Short case approach to parkinson's dz summary
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Short case approach to parkinson's dz summary

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Short case approach to parkinson's dz summary Short case approach to parkinson's dz summary Document Transcript

  • Short Case Approach to Parkinsons Disease1) Comment on mask-like facies, resting/pill rolling tremor & drooling of saliva2) Rigidity: lead pipe rigidity & cog-wheeling3) Bradykinesia: ask PT to touch each finger in turn w thumb, ask PT to tap foot4) Glabellar tap5) Postural instability: ask PT to get out of chair unaided - PT will have difficulties6) Gait - difficulties initiating movt, lack of arm swing, stooped posture, festinant gait (chasing afterown centre of gravity), feet scraping floor, turning by numbers.Parkinson’s Plus Syndromes7) Progressive supranuclear palsy: upward gaze8) Multiple Systems Atrophy (if >1 present):- Striato-nigral Degeneration: pronator drift- Olivopontocerebellar Atrophy: cerebellar signsAsk to perform the following:- Shy-Drager Syndrome: postural hypotension9) Diffused Lewy-Body Disease: dementia, neuropsychiatric manifestations. Do MMSEOther features of Parkinsonism:10) Assess speech11) Assess handwriting.Causes of true Parkinsonism 1. Parkinson’s disease / Idiopathic (substantia nigra degeneration) 2. Drug induced (Chlorpromazine, metaclopramide, prochlorperazine) 3. Anoxic brain damage 4. Postencephalitic 5. Drug abusers – toxicity of certain drugs of abuse 6. Multiple system atrophy 7. Progressive supranuclear atrophy 8. Familial 9. Genetic mutationDifferential causes Parkinsonism 1. Essential tremors 2. Feature of a space-occupying lesion Digitally signed by DR WANA HLA SHWE DN: cn=DR WANA HLA SHWE, c=MY, o=UCSI University, School of Medicine, KT-Campus, Terengganu, ou=Internal Medicine Group, email=wunna. hlashwe@gmail.com Reason: This document is for UCSI year 4 students. Date: 2009.02.24 14:12:12 +0800