Parkinson's disease

Define parkinson's disease

Progressive neurodegenerative disorder caused by degeneration of dopaminergic neurons in the substantia nigra

Epidemiology of Parkinson's disease:- More common in men or women?- Mean age of diagnosis

2x more common in men Mean age diagnosis 65 yrs

Risk factors for Parkinsons (4)

1) Increasing age2) FHx parkinson's in younger onset-disease3) Mutation in gene encoding glucocerebrosidase 4) MPTP exposure

Classical triad of features in Parkonsins (3)

BradykinesiaTremorRigidity

Describe bradykinesia in Parkinson's (3)

- Short, shuffling gait w reduced arm swinging - Difficulty initiating movement- Hypokinesia

Describe tremor in Parkinson's disease (4)

- Most marked at rest- 3-5 Hz- Worse when stressed/tired- Better w voluntary movement

Describe rigidity in Parkinsons (2)

- Lead pipe- Cogwheel - due to superimposed tremor

Other features of Parkinsons

0

Define parkinsonism

A clinical syndrome characterised by tremor, bradykinesia, rigidity, and postural instability

Causes of parkinsonism (7)

1) Parkinsons disease2) Drugs & toxins 3) Progressive supranuclear palsy4) Multiple system atrophy5) Wilson's disease6) Post-encephalitis7) Dementia puglistica (2nd to chronic head trauma e.g. boxing)

Which drugs can cause parkinsonism (2)

Antipsychotics, metoclopramide

Which toxins can cause parkinsonism

Carbon monoxideMPTP