[MND] Parkinson's Disease Flashcards Preview

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Flashcards in [MND] Parkinson's Disease Deck (16):
1

Parkinson's Disease can be defined as a

Chronic progressive neurodegenerative disease of the central nervous system resulting from death of the dopamine-generating cells in the substantial nigra (midbrain)

2

Causes?

Cause is unknown (idiopathic) but there are theories of viral and/or genetic predisposition or combinations of ageing, environmental toxins, genetics and programmed cell death

3

What are the risk factors for Parkinson's Disease?

Age (middle to late), male>female, family history, post menopause, agriculture (pesticides, herbicides), and possibly head trauma

4

Epidemiology

NZ 1 in 500
10,000 people in NZD have
Believed 1% of people above 60 have Parkinson's
Mean age onset is 58/59

5

Pathophysiology

- Interruption between the pathways of the substantial nigra to striatum
- Degeneration of Neuromelanin containing cells in substantial nigra (>70% of cells lost) leads to reduced dopamine which results in neurotransmitter imbalance, resulting in disruption of the output of the BG to thalamus/cortex

6

Lesion location

Basal ganglia, primarily the pars compacta of the substantia nigra (midbrain)

7

Progression

- Chronic Progressive

8

Facial expressions? (clinical features)

Expressionless, stoney, mask-like

9

Postural features (clinical features)?

Stooped, postural instability, abnormal reflexes, gait disturbances

10

Symptoms of PD is evident when ___ to ____ of dopamine is lost

70-80%

11

Diagnosis

- Medical history and neurological exam
- Based mainly on symptoms (i.e. movement and non-movement symptoms)
- Response to Levadopa
MRI and CTs of PD patients are usually normal

12

Explain what 'Dopamine Precursors'; 'Levadopa'; and 'Dopamine Agonists' are?

Medication for PD
- Dopamine Precursors boost production in substantia nigra, but may become ineffective and lead to dyskinesia
- Levadopa (i.e. sinamet), can improve bradykinesia and rigidity
- Dopamine agonists increase uptake of receptors in striatum

13

Prognosis

- Rate of motor decline is greater in those with less impairment at the time of diagnosis; cognitive impairment more frequent in those over 70 years
- Little effect on life expectancy
- Can affect employment
- Autonomic disturbances 10~ years post onset
-

14

Hoehn & Yahr Scale is

A outcome measure for PD, classification of disabilities (5 stages of progression), takes into account cognitive difficulties

15

Cognitively, there can be

impaired memory

16

Basal Ganglia disorders cause deficits in

the generation of internal (automatic) behaviour