Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
Parkinson's Disease basic features
|
Onset: 40-70 years old
Progresses over 10-20 years ~20 new patients/100,000/year Etiology currently unknown |
|
|
Prkinson's symptoms (8) :
|
* resting tremor
* slowed movement * cogwheel rigidity * postural impairment other: * hypophonic * micrographia * freezing * higher order cognition may be impaired (other than motor) |
|
|
resting tremor
|
shake of the hand that happens at rest, often
improves or disappears w/ purposeful function (goal directed action) |
|
|
Bradykinesia
|
slowed movement
|
|
|
cogwheel rigidity
|
rigid in arms and legs. stiff. can't straighten up.
|
|
|
postural impairment
|
difficulty correcting posture
|
|
|
hypophonic
|
soft speach
|
|
|
Micrographia:
|
very small writing (difficulty moving fingers b/c of rigidity)
|
|
|
Freezing
|
periods where body locks up and person cannot move for a period of time
|
|
|
Parkinson’s disease cause
|
seems to be related to the degeneration of the
substantia nigra and to the loss of the neurotransmitter dopamine, |
|
|
akinesia
|
no longer able to move (in parkinson's)
|
|
|
relation between substantia nigra and movement
|
Substantia nigra creates dopamine -> projects to basal ganglia -> initiates movement
|
|
|
Risk of drug-induced dyskinesias (tardive dyskinesia):
|
if drug is taken too long may lose control over certain types of movement, permanent even if dopamine medication is stopped
|
|
|
risks of dopamine for Parkinson's disease
|
* tardive dyskinesia
* problems in other parts of the brain regarding reinforcement - reward * addiction to dopamine * medication will eventually stop working |
|
|
Parkinson's disease surgical treatments
|
* pallidotomy
* thalamotomy |
|
|
Pallidotomy:
|
destroy part of the globus pallidus (part of basal ganglia) -> reduce inhibition on the thalamus
|
|
|
Thalamotomy:
|
lesion part of the thalamus to reduce inhibition
Older technique, used in 60s |
|
|
Destroying part of the brain
|
but the effects are immediate (ex. Tremors will immediately disappear)
Not a long term treatment, symptoms will come back |
|
|
Deep brain stimulation
|
stick an electrode into the basal ganglia, connect it to a battery, can control how much stimulation brain is getting. As region is stimulated the tremors start to go away immediately
* Can modulate how much stimulation someone gets over time (turn battery stimulation up as tremor returns) * Scrambling the part of the brain that is resulting in inhibition |
|
|
Encephalitis lethargica: sleeping sickness
|
, fell asleep for years (up to 40 years), or became sick and recovered and then fell asleep again
Spanish flu spread in WWI (1910s+20s) considered a cause of sleeping sickness Patients put into asylums Dopamine agonists given to patients (like they were akinetic) and they woke up |
|
|
Manganese intoxication :
|
high levels of manganese can result in brain damage, symptoms mirror what you would expect in Parkinson’s
|
|
|
Causes of Parkinsonian symptoms
|
* encephalitis lethargica
* manganese intoxication * dementia pugilistica * multiple cerebral infracts |
|
|
Neuroleptics/antipsychotics :
|
medications designed to reduce dopamine in the brain (frontal lobe), used to reduce hallucinations. Drugs reduce dopamine in basal ganglia -> causes movement problems
|
|
|
Dementia Pugilistica:
|
excessive hits to the head, usually because of violent sports. Some will develop syndrome that looks just like Parkinson’s (its not b/c it is a different cause)
|
|
|
Multiple cerebral infarcts:
|
area of brain that is damaged b/c of stroke, if it is an area that affects movement can see same symptoms as Parkinson’s
|
