2. Primary Symptoms It is important to note that not all patients experience the full range of symptoms; in fact, most do not. Rigidity is an increased tone or stiffness in the muscles. Unless it is temporarily eased by anti- Parkinson's medications, rigidity is always present. However, it increases during movement. It is often responsible for a mask- like expression of the face. In some patients, rigidity leads to sensations of pain, especially in the arms and shoulders.

3. Tremor is the symptom the public most often identifies with PD, but in fact, up to 25% of patients experience very slight tremor or none at all. When it is present, the tremor may be worse on one side of the body. Besides affecting the limbs, it sometimes involves the head, neck, face, and jaw. Bradykinesia means slowness of movement. This symptom is characterized by a delay in initiating movements, caused by the brain's slowness in transmitting the necessary instructions to the appropriate parts of the body. When the instructions have been received, the body responds slowly in carrying them out.

4. Poor balance tends to affect people with PD. This is particularly true when they move abruptly, causing a sudden change in the position of their bodies. Some patients experience repeated falls due to poor balance. Walking problems commonly include a decreased or non-existent arm swing; short, shuffling steps (festination); difficulty in negotiating turns; and sudden freezing spells (inability to take the next step).

10. Pharmacological Treatments Levadopa/carbidopa – increase available DA COMPT inhibitors – prevent the breakdown of DA Anticholinergics – restore balance of Ach and DA.

11. Surgical Treatments Pallidotomy – resect part of the globus pallidus Thalamotomy – resect part of the thalamus Brain Tissue transplants Deep Tissue Stimulation

12. What causes Huntington's disease? Huntington's disease is caused by a faulty gene on chromosome 4. The gene, which produces a protein called Huntingtin, was discovered in 1993. In some way - which is not yet understood - the faulty gene leads to a damage of the nerve cells in areas of the brain, including the the basal ganglia and cerebral cortex. Each person whose parent has Huntington's disease is born with a 50-50 chance of inheriting the faulty gene. Anyone who inherits the faulty gene will, at some stage, develop the disease. A genetic test is available from Regional Genetic Clinics throughout the country. This test will usually be able to show whether someone has inherited the faulty gene, but it will not indicate the age at which they will develop the disease.

13. Huntington’s Disease: The early symptoms include: slight, uncontrollable muscular movements stumbling and clumsiness lack of concentration short-term memory lapses depression changes of mood, sometimes including aggressive or antisocial behaviour

14. How Huntington's disease progresses Later on in the illness people experience many different symptoms which may include: involuntary movements difficulty in speech and swallowing weight loss as well as emotional changes resulting in: stubbornness frustration mood swings depression

15. Later Stages of Huntington’s: Cognitive changes that people experience can result in a loss of drive. Initiative and organizational skills, which may result in the person appearing to be lazy. There also may be difficulty in concentrating on more than one activity at a time.

16. Potential Cause of Movement Initiation Slowing

17. Potential Cause of Jerky movements: Here is what I was blanking on in class: Please forgive me for this momentary lapse!!

19. Treatment for Huntington’s Clonazapam – Benzodiazapine (sedative/hypnotic)– potentiates GABA Antipsychotics Tranquilizers Anti-depressents