Parkinson's Disease Flashcards
What is the prevalence and incidence of Parkinson’s in the US?
500,000-1 million patients in US, with 40-60k new cases per year. Average age of onset is 60 yrs.
What is YOPD? What percentage of patients does this make up?
Young onset (before age 40). Makes up 5-10% of cases
Other than motor problems, what are the other common clinical features of Parkinson’s disease?
Autonomic failure (constipation, impotence) Neuropsychiatric dysfunction (depression, dementia)
What marks the beginning of severe Parkinsonian disease?
After it has spread to bilaterally, the postural instability is the main feature
Is continuous or pulsatile dopamine stimulation better?
Continuous. Pulsatile may be the root of the fluctuations and dyskinesia of the motor system.
Is Parkinson’s autosomal dominant or recessive?
Both inheritance patterns have been identified, but it is also multifactorial and most cases are sporadic.
What are the risk factors for PD?
Advanced age, male, exposure to environmental toxins, family history of Parkinson’s disease
What does early dementia and early onset of postural instability suggest?
A diagnosis other than Parkinson’s disease.
What are the general stages of Parkinson’s disease progression?
- Mild, unilateral
- Mild, bilateral
- Mild, postural reflex disability
- Severely debilitated, but can walk
- Bedridden
Why might someone choose to use a dopamine agonist before levadopa treatment?
Reduced dyskinesia compared to levadopa therapy early on. Works just as well in early stages of disease.
What percentage of Parkinson’s patients experience hallucinations and why?
Around 20%, due to antiparkinson drug side effects (i.e. dopamine agonists or levadopa). Typically they are associated with sleep, particularly REM sleep.
When are anticholinergics typically used?
Young patients whose predominant symptom is resting tremor and hypersalivation
