sᴘᴏᴛ ᴅɪᴀɢɴᴏsɪs

2021-12-11 00:23:02 Open / Comment

2021-12-11 00:21:03 Open / Comment

2021-12-10 16:39:46 Open / Comment

2021-12-10 11:18:23 #Supranuclear_gaze_palsy:

Vertical gaze palsy (downgaze affected more) horizontal gaze is intact.

Supranuclear gaze palsy +Parkinson = progressive Supranuclear palsy (PSP)

#Pathogenesis:
Tauopathy : accumulation of tau protiens within the neurons.

#Reference :
Goldman-Cecil medicine 25th ed /QR library

http://static.us.elsevierhealth.com/goldman_cecilmedicine25e_9781455750177/9781455750177_0072 Open / Comment

2021-12-10 02:51:02 #Parkinson_disease vs #Parkinsonism (Parkinson plus syndromes) :

Similar in term of clinical presentation but differ in pathogenesis and Eiteology

Parkinson + syndrones:
#Example :
1- Lewy body dementia:
https://t.me/spotdiagnosis/182

2- Multiple system atrophy( shy drager) = Parkinsonism + #autonomic_dysfunction
Has two clinical picture:
- MSA- P (Parkinsonism)
- MSA - C (cerebellar symptoms ).
3-Progressive Supranuclear palsy(PSA): Parkinson + #Vertical_gaze palsy.

4- Corticobasilar degeneration :
Parkinsonism + (#alien_limb & myoclonus).

5- vascular Parkinsonism : Parkinsonism + vascular risk factors & multiple strokes.


#Further_reading :
Toronto notes 2020 /779 Open / Comment

2021-12-10 02:33:53 Open / Comment

2021-12-10 02:27:01 #Management: Pharmacological : - manisty : #levodopa/carpidopa -other : Dopamine agonist, mono amine oxidase inhibitor (MAOI) & Catchol-O-methyltrasnferase inhibitor ( COMTI). Psychiatric: Selective Serotonin reuptake inhibitor ( SSRI). Tricyclic antidepressants… Open / Comment

2021-12-10 02:20:36 #Management:

Pharmacological :
- manisty : #levodopa/carpidopa
-other : Dopamine agonist, mono amine oxidase inhibitor (MAOI) & Catchol-O-methyltrasnferase inhibitor ( COMTI).

Psychiatric:
Selective Serotonin reuptake inhibitor ( SSRI).
Tricyclic antidepressants ( TCA)

Neurosurgical :
- Thalamatomy, palidotimy and deep brain stimulation.

#Further_reading:

Toronto notes 2020 /page 779 Open / Comment

2021-12-10 00:09:49 #Parkinson_Disease (PD) :

Progressive neurodegenerative disease (2nd MCC after Alzheimer's disease) affecting extrapyramidal motor system classical picture is an old patient with global hypokinesia.

#Eiteology :

*Sporadic : multifactorial : repeated trauma, pesticide, post encephalitis, genetic.
*Familial

#Pathogenesis:
loss of dopaminergic neuron in pars compacta of substantia nigra this increases the inhibitory signals to the motor cortex.

#Presentation :(TRAP)
1- Tremor : coarse resting tremor.
2 - Rigidity : lead pipe or cogwheel (lead + tremor)
3- Akinesia /bradykinesia
Global hypokinesia (laziness):
Difficulty intitating movements,freezing,Micrographia (small calligraphy), Hypophonia, Hypomimia (mask face), loss of arm singing and blinking.

Postural instability : frequent fall, stooping.
Other: depression, dementia, urinary incontinence.

#Diagnosis :
History & Physical Examination

#Reference:
Toronto notes 2020
Goldman-Cecil medicine 25th ed /video library.

Netter images physiology Open / Comment