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Flashcards in Basal Ganglia Disorders Deck (51)
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31

Where are common contractures in PD?

flexors, adductors

32

Persistent posturing in PD:

kyphosis with forward head
Many patients osteoporotic with high risk of fracture

33

Sensation/Perceptual Function in PD:

Aching and stiffness
Abnormal sensations (cramp like sensations)
Problems in spatial organization
Perception of vertical
Extreme restlessness (akathisia)

34

Vision in PD:

Blurring
Cogwheeling eye pursuit
Eye irritation from decreased blinking
Decreased pupillary reflexes

35

PD drugs to control tremor:

Anticholinergic drugs

36

PD drug to enhance dopamine release:

amantadine

37

What drug is used during early disease to slow progression:

selegiline

38

Diagnostic Categories of Atypical PD

Progressive SupranuclearPalsy
Cortical Basal Degeneration
Multiple System Atrophy
LewyBody Dementia

39

Clues Suggesting Atypical PD

Eye movement dysfunction
Vertical saccade slowing
Vertical gaze palsy: Downgaze > upgaze
Upper motor neuron signs (DTR’s, Babinski)
Cerebellar signs: dysmetria, ataxia
Autonomic dysfunction
Orthostatic hypotension
Urinary incontinence
Early onset/Rapid Progression
Falls & dementia

40

Progressive Supramuclear Palsy:

Most common atypical parkinsonism
“tauopathy” due to accumulation of Tau protein in brain

41

Progressive Supramuclear Palsy signs:

Limited vertical eye movement: down > up
Eye palsy= limited blinking
Loss of righting reaction: fall backwards suddenly
Severe axial rigidity
“Surprised expression”
Growling/groaning
Increased extensor tone, wide BOS
Dysphagia & dysarthria
Cognitive dysfucntion& emotional lability

42

Which cranial nerve is tested in PSP?

CNIII

43

What area of brain is involved in multiple system atrophy?

alpha-synucleininclusions in the glial cells
cerebellar involvement

44

Mean onset of multiple system atrophy?

54 years of age

45

Multiple System Atrophy signs:

autonomic symptoms
Orthostatic hypotension, supine hypertension, urinary & sexual dysfunction, respiratory & breathing problems
▪**decrease >20 mm Hg systolic BP > 10 mm Hg diastolic
▪Impotence is often first symptom
▪Loud sighing
▪Gait & limb ataxia: irregular, jerky tremor,
▪Wide based gait vs. narrow in idiopathic
▪Head/oral dyskinesias
▪“Pisa” syndrome: frequent falls early

46

What is the second most frequent cause of dementia in elderly?

dementia with Lewy Body

47

Signs and symptoms of Lewy Body:

Rigidity, bradykinesia, tremor
Shuffling gait, instability, frequent falls
Depression, paranoid ideation
Hallucinations

48

Huntington's Disease:

A fatal autosomal dominant hereditary disorder, which occurs with an insidious onset, generally occurring in the mid-30s – 40s

49

Signs and Symptoms of Huntington's Disease:

Causes cognitive & emotional disturbances
Problems with voluntary a& involuntary movement
Degeneration of the caudate & putamen are most characteristic of HD.
Dystonia, Athetosis, akinesia, & bradykinesia develop
Other problems: executive function, STM, Visuospatial function (early) to dementia (late). Cause of death tends to be respiratory.

50

Stages I-III—MILD to Moderate of HD:

Increased concerns about cognitive issues
Irritability
Small coordination problems
Chorea: athetoid movements develop

51

Stage IV and V—Severe
of HD:

Lack of cognitive concern-dementia is late stages
Fatal stage-usually do to respiratory problems