Parkinsons Disease Examination

Bradykinesia, Tremor, Rigidity, Postural Instability

list the 4 cardinal motor symptoms of Parkinsons Disease

70.5

average age of onset for parkinsons disease is ____ years old

Postural Instability and Gait Disturbances (PIGD)

clinical subgroup of parkinsons disease that is typically a worse prognosis and more likely to cause anxiety/depression

Tremor dominant (TD)

clinical subgroup of parkinsons disease that is typically associated with a better prognosis

Parkinsonism

generic term used to describe a group of bradykinetic syndromes with primary disturbances in the dopamine system of basal ganglia (BG)

Secondary parkinsonism

type of parkinsonism caused by virus, toxins, or drug induced

Parkinson-plus syndromes

a group of neurodegenerative diseases that affect the substantia nigra and produce parkinson's symptoms along with other neurological symptoms

Progressive Supranuclear Palsy (PSP)

Parkinson's plus syndromes; eye movement abnormalities, postural instability

Multiple system atrophy (MSA)

Parkinson's plus syndromes; autonomic dysfunction and ataxia

Corticobasal degeneration (CBD)

Parkinson's plus syndromes; apraxia, myoclonus, "alien hand"

Parkinson's Disease Dementia

Parkinson's plus syndromes; dementia

Basal ganglia

Network of subcortical nuclei; Caudate nucleus, putamen, globus pallidus, subthalamic nucleus, substantia nigra; activate the motor cortex and assist in the initiation of voluntary movement, sleep and wakefulness, arousal, memory, and cognitive function

substantia nigra

With parkinsons disease there is a degeneration of neurons in the ___ ___ of the basal ganglia that produce dopamine

before

substantial neurodegeneration occurs in PD ____ the onset of motor symptoms

thalamus basal ganglia

Parkinsons is characterized by inhibition of the ____ by the ____ _____

direct

Damage to the ____ pathway results in difficulty initiating movement (PD)

indirect

damage to the ____ pathway results in difficulty stopping movement (Huntingtons)

lead pipe

type of resistance that is sustained and uniform

Cogwheel

type of resistance that is jerky and inconsistent

postural stability

ability to achieve, maintain, and regain balance during posture and movement

Akinesia

poverty of spontaneous movement

Hypomimia

Masked facial expression

hypokinesia

slowed and reduced movements, decreased amplitude of movement

micrographia

small handwriting;

excessive drooling

Sialorrhea

Hypokinetic dysarthria

decreased voice volume, monotone, imprecise or distorted articulation, uncontrolled rate

Bradyphrenia

slowed thinking

stage I

Hoehn-Yahr Classification of Disability; minimal or absent, unilateral if present

stage II

Hoehn-Yahr Classification of Disability; minimal bilateral or midline involvement. Balance not impaired

stage III

Hoehn-Yahr Classification of Disability; impaired righting reflexes. Unsteadiness when turning or rising from chair. Some activities are restricted, but patient can live independently and continue some forms of employment

Stage IV

Hoehn-Yahr Classification of Disability; All symptoms present and severe. Standing and walking possible only with assistance

Stage V

Hoehn-Yahr Classification of Disability; confined to bed or wheelchair

Unified Parkinson's Disease Rating Scale (UPDRS)

gold standard for measuring progression of PD

carbidopa/levodopa (sinemet)

Gold standard drug for PD

short

Levodopa has a ____ half-life requiring multiple doses throughout the day