Parkinson's disease Flashcards
Define Parkinson’s disease
- a progressive neurodegenerative condition caused by degeneration of dopaminergic neurons in the
substantia nigra - Damage to the nigrostriatal pathway lead to difficulty initiating and maintaining movements
What are risk factors of Parkinson’s?
- increasing age
- family history
- males
What is a mnemonic to remember Parkinson’s symptoms?
TRAP
* Tremor (resting)
* Rigidity
* Akinesia (bradykinesia)
* Postural instability
What are other symptoms of Parkinson’s?
Symptoms: asymmetrical at first
* Resting tremor-> pill rolling tremor
* Cogwheel and lead pipe rigidity
* ‘Mask like’ face
* Shuffling gait
* Micrographia
* Constipation
* Depression
* Anosmia seen early
How is Parkinson’s diagnosed?
- Bradykinesia + 1 or more other cardinal symptom
What is the treatment for Parkinson’s?
- Levodopa (severely/moderately symptomatic)
- Dopamine agonist
- COMT inhibitors
- MOA-B inhibitors
What does levodopa do?
- Improves motor symptoms
- Usually combined with peripheral decarboxylase inhibitors->carbidopa and benserazide
What do dopamine agonists do?
Mimics dopamine in the basal ganglia and stimulate the
dopamine receptors
What do COMT inhibitors do?
Slows the breakdown of levodopa in the brain
What do MOA-B inhibitors do?
Inhibits the breakdown of dopamine secreted by the
dopaminergic neurons
What are side effects of levodopa?
can cause dyskinesia
- Chorea
- Dystonia
- Athetosis (involuntary writhing movements)
with the main drawback being it loses its effectiveness over time – can lead to more severe symptom relapses
What are side effects of dopamine agonists?
- Poor impulse control
- Gambling
What are 2 Parkinson’s associated syndromes?
- Multiple system atrophy
- Lewy body dementia
What is multiple system atrophy?
Parkinsonism and early autonomic clinical features such as:
postural hypotension
incontinence
impotence
What is Lewy body dementia?
Visual hallucinations, problems with REM sleep and cognitive
impairment before parkinsonism occurs
