Parkinson's disease & pathophysiology

Parkinson's disease, their causes, symptoms and physiology

1. By : Subham kuma r vishwa karma B . P H A R M

2. PARKINSON'S DISE ASE Parkinsan's d isease ( PD ) is typicall y considered a chroni c , progress ive neurode generative moveme nt disord er . L a k e of Dopamine is respon sible for the Parkinson's d isease .

3. Dopamine Dopamine is an amine synthesized by remov ing a carboxyl group from a molecul e of it s precur sor chemical L-DOPA , which is synthesized in the brain and kidneys .

4. Major symptom s Tremor Rigidity Bradykinesia / akinesia Postural Instabi lity Fatigu e

5. Tr e mor Rest tremor , easily recogniz ed , is unilateral , occurs at frequencies between 4 & 6 Hz , is almo st alwa ys promin ent in distal extremities , and disappear s with action and duri ng sleep . Supina tion -pronation ( pillrolling ) tremor spread from one hand to th e oth er . Rest tremor can also invol ve the lips , chin , jaw and legs . The neck , head , or voic e are usu ally uninvol ved .

6. Rigidity Rigidity is increas ed resis tance , usua lly demonstrate d by the cogwheel phenomenon circul ar jerking rigi dity in flexion and extension in a back ground of tremor , which continues throughout an enti re range of movement . It can be painful , and painful shoulder is one of PD's most frequent initial manifestation s . Rigidi ty of the neck and trunk may cause postural deformities , generally late in the disea se .

7. Bra dykinesia Br adykinesia , or slow movement , is PD's most characteri stics clinical feature . Initially , it creates difficu lty with ordinary activities and slow move ment and reac tion time s . Eventuall y , patient s become frozen and ca nnot gesture , drool beca use of impai red swallowing , loose facial expression . Bra dykinesia appe ars to be rela ted to degree of dop amine defici ency .

8. Pos tural Instability Pos tural i nstability occ urs as the pati ent loses postu ral reflexes , often at the late stage of PD 'S . Po stural i nstability frequentl y causes falls , many of whi ch lead to hip fractures .

9. Cause s Idiop athic Genetic Drug induced Toxins Head Trauma Cerebral Anoxia

10. Pathophy siology Decreased stimul ation of the motor cortex by the basal ganglia , usua lly due to the madequate production and actio n of dopa mine . The specifi c region affected seems to be the pars compac t in the substantia nigra where there is a marked loss in dopaminergic cells . High presence of lewy bodies in dopamine rgic cells .

11. Pathophy siology Loss of dopa minergic neurones in the substantia nigra a nd appearance of eosinophilic inclusion bodies ( Le w y bodies )