Demylinating Disorders Flashcards
Parkinson’s dz
degeneration of cells in the substantia nigra= deficiency of DA and leads to an imbalance of acetylcholine
what can cause parkinsonsinian syndrome?
euroleptic (antipsychotics), metoclopramide use, postencephalitis, toxic exposures, bihemispheric ishemcia, trauma
sx of PD?
slowed movements, difficulty arising from a seated position, difficulty ascending and descending stairs, micrographia
essential features that establish dx of PD?
resting tremor, badykinesia, rigidity, postural instability
what is the earliest sign?
tremor! “pill-rolling”
what is the typical gait of someone w/ PD?
festinating gait w/o are swing. wide leg stance w. short acceleratin step
what is cogwheel and clasp knife?
resistance against flexion then once it reaches a certain point, the arm moves fully
-cogwheel: like a slow crank
tx of PD?
anticholinergic drugs + levodopa
tx of mild sx but no disability?
amantadine
what can tx the tremor and rigidity of PD?
benztropin or trihexyphenidyl
what are the mainstays of tx?
levodopa and carbidopa
what is next line for PD
bromocriptine
what can be added in addtion to levo/carbidoap?
catecholamine-O-methyl-transferase (COMT) reduce the metabolism of levodopa- that result in mre stable plasma levels and more constant dopaminergic stimulation of the brain
tolcapone and entacapone
what surgery can be used for PD?
surgical pallidotomy
essential tremor
? can be inheritied in an autosomal dominant manner
“familial tremor”
