HC 4: Parkinson
1. Inleiding: voorkomen van ziekte van Parkinson
• Voorkomen van ziekte van Parkinson = primair neurodegeneratieve aandoening (=
geen duidelijke oorzaak hebben + aftakeling van het hersenweefsel)
• Pathologisch = selectieve degeneratie van de dopaminerge neuronen in de substantia
nigra
• Lewy-bodies = insluitsels van alfa-synucleine
• Idiopathische ziekte van Parkinson VS secundair parkinsonisme
o Neuroleptica
o Cinnarizine De medicatie bij secundair
o Flunarizine parkinsonisme
o Vasculair
• Prevalentie
o 0,3% in de algemene populatie
o 1,6% in 65+
o 10% in 80+
o Begin tussen 50 en 70 jaar
• Klinische diagnose = motore symptomen = tremor – akinesie – rigiditeit
• Ondersteund door niet-motore verschijnselen (beeldvorming) + positief effect van
R/L-Dopa (= voorloper van Dopamine → L-Dopa kan hersenvlies doorbreken en
dopamine kan dat niet)
2. Motorische verschijnselen
2.1. Rusttremor
• Beven = rust-tremor van de ledematen
2.2. Bradykinesie
• Bewegingsarmoede = akinesie (traagheid)
• Traagheid, minder spontane bewegingen
• Verlies van spontane mimiek aangezicht
• Minder armzwaai bij het stappen
2.3. (Tandrad)rigiditeit
• Stijfheid = rigiditeit
• Voorovergebogen houding
• Last van fijne bewegingen (motoriek)
2.4. Anderen
• Moeilijk opstaan
• Draaien in bed
• Schrijfstoornis
• Minder stem
• Minder slikken → speekselvloed kan ontstaan
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