Parkinson's Disease Flashcards
What is the definition of Parkinson’s disease?
Movement disorder characterised by resting tremor, rigidity, bradykinesia.
What are some risk factors for Parkinson’s disease?
Age
Family history
Male gender
Environmental exposure (pesticides, head injury, rural living, beta blocker use)
Genetic (LRRK2 and PARKIN)
What is the pathophysiology of Parkinson’s disease?
Accumulation of Lewy bodies (intracellular inclusions composed of misfolded alpha synuclein)
Neuronal death in dopaminergic cells of substantia nigra of basal ganglia
What are the subtypes of Parkinson’s disease?
Tremor dominant
- With relative absence of other motor symptoms
- Slower rate of progression and less functional disability
Non-tremor dominant
- Akinestic-rigid syndrome and postural instability gait disorder
What are some motor symptoms of Parkinson’s disease?
Bradykinesia
Resting tremor
Rigidity
Postural stooping
Shuffling gait
What are some non-motor symptoms of Parkinson’s disease?
Sleep disorders
Hallucinations
GI dysfunction
Depression
Cognitive impairment/dementia
Anosmia
Quiet, indistinct and flat speech
Drooling
Swallowing difficulty in late stages
What are some investigations for Parkinson’s disease?
Primarily clinical diagnosis supported by positive response to treatment trials
Rule out treatable conditions of asthenia (hypothyroidism, anaemia)
Structural brain involvement and SPECT can be helpful
What is symptomatic treatment for Parkinson’s disease?
Levadopa
Dopamine agonists
MAO type B inhibitors
Amantadine
What can tremor in Parkinson’s disease be treated with?
Anticholinergic agents
Trihexyphenidyl
Clozapine
What can non-motor symptoms in Parkinson’s disease be treated with?
Depression- SSRIs
Constipation- laxatives
What can happen if Parkinson’s drugs are withdrawn or allowed to fail suddenly due to poor absorption?
Neuroleptic malignant syndrome
What are some side effects of Parkinson’s drugs?
Dopamine agonists:
- Impulse control disorders
- Excessive sleepiness
- Psychotic symptoms
