Parkinson's Flashcards
(43 cards)
general S&S of BG dysfunction
difficulty initiating, continuing or stopping movement
muscle tone abnormalities
increased involuntary movements
what is parkinson’s disease
idiopathic, slowly progressive degenerative disease
degeneration of dopaminergic neurons in teh BG - loss of DA stores in substantia nigra
incidence and prevalence of PD
> 60 yrs
men > women
what causes primary parkinsonism
complex interaction
age, genetics, envrionment
what causes secondary parkinsonism
infectious/postencephalitic, atherosclerosis, toxic, drug induced
what is the only definite way to diagnosis PD
post-mortem examination of the brain
what are the cardinal motor symptoms seen
bradykinesia
hypokinesia
akinesia
rigidity
tremor
postural instability
weakness
breakdown of complex motor planning
when do motor symptoms occur
when roughly 60% of neurodegeneration has already occurred in the BG
what does rigidity look like in this population
asymmetrical early on then progresses to whole body involvement even including trunk
proximal first
what do tremors look like in this population
resting tremor early on
mild, low frequency
what body part’s typically have tremors
hand and foot most common but can see head, neck, jaw or tongue
patients with PD are 9x more likely to do what
fall - increasingly prevalent in middle stages, disappear in late stages as pt’s become immobile
what are the 3 biggest overall risk factors for falls in PD pt’s
postural instability
disease severeity
gait impairments (freezing)
what are some other risk factors for falls
dementia, depression, postural hypotension, involuntary movements from long term med use
what would an EMG result look like for these pt’s
delayed MU recruitment, asynchronization
what does continuous gait look like
overall hypokinetic presentation
slower, smaller steps, decreased arm swing, minimal trunk rotation
as disease progresses, what type of gait do they demonstrate
festinating gait
episodic early and middle stages of PD - what are three gait characteristics seen
festinating gait
midline disorientation
en bloc turning
freezing of gait
what is en bloc turning
compensatory movement
decreased rotation of head, trunk, pelvis
turning as one whole unit
what can en bloc turning be impacted by
increased postural tone, axial rigidity and/or loss of flexibility
impaired motor control, bradykinesia, freezing
what are some non-motor symptoms seen with PD
pain - likely MSK related
loss of smell
sleep issues
visual impairments
OH
fatigue
etc.
what areas of the body are pt’s typically feeling pain
lower back
legs
shoulders
face
what are 2 PD subgroups
postural instability gait disorder phenotype
tremor dominant phenotype
postural instability gait disorder phenotype is like what
20% of all cases
postural instability and gait issues
more significant disease course
