Parkinson: Difference between revisions

Latest revision as of 23:45, 11 December 2024

Parkinson's Disease

Parkinson's disease is a progressive neurodegenerative disorder that primarily affects movement. It is characterized by the degeneration of dopamine-producing neurons in the substantia nigra, a region of the midbrain. This leads to a variety of motor and non-motor symptoms that can significantly impact a person's quality of life.

Pathophysiology

The hallmark of Parkinson's disease is the loss of dopaminergic neurons in the substantia nigra pars compacta. This loss leads to a decrease in dopamine levels in the striatum, a critical component of the basal ganglia, which is involved in the regulation of movement. The exact cause of neuronal death is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

The presence of Lewy bodies, which are abnormal aggregates of protein, particularly alpha-synuclein, is another pathological feature of Parkinson's disease. These inclusions are found in the remaining neurons and are thought to play a role in the disease process.

Symptoms

Parkinson's disease symptoms can be divided into motor and non-motor categories:

Motor Symptoms

Tremor: Often the first symptom, typically a resting tremor that affects one side of the body.
Bradykinesia: Slowness of movement, which can make simple tasks difficult and time-consuming.
Rigidity: Muscle stiffness that can occur in any part of the body, leading to discomfort and pain.
Postural Instability: Impaired balance and coordination, increasing the risk of falls.

Non-Motor Symptoms

Cognitive Impairment: Ranging from mild cognitive difficulties to dementia.
Mood Disorders: Depression and anxiety are common.
Sleep Disturbances: Including insomnia and REM sleep behavior disorder.
Autonomic Dysfunction: Such as constipation, orthostatic hypotension, and urinary problems.

Diagnosis

Diagnosis of Parkinson's disease is primarily clinical, based on the presence of characteristic motor symptoms. Neurologists may use the Unified Parkinson's Disease Rating Scale (UPDRS) to assess the severity of symptoms. Imaging studies, such as DaTscan, can support the diagnosis by showing reduced dopamine transporter activity in the brain.

Treatment

While there is no cure for Parkinson's disease, several treatments can help manage symptoms:

Medications: The mainstay of treatment is Levodopa, often combined with carbidopa. Other medications include dopamine agonists, MAO-B inhibitors, and COMT inhibitors.
Surgical Options: Deep brain stimulation (DBS) is an option for patients with advanced disease who do not respond well to medications.
Rehabilitation: Physical, occupational, and speech therapy can help improve function and quality of life.

Prognosis

Parkinson's disease is a chronic and progressive condition. The rate of progression varies among individuals. While the disease itself is not fatal, complications such as falls, pneumonia, and infections can lead to increased mortality.

Research

Ongoing research is focused on understanding the underlying mechanisms of Parkinson's disease, developing new treatments, and finding potential neuroprotective strategies. Gene therapy, stem cell therapy, and novel pharmacological approaches are areas of active investigation.

Also see

edit

WikiMD neurology

Neurology

Neurological diseases and disorders

Cerebrovascular diseases‎ | Chronic fatigue syndrome‎ | Congenital disorders of nervous system‎ | ‎Demyelinating diseases of CNS

Epilepsy‎ | Extrapyramidal and movement disorders‎ | Inflammatory diseases of the central nervous system‎

Motion sickness‎ | Myoneural junction and neuromuscular diseases‎ | Nervous system neoplasia‎

Sleep disorders‎ | Neurocutaneous conditions‎ | Neurodegenerative disorders‎ | Neurodevelopmental disorders‎

External links

Comprehensive information from the National Institute of health.

