Parkinson Disease

Parkinson Disease is disorder of neurological movement which eventually leads to disability because of decreased level of dopamine .

Pathophysiology:-

Clinical manifestations:-

Cardinal signs of Parkinson Disease are :-

1. Tremor

2. Rigidity

3. Bradykinesia

4. Postural instability

5. Uncontrolled sweating

6. Drooling 

7. Paroxysmal flushing 

8. Orthostatic hypothension

9. Gastric retention

10. Urinary retention

11. Constipation

12. Sexual dysfunction

13. Anxiety

14. Dysphagia

15. Dementia

16. Stress 

Subtypes of Parkinson Disease:-

1. Tremor dominant 

- symptoms are absent

2. Nontremor dominant

- postural instability

- rigidity

- bradykinesia

Diagnosis:-

1. Patient history 

2. Presences of cardinal signs

3. Neurological examination

4. Diagnosis confirmed with postive response of levodopa ( artificial dopamine )

5. Single Photon emission computer tomography 

Management :-

Treatment is to directed towards controlling of symptoms and maintenance of functions.

Pharmacology therapy for Parkinson Disease:-

1. Antiparkinsonian medication 

- increase dopaminergic activities

- acting on neurotransmitter pathway other than the dopaminergic pathway

- reduce the excessive influence of excitatory cholinergic neurons on the extra Pyramidal tract to restore balance between dopaminergic and cholinergic activities.

2. Levodopa 

Surgical management for Parkinson Disease:-

 Surgery provides symptoms relief in selected patient .

1. Stereotactic procedure

2. Neural transplantation

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