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Surgical Interventions for Parkinson's Disease
What is the purpose of stereotactic surgery in Parkinson's treatment?
To make a lesion in the brain resulting in decreased symptoms.
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Surgical Interventions for Parkinson's Disease
What modern technique is used instead of making a physical lesion in the brain?
Inserting an electrical probe to stimulate the brain.
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Side Effects of Parkinson's Treatments
What is the 'on-off phenomenon' in Parkinson's treatment?
Symptoms range from well controlled to poorly controlled at random times.
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Pathogenesis of Parkinson's Disease
What neurotransmitter imbalance is created by the loss of dopamine release in the striatum?
An imbalance that favors acetylcholine (ACh).
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Levodopa and its Mechanism
What happens to the efficacy of Levodopa over time?
It decreases while side effects increase.
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Side Effects of Parkinson's Treatments
What is a major problem associated with dopamine supplementation in Parkinson's Disease?
Side effects due to unaffected dopamine pathways.
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Surgical Interventions for Parkinson's Disease
What are the benefits of using a brain stimulator in Parkinson's treatment?
Good control of tremor and the on/off phenomenon.
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Prevalence and Onset of Parkinson's Disease
At what age does Parkinson's Disease typically onset?
Mean age of onset is 55 years.
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Surgical Interventions for Parkinson's Disease
What is a disadvantage of surgical interventions for Parkinson's Disease?
They can be dangerous and are only beneficial for a small subgroup of patients.
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Treatment Options for Parkinson's Disease
When is treatment for Parkinson's Disease typically delayed?
Until symptoms are sufficient to impact the person's life.
What are the three components of Parkinson's Triad?
Resting tremor, rigidity, and bradykinesia/akinesia.
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Clinical Features and Symptoms
What does bradykinesia refer to?
Slowness or inability to initiate/execute movement.
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Levodopa and its Mechanism
Why is Levodopa usually administered with decarboxylase inhibitors?
To prevent conversion to dopamine systemically before reaching the brain.
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Clinical Features and Symptoms
What is 'Lead-Pipe Rigidity'?
Constant resistance to passive joint movements.
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Treatment Options for Parkinson's Disease
What is the aim of treatment for Parkinson's Disease?
To increase dopamine levels in the brain or mimic the effect of dopamine.
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Side Effects of Parkinson's Treatments
What is the 'On-Off Phenomenon' in Parkinson's treatment?
Symptomatic relief is random and fluctuating.
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Clinical Features and Symptoms
What are some other symptoms of Parkinson's Disease?
Diminished facial expressions, stooped posture, shuffling gait, declined intellectual function, and depression.
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Treatment Options for Parkinson's Disease
What are dopamine agonists?
Drugs that mimic dopamine by binding to dopamine receptors.
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Clinical Features and Symptoms
What is 'Cog-Wheel Rigidity'?
Fluctuating resistance to passive joint movements.
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Levodopa and its Mechanism
What is Levodopa and its role in treating Parkinson's Disease?
Levodopa (L-Dopa) can cross the blood-brain barrier and is converted to dopamine in the brain.
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Side Effects of Parkinson's Treatments
What happens to Levodopa's efficacy over time?
Its efficacy decreases while side effects increase.
What is the morphology associated with Parkinson's Disease at a macro level?
Loss of Pigment Neurons (Melanin) in the Striatum.
What are the aetiologies of Parkinson's Disease?
Parkinsonism (Drugs/Toxins/Post Encephalitis) and Primary Atrophy of Substantia Nigra (Dopaminergic System).
What is the impact of the loss of input from the Substantia Nigra?
No activation of Inhibitory Neurons of the Putamen, leading to unopposed inhibition of Neurons of the VL-Thalamus.
What is the primary cause of Parkinson's Disease?
Primary Atrophy of Substantia Nigra (Dopaminergic System).
What is the role of dopamine in the basal ganglia?
Dopamine is required by the basal ganglia to coordinate complex movements.
What is the pathogenesis of Parkinson's Disease?
Loss of Substantia Nigra Neurons → Dopamine Deficiency in the Basal Ganglia → Basal Ganglia Dysfunction.
