PARKINSON`S DISEASE :
PARKINSON`S DISEASE PARKINSON`S DISEASE is movement disorder of unknown etiology due to degeneration of neurons in the nigrostrial dopamine system
CLINICAL FEATURE :
CLINICAL FEATURE TREMORS(4-6hz): tremors[pill rolling] at rest, decreases on action. Usually first in finger/thumb. Coarse flexion/extension of finger[pill rolling & drum beating]
RIGIDITY- Cog wheel type especially in upper limb {stiffness in all direction of movement}. Plastic type {lead type} mostly appreciated in legs. In trunk rigidity manifest by flexed& stooped posture
Hypokinesis :
Hypokinesis Charactrized by poverty & slowness of movement. Slowness in initiating movement. Handwriting micrographia.
GAIT-patient walk with short step , with a tendency to run{as they are catching their own centre of gravity}-festinating gait
General-expressionless face with staring look with infrequent blinking. Monotonus speech. Dementia & Depression in advance stage
Causes of Parkinsonism :
Causes of Parkinsonism Impaired release of dopamine- Idiopathic parkinsonism.
Drug depleting dopamine store-reserpine, tetrabenzine.
Toxin damaging dopaminergic neuron
Viral infection- Encephalitis ,Japanese encephalitis
Trauma-repeated head injury[punch drunk syndrome]
Miscellaneus-wilson disease,huntingtion,s disease
TREATMENT :
TREATMENT Anticholinergic drug- to relieve tremors.
Dopamine agonist-bromocriptine& pergolide.
Amantadine-potentiate release of dopamine.
Selegeline : early stage ,neuroprotective,delay neuronal degeneration.
Levodopa&carbidopa
Slide 7:
THANK YOU