PTA 241 Parkinson's Disease

Parkinson's disease

what is a progressive disorder of the CNS with both motor and nonmotor symptoms?

tremors, rigidity, bradykinesia, postural instability

motor symptoms include what? (4)

rigidity

what is defined as increased resistance to passive motion regardless of movement velocity?

cogwheel rigidity

what is a jerky, ratchet-like resistance to passive movement as muscles alternately tense and relax?

lead pipe rigidity

what is a sustained resistance to passive movement in all directions, with no flucctuations?

asymmetrical

rigidity is often __.

bradykinesia

*what refers to slowness of movement and is the one cardinal feature common to all parkinsonian disorder?

akinesia

*what refers to a decrease in spontaneous movement?

reduction or loss of facial expression

*what is hypomimia in Parkinson's disease?

freezing of gait

*what is trembling of the legs and transient inability to effectively step, or absence of leg movement/kinesia, described as being "stuck to the ground"?

hypokinesia

*what refers to slowed and reduced movements?

small handwriting

*what is micrographia?

tremors

what involves involuntary shaking or oscillating movement of a part or parts of the body resulting from contractions of opposing muscles?

anteropulsive

*what is forward festinating gait?

retropulsive

*what is a backward festinating gait?

sialorrhea

*what is excessive drooling?

hypokinetic dysarthria

*what is characterized by decreased voice volume, monotone/monopitch speech, and uncontrolled speech rate?

bradyphrenia

*what is slowed thinking, and is seen in patients with PD and may be one of the early nonspecific features of the disease?

hyperhidrosis

*what is excessive sweating?

seborrhea

*what is increased oil secretion of the sebaceous glands of the skin?

seborrheic dermatitis

*what is oily, chafing, and reddened skin?

apathy

what is characterized by decreased motivation, a reduction in goal-directed behavior, and includes affective, cognitive, and behavioral aspects?

Hoehn and Yahr

what is used to classify Parkinson's disease?

carbidopa/levodopa

what is the gold standard drug therapy for PD?

high-protein diet

what can block the effectiveness of levodopa?

rigidity and bradykinesia

what 2 things can limit upright posture and UE feeding movements?

deep brain stimulation (DBS)

what involves the implantation of electrodes into the brain where stimulation of the relatively small area can result in network-wide changes that can improve symptoms of PD?

When they are supine, their head stays off the surface, as if there is a pillow there

what is shadow pillow posture?

flexed, stooped posture with kyphosis, forward head, and hip and knee flexion

what is the typical posture for PD patients?

60-80%

approximately what percent of dopamine neurons lost when motor symptoms onset?

parkinsonism

what is a generic term used to describe a group of bradykinetic syndromes with primary disturbances in the dopamine systems in the basal ganglia?

idiopathic

what is the most common form of PD?

secondary parkinsonism

what results from a number of different identifiable causes, including viruses, toxins, drugs, and tumors?

atypical parkinsonism

what refers to those conditions that mimic PD in some respects, but the symptoms are caused by other neurodegenerative disorder?

substantia nigra

Where is dopamine produced?

rigidity, bradykinesia, tremor, postural instability

what are the cardinal motor symptoms?

arm swing during walking

what is an example of akinesia that include the absence of associated movements?

fatigue

what is the most common symptom reported by PD?

festination

what is unintentionally rapid short steps?

orthostatic hypotension

what is common in middle and late PD and is caused by a sharp drop in BP that occurs with position changes?

resting tremors

what is present when pt is resting; disappears with activity and sleep?

action/kinetic tremors

what type of tremor continues with movement; sign of disease progression?

pain, proprioception and kinesthesia, olfactory dysfunction, visual perception disturbances

sensory symptoms include: