BackgroundParkinson’s disease (PD) affects 1:500 people in the UK. It is more common over the age of 50, but younger people can develop the disease. PD affects both sexes but is slightly more common in men. Many people think Parkinson’s is just a tremor, but it is much more than this —Parkinson’s is a complex neurodegenerative condition. It is still not completely understood, but the pathophysiology is related to the progressive loss of dopamine-producing neurons within the brain. Patients with PD rarely come into hospital because of the disease itself. However, patients often present to hospital with complications of their PD (e.g. falls, delirium, severe constipation, aspiration pneumonia). Patients may also present to hospital for any other reason and then suffer additional complications as a result of their PD. With thanks to the Hector Course, Heart of England NHS Trust, for this slide Signs & SymptomsThe triad of symptoms and signs that commonly characterize PD are tremor, rigidity and bradykinesia (slowness of movement). However, Parkinson’s has many different symptoms and signs affecting a range of systems —PD can affect patient’s lives in many different ways:
Golden ruleParkinson’s medication is time critical —if Parkinson’s medications are delayed or omitted, patients can deteriorate very quickly in terms of their ability to move, speak and swallow safely. Some drugs will interfere with PD medications or exacerbate the condition. Do not prescribe metoclopramide or prochlorperazine (stemetil), use domperidone first line for antiemetic. Do not prescribe haloperidol or risperidone, use lorazepam if patient is severely agitated. The trust guideline is accessible on intranet ED Home Page > Adult Guidelines > Adult Medicine > Neurology Further Reading
Clare Bosanko
July 20th 2016
13 Comments
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