7. Disease
        Neurology
Parkinson's disease

Parkinson's disease (PD)

 

A. Presentation

4 cardinal signs:

  1. Tremor at rest
  2. Bradykinesia
  3. Rigidity
  4. Postual instability (appear late)

 

S&S Can be more prominent on one side.

 

Tremor

 

Bradykinesia

 

 

Rigidity

 

Postural instability

 

Speech

 

Other symptoms:

 

Other less prominent non-motor manifestations:

 

 

B. Investigation

No laboratory test

Diagnosis is clinical.

 

Out of the 4 cardinal signs, stooped posture often occurs late.

Therefore diagnosis relies on

  1. presence of 2 of the 3 other signs, i.e.
    - tremour
    - bradykinesis
    - rigidity
    PLUS
  2. response to levodopa.

 

 

 

C. Treatment

No disease-modifying treatment at this time.

 

Drug treatment

Treatment with levodopa and/or dopaminergic agnoist is symptomatic only, and should be avoided until they are necessary clinically because of delayed unwanted effects.

Drug treatments are directed at increasing the action of dopamine at the receptor sites, and reducing the side-effects of levodopa.

 

Levodopa

Levodopa

 

 

D. Other notes

 

 

 


Things to revise/add later: Add treatment info

Bibliography: Kumar and Clark,


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