Parkinson's disease: Difference between revisions
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***Impaired ability to turn or change direction while walking | ***Impaired ability to turn or change direction while walking | ||
== | == Treatment == | ||
*Dopamine agonists | |||
*Dopamine agonists | **Levodopa +Carbidopa (peripheral decarboxylase inhibitor) = gold standard | ||
**Levodopa +Carbidopa (peripheral decarboxylase inhibitor) = gold standard | **pramipexole (Mirapex)<br>ropinirole (Requip) | ||
**pramipexole (Mirapex)<br>ropinirole (Requip) | *Anticholenergics | ||
*Anticholenergics | **Benztropine | ||
**Benztropine | *Monoamine oxidase inhibitor - blocks DA reuptake | ||
*Monoamine oxidase inhibitor - blocks DA reuptake | **selegiline (Eldepryl) | ||
**selegiline (Eldepryl) | **rasagiline (Azilect) | ||
**rasagiline (Azilect) | |||
==Source== | ==Source== | ||
Revision as of 20:42, 21 November 2012
Background
- Extrapyramidal movement disorder a/w reduced dopaminergic receptors in substantia nigra
Clinical Features
- TRAP mnemonic:
- Tremor (resting)
- Initially is unilateral tremor of upper extremity, esp finger and thumb ("pill rolling")
- Dissipates when intentional movement is performed
- Rigidity (cogwheel)
- Elicited by causing passive movement of limb through full range of motion
- Akinesia
- Slowness of voluntary movement
- Posture/equilibrium impairment
- Impaired ability to turn or change direction while walking
- Tremor (resting)
Treatment
- Dopamine agonists
- Levodopa +Carbidopa (peripheral decarboxylase inhibitor) = gold standard
- pramipexole (Mirapex)
ropinirole (Requip)
- Anticholenergics
- Benztropine
- Monoamine oxidase inhibitor - blocks DA reuptake
- selegiline (Eldepryl)
- rasagiline (Azilect)
Source
Tintinalli