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-'''Parkinson's disease''' (PD) is a long-term degenerative disorder of the nervous system that mainly affects the motor system. The symptoms generally come on slowly over time. Early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking. Thinking and behavioral problems may also occur. Dementia becomes common in the advanced stages of the disease. Depression and anxiety are also common, occurring in more than a third of people with PD. Other symptoms include sensory, sleep, and emotional problems. The main motor symptoms are collectively called "parkinsonism", or a "parkinsonian syndrome".
+Parkinson's Disease
-==Etiology==
+Parkinson's disease is a progressive neurodegenerative disorder that primarily affects movement. It is characterized by the degeneration of dopamine-producing neurons in the substantia nigra, a region of the midbrain. This leads to a variety of motor and non-motor symptoms that can significantly impact a person's quality of life.
-The cause of Parkinson's disease is generally unknown, but believed to involve both genetic and environmental factors. Those with a family member affected are more likely to get the disease themselves. There is also an increased risk in people exposed to certain pesticides and among those who have had prior head injuries. The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit.
-==Pathophysiology==
+== Pathophysiology ==
-The pathology of the disease is characterized by the accumulation of a protein called alpha-synuclein into inclusions called Lewy bodies in neurons, and from insufficient formation and activity of dopamine produced in certain neurons within parts of the midbrain. Lewy bodies are the pathological hallmark of the idiopathic disorder, and the distribution of the Lewy bodies throughout the Parkinsonian brain varies from one individual to another. The anatomical distribution usually corresponds to the expression and degree of the clinical symptoms of each individual.
-==Diagnosis==
+The hallmark of Parkinson's disease is the loss of dopaminergic neurons in the substantia nigra pars compacta. This loss leads to a decrease in dopamine levels in the striatum, a critical component of the basal ganglia, which is involved in the regulation of movement. The exact cause of neuronal death is not fully understood, but it is believed to involve a combination of genetic and environmental factors.
-Parkinson's disease is typically diagnosed based on the presenting symptoms and signs, with support from medical imaging. There is no definitive test for the disease.
-==Treatment==
+The presence of [[Lewy bodies]], which are abnormal aggregates of protein, particularly alpha-synuclein, is another pathological feature of Parkinson's disease. These inclusions are found in the remaining neurons and are thought to play a role in the disease process.
-While there is no cure for Parkinson's disease, treatments aim to manage symptoms. They typically involve medications, physical therapy, and in some cases, surgery.
-==Prognosis==
+== Symptoms ==
-The disease progresses differently in everyone, with symptoms and disease progression varying greatly from person to person.
-==Epidemiology==
+Parkinson's disease symptoms can be divided into motor and non-motor categories:
-Parkinson's disease affects more than 6 million people globally and is the second most common neurodegenerative disorder (after Alzheimer's disease). It is more common in older people, with most cases occurring after the age of 50.
-==History==
+=== Motor Symptoms ===
-The disease is named after the English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817.
-[[Category:Neurological disorders]]
+* '''[[Tremor]]''': Often the first symptom, typically a resting tremor that affects one side of the body.
-[[Category:Degenerative disorders]]
+* '''[[Bradykinesia]]''': Slowness of movement, which can make simple tasks difficult and time-consuming.
-[[Category:Parkinson's disease]]
+* '''[[Rigidity]]''': Muscle stiffness that can occur in any part of the body, leading to discomfort and pain.
+* '''[[Postural Instability]]''': Impaired balance and coordination, increasing the risk of falls.
-{{stub}}
+=== Non-Motor Symptoms ===
-{{dictionary-stub1}}
+* '''[[Cognitive Impairment]]''': Ranging from mild cognitive difficulties to dementia.
+* '''[[Mood Disorders]]''': Depression and anxiety are common.
+* '''[[Sleep Disturbances]]''': Including insomnia and REM sleep behavior disorder.
+* '''[[Autonomic Dysfunction]]''': Such as constipation, orthostatic hypotension, and urinary problems.
+== Diagnosis ==
+Diagnosis of Parkinson's disease is primarily clinical, based on the presence of characteristic motor symptoms. Neurologists may use the [[Unified Parkinson's Disease Rating Scale]] (UPDRS) to assess the severity of symptoms. Imaging studies, such as [[DaTscan]], can support the diagnosis by showing reduced dopamine transporter activity in the brain.
+== Treatment ==
+While there is no cure for Parkinson's disease, several treatments can help manage symptoms:
+* '''[[Medications]]''': The mainstay of treatment is [[Levodopa]], often combined with carbidopa. Other medications include dopamine agonists, MAO-B inhibitors, and COMT inhibitors.
+* '''[[Surgical Options]]''': [[Deep brain stimulation]] (DBS) is an option for patients with advanced disease who do not respond well to medications.
+* '''[[Rehabilitation]]''': Physical, occupational, and speech therapy can help improve function and quality of life.
+== Prognosis ==
+Parkinson's disease is a chronic and progressive condition. The rate of progression varies among individuals. While the disease itself is not fatal, complications such as falls, pneumonia, and infections can lead to increased mortality.
+== Research ==
+Ongoing research is focused on understanding the underlying mechanisms of Parkinson's disease, developing new treatments, and finding potential neuroprotective strategies. Gene therapy, stem cell therapy, and novel pharmacological approaches are areas of active investigation.
+== Also see ==
+* [[Neurodegenerative disorders]]
+* [[Dopamine]]
+* [[Basal ganglia]]
+* [[Lewy body dementia]]
+{{Neuroscience}}
+{{Neurology}}
+[[Category:Neurology]]
+[[Category:Neurodegenerative disorders]]
+[[Category:Movement disorders]]