Parkinson's Disease
von Shelby Wagoner
1. motor symptoms
1.1. weakness
1.2. fatigue
1.2.1. lessens after L-dopa but reappears
1.3. decreased motor planning
1.4. decreased dual-task control
1.5. difficulty set-switching
2. 80% harder to ambulate with PD
2.1. festinating
2.1.1. anteropulsive
2.1.2. retropulsive
2.2. increased steps to turn
3. early symptoms
3.1. loss of smell
3.2. constipation
3.3. REM sleep disorder
3.4. mood disorder
3.5. orthostatic hypotension
4. slow rate of progression
5. depression is common
6. incidence second only to Alzheimer's in aging adults
7. average age of onset: 50-60 years
7.1. young onset: 21-40
7.2. juvenile onset: <21 years
8. disturbance in dopamine systems of basal ganglia
9. "the shaking palsy"
10. Awakenings by Oliver Sacks
11. progressive disorder of the CNS
12. motor and non motor symptoms
13. cardinal features
13.1. rigidity
13.1.1. increased resistance to passive motion
13.1.2. heavy, stiff
13.1.3. cogwheel
13.1.4. leadpipe
13.1.5. typically asymmetrical
13.1.6. increases resting expenditure
13.1.7. contractures
13.1.8. postural deformity
13.2. bradykinesia
13.2.1. bradyphrenia contributes
13.2.1.1. slowness of thought
13.2.2. akinesia
13.2.3. hypomimia
13.2.4. freezing of gait
13.2.5. micrographia
13.3. tremor
13.3.1. resting tremor
13.3.2. postural tremor
13.3.3. action tremor
13.4. postural instability
13.4.1. difficulty with feed forward