Neurology – Parkinson’s Disease – Flashcards
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1. Tremor (pill rolling) 2. Muscular Rigiidity (cogwheeling) 3. Slowness and restricted movement (bradykinesia)
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3 symptoms of parkinson's, 2 of which are required for diagnosis
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ubiquitin
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found at the rim of lewy bodies
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MPTP Rotenone Paraquat
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3 toxins associated with parkinsons disease
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no definitive test
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lab tests for parkinsons
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1. CT or MRI can show non specific atrophy 2. Fluorodopa Pet Scan 3. DAT (SPECT) Scan (EEG, blood, and CSF studies are normal)
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diagnostic tests for Parkinsons
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1. head trauma 2. post encephalitic parkinsons 3. metabolic disorders (thyroid disease) 4. toxins and industrial exposure (manganese, CO, and carbon disulfide) 5. drugs (neuroleptics, antiemetics, reserpine, LiCO3)
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secondary causes of Parkinson's Disease
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tremor
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symptom of parkinson's treated by anticholinergics
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Essential tremor (use DAT scan to differentiate)
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differential diagnosis along with parkinsons where tremor is the only feature
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Progressive Supranuclear Palsy
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differential diagnosis along with parkinsons with signs of early gait instability, supranuclear downgaze palsy square wave jerks, dysphagia, and pseudobulbar affect
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Multiple System Atrophy
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differential diagnosis along with parkinsons with signs of autonomic disturbance, cerebellar signs, absence of tremor, early gait instability and dysphagia
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corticobasal degeneration
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differential diagnosis along with parkinsons with signs of limb apraxia, cortical sensory abnormalities, coarse unilateral tremor and early dementia
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midbrain
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area of brain showing atrophy in progressive supranuclear plasy
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pontine atrophy
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area of brain characteristically showing atrophy in multiple system atrophy
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Hot Cross Bun Sign of multiple system atrophy
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T2 hyperintensity forms a cross on axial images through the pons, representing selective degeneration of pontocerebellar tracts
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Lewy Body dementia
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diagnosis for parkinson featurse along with psychosis, agitation and early dementia
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drug induced parkinsonism (check medications)
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differential for parkinson like features lacking asymmetry
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Vascular Parkinsonism
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differential for parkinson featurse with history of chronic hypertension and stepwise progression of symptoms
