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definition
Parkinson's disease:
Chronic disease and progressive
neurological disorder that
characterized by shaking, stiffness,
reduced
speed of movement, and facial
expression blank
like mask dg excessive salivation.
epidemiology
1. incidence increases with increasing
age (figure
life expectancy)
2. onset occurs at about age 60 years old
3. Environmental factors are not so
influential
4. In Parkinson's disease that occurs
under 50 years old,there may be a
genetic factor
etiology
risk factors are unknown, but most patients
etiology can be identified is patients who received
dopamine antagonists
some of the things that can cause symptoms
Parkinson's, among others:
- Medications, such as: phenothiazines, benzamid,
methyldopa, and reserpine,
metoclopramide, SSRI, Amiodarone, Diltiazem,
acid
Valproate
- Heavy metal poisoning (Mn)
- Anoxia (CO poisoning)
- Post-trauma, etc..
pathophysiology
main pathological abnormalities: cell degeneration with
loss of the pigmented dopaminergic neurons in the pars
compacta substantia nigra in the brain and imbalance
extrapyramidal motor circuit (control movement in the
brain).
In normal person: reduced dopamine: 5% per decade
in 45% of Parkinson's patients during the first decade after
diagnosis
Usually new symptoms appear when dopamine in striatal
already reduced by 80%
nerve degeneration in the nigrostriatal dopamine causes
increased activity of striatal cholinergic tremor effect
Dopaminergic neurons
diagnosis
- Need to see any info druginduced history
of drug use.
Parkinsonism
- The possibility of precise diagnosis if
patients show
bradikinesia, tremor, rigidity
- Symptoms usually begin unilaterally motor
- Once diagnosed, it can be evaluated
progress
disease by Hoehn and Yahr scale
therapeutic strategies
Non-pharmacological :
- Exercises
- Education
- Nutrition
- Surgery
Pharmacology:
- Increasing levels of endogenous dopamine
- Enabling the dopamine receptor agonist
- Pressing cholinergic activity with drugs
anticholinergic