Parkinson

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".

Etiology

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

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

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

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

The disease progresses differently in everyone, with symptoms and disease progression varying greatly from person to person.

Epidemiology

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

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.

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