Corticobasal Degeneration caused by

accumulation of tau proteins in the neurons

cause is unknown

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what is the onset for Corticobasal Degeneration

60-70

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Characteristic signs of Corticobasal Degeneration

motor similar to park

dystonia

visuospatial and cognitive impairments

apraxia

dysphagia

speech hesitancy

myoclonus

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what is dystonia

Involuntary muscle contractions that cause repetitive or twisting movements.

what is myoclonus

a quick jerking movement that you can't control hiccups

Corticobasal Degeneration one sided

it may effect one side more then the other

Movement dysfunction meds

levadopa

Dystonia meds

botox

Memory/cognitive impairment meds

Exelon, Aricept, Razadyne, Namenda

Hallucinations meds

atypical antipsychotics (Nuplazid, Clozaril, Seroquel)

is there high-quality evidence for specific PT interventions for those with AP

no - it is limited

what causes huntingtons disease

abnormal expansion of a gene on chromosome 4

does the person with the abnormal gene alwats get hunt

Child of someone with HD has what chance of having the gene

50%

what is the normal age of onset for hunt

30 -40

what is the life expectancy for some with hunt

15 -20 from onset

Pathophysiology of hunt

the striadted neuron that go to the external GP in the indirect pathway are damaged

what does damage to the striated neuro in the BG pathway do

since the no-go pathway is damage we get hyperkinesia

what is hyperkinesia

too much movement

what patho-wis happens with disease progression

more neurons are impacted

where can neural damage occur

in the frontal cortex

what are the Signs and Symptoms of HD

Dyskinesias Oculomotor dysfunction Bradykinesia Dystonia Myoclonus Tics Ataxia Dysarthria Dysphagia Cognitive impairment Personality changes, depression

what is Dyskinesias

involuntary, erratic, writhing movements of the face, arms, legs or trunk.

Chorea Athetosis what is the difference

Chorea - involuntary rapid movement s athetosis - slow involuntary movement - worm like

how is HD diagnosed

clinical assessment and genetic testing

Medications for chorea

Dopamine depleting agents (Tetrabenazine) Neuroleptic agents (Haloperidol)' Anti-Parkinson drugs (Amantadine) Glutamate blocker (Riluzole)

Prioritize assessment of with HD

Mental status/cognition Motor Balance Function

May screen or assess in more detail what with HD

Oculomotor function Speech/swallowing Sensory Coordination

what are the core outcome

Core outcome measures 10MWT 6MWT ABC 5xSTS Berg Balance Scale FGA

what is the Unified HD Rating Scale (UHDRS) used for

Used to quantify the severity of HD symptoms

what is the Behaviours Assessment for Huntington’s Disease

Severity and frequency of behavioral abnormalities

what are the best interventions for HD

Aerobic paired with strengthening exercise gait training

what is a okay intervention for HD

balance and breathing exercises

what aeorbic and stregthing exercises shoudl we use for those with HD

mod intensoty aeoribc (50-90) max heart rate paired with strengthening at least 3x per week for a min of 12 weeks to improve fitness and stablization

how should PT be for prescribing gait training

PTs should prescribe 1:1 gait training to improve the spatiotemporal parameters of gait

what is Alzheimer Disease (AD)

Progressive neurodegenerative disease associated with build up of amyloid plaques, neurofibrillary tangles, and loss of neuronal connections in the brain

does the risk of AD chnage with age

yes the risk increases

Signs and symptoms of AD

Memory changes that disrupt daily life. Difficulty making decisions, especially in planning or solving problems. Difficulty completing familiar tasks. Confusion about time and/or place. Trouble understanding visual images, or the way things fit together (spatial relationships). Finding the right words to say when speaking or writing. Misplacing items and losing the ability to retrace your steps. Poor or decreased judgment about safety. Withdrawal from work or social activities. Changes in mood or personality.

exercise and AD

Regular exercise may delay the onset of AD in healthy older adults

Atypical Parkinsonism Flashcards

(60 cards)