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Flashcards in degenerative diseases of the CNS Deck (29):
1

what are some common feature of neurodegenerative disease?

usually late onset
gradual progression
neuronal loss
structural imaging often normal

2

what is dementia defined as?

syndrome consisting of progressive impairment of multiple domains of cognitive function i alert patient leading to loss of acquired skills and interference in occupational and social role

3

what are the most common causes of late onset dementia?(65+ yrs)

alzheimers (55%)
vascular (20%)
lewy body(20%)
others(others)

4

what are the most common causes of young onset dementia? (<65 yrs)

alzheimers (33%)
vascular (15%)
frontotemporal (15%)
other (33%) (toxic, genetic, infection, inflammatory)

5

what conditions can "mimic" dementia?

hydrocephalu
tumour
depression

6

what are some treatable causes of dementia?

vitamin b12 deficiency
thyroid disease
HIV, syphilis

7

what examinations would you perform to help diagnose dementia?

cognitive function
neurological
vascular

8

what investigations are appropriate to help diagnose dementia?

bloods
CT/MRI
CSF
EEG

9

what are the 2 screening tests used to assess cognitive function?

mini mental (MMSE)
montreal (MOCA)

10

what type of dementia would a stepwise progression indicate?

vascular

11

what would a rapid progression of dementia indicate?

creutzfeld jacob disease

12

what are some other neurological signs that could help show the cause of dementia?

abnormal movements (huntingtons)
parkinsonism (lewy body)
myoclonus (CJD)

13

what type of dementia is associated with alzheimers disease?

temporo-parietal dementia

14

what are some features of temporo parietal dementia?

early memory disturbance
language and visuospatial problems
personality preserved until later

15

what are some features of frontotemporal dementia?

early change in personality/behaviour
often change in eating habits
early dysphasia
memory/visuospatial relatively preserved

16

what pharmacological treatments are used to treat alzheimers?

cholinesterase inhibitors
NMDA antagonist (memantine)

17

what are some examples of cholinesterase inhibitors?

donepezil
rivastigmine
galantamine

18

what features must a patient present with 2 or more of to be classed as having "parkinsonism"?

bradykinesia
rigidity
tremor
postural instability

19

what is the pathology of parkinsonism?

loss of dopamine in the basal ganglia

20

what causes parkinsonism?

idiopathic parkinsons disease
drug induced
vascular parkinsonism
parkinson plus syndromes

21

what are some examples of parkinsons plus syndromes?

multiple system atrophy
progressive supranuclear palsy/corticobasal degeneration

22

how is parkinsons disease diagnosed?

bradykinesia + 1 or more of: tremor, rigidity or postural intability
no other cause/atypical features
slowly progressive

23

what does parkinsons disease have a good response to?

dopamine replacement treatment

24

what imaging modality is useful for diagnosing/staging parkinsons disease?

dopamine transporter SPECT

25

what are some examples of dopamine agonists?

ropinirole
pramipexole
rotigotine

26

what is a drug used to convert tyrosine to dopamine?

levodopa

27

what are some drug induced complications of parkinsons disease?

motor fluctuations - levodopa wears off
dyskinesias - involuntary movements
hallucinations

28

what are some non drug induced complications of parkinsons?

depression
dementia
autonomic
speech, swallow
balance

29

what drugs can prolong levodopas half life?

MAO-B inhibitors
COMT inhibitors
slow release levodopa