Excessive and abnormal movements; chorea, athetosis; hemiballism (sudden movement of an extremity)
Hyperkinetic disorders (BG)
Two major disorders of the basal ganglia
1. hyperkinetic disorders
2. hypokinetic disorders
s/s of: resting tremor; rigidity; bradykinesia; postural instability
Parkinson's disease
Early onset of parkinson's is at what age?
20-45 yo
Late onset of parkinsons is at what age?
50+ yo
Control movement through influence on the cortex; assist in the regulation and execution of voluntary movement and the learning of motor skills; help prepare for movement
Purpose of BG
Caudate, putamen, globus pallidus, amygdala, substantia nigra
Basal ganglia
Loss of how much dopamine before symptoms of Parkinson's occurs?
70%
Control movement through influence on the cortex; assist in the regulation and execution of voluntary movement and the learning of motor skills; help prepare for movement
Purpose of the BG
Lack or slowness of movement; athetosis
Hypokinetic disorders (BG)
Progressive and degenerative; loss of dopamine from the SUBSTANTIA NIGRA; can be early or later onset
Parkinson's disease
Little steps because momentum is building and feet are not moving fast enough
Festinating gait
Slow movement; full amplitude
Bradykinesia
No movement
Akinesia
Low amplitude movement
Hypokinesia
Loss of movement accuracy; impaired voluntary movement; decreased posturL STABILITY with attempts to move
EX: resting tremor
Causes of Basal ganglia damage
Reduced facial expression
Hypomimia
Slow thinki8ng/processing
Bradyphrenia
Small handwriting
Micrographia
Type of Parkinson:
Not related to anything; must do dopamine trial to see if they have true PD
Idiopathic PD
Type of Parkinson:
Medications; microvascular strokes right around BG; dopamine will not help and will have no effect on s/s
Parkinsonism (acquired PD)
Type of Parkinson:
Multisystem atrophy; hyper/hypokinetic symptoms; does not respond to dopamine
Parkinson's plus
4 categories of medications for PD
1. Levodopa/carbidopa
2. COMT inhibitors
3. Dopamine agonists
4. MAO B inhibitors
A common side effect of all 4 classes of PD medications
Low BP
Increase of resting tremor before medication times.