NEUROLOGICAL DISORDER

Neurological disorders are diseases of the brain, spine

and the nerves that connect them. There are more than
600 diseases of the nervous system, such as brain
tumors, epilepsy, Parkinson's disease, Depression,
mania , schizophrenia, anxiety, psychosis and
stroke as well as less familiar ones such as dementia.
Parkinsonism Disease
 PARKINSONISM (Neurological disorder / movement
disorder)
 Parkinsonism disease is a neurological disorder in which there is
degeneration of dopamine producing neurons of substantia nigra.
 Dopamine is a chemical in the brain, known as a neurotransmitter,
which sends messages that control movement.
 As Parkinsonism disease progresses, more dopamine neurons in the
brain are lost.
 It is caused due to decreased activity of dopamine or an increased
activity of acetylcholine in straitaum present in the basal ganglia.
In normal condition

Dopamine acetylcholine

In parkinsonism condition

↓ Dopamine

↑ acetylcholine
 Causes:

• The exact cause of parkinsonism disease is unknown,

research points to a combination of genetic and environmental
factors. Some cases may be caused more by genetic factors
and others due more to environment, with many somewhere in
between.
• Researchers have identified certain genes (pink 1, parkin )
that may play a role in parkinsonism disease, but studies are
still ongoing to understand exactly how mutations in these
genes are associated with parkinsonism.
RISK FACTORS

RISK FACTORS that have been identified include:

• Advancing age
• Family history
• Male gender
• Exposure to toxins, such as herbicides and pesticides
• Head injury
 SIGN AND SYMPTOMS

Movement/motor-related symptoms
Bradykinesia
Rigidity
Resting Tremor
Postural Instability
Reduced facial expression
Non-movement/ non-motor-related symptoms
Cognitive Impairment
Mood Changes
Sleep disorders
Hyposmia
Fatigue
Constipation
Bladder Problems

Other treatment-related symptoms

Dyskinesia
Impulse Control
 STAGES OF PARKINSONISM

• Stage 1: Symptoms on one side only

• Stage 2: Symptoms on both sides without balance impairment

• Stage 3: Mild to moderate disease, some postural instability,
physically independent
• Stage 4: Severe disease, able to walk or stand unassisted
• Stage 5: Wheelchair bound or bedridden unless assisted
 Types of parkinsonism
Primary parkinsonism Secondary parkinsonism

known as idiopathic parkinsonism. Known as drug induced

causes of disease is unknown.
Seen above 60 yrs of age.
Over the years, the dopaminergic
neurons degenerate due to H2O2 and
free radicals such as O2- (superoxide)
and peroxynitrite.
parkinsonism.
Drugs are the cause for this type of
parkinsonism.
Can be seen any age of the life.
No degeneration of dopaminergic
neuron as in primary parkinsonism
 TREATMENT
There are currently no available treatments to slow the progression of Parkinson’s over
time, but available drugs and therapies can effectively treat symptoms often for years.
Because Parkinson’s disease is highly variable, what works for one patient may not
work for another. Many different treatment approaches are used for Parkinson’s disease

1. DOPAMINERGIC STRATEGIES ( eg Carbidopa , levadopa )

Since many symptoms of Parkinsonism are due to a lack of dopamine in the brain,
dopaminergic strategies act to temporarily increase dopamine in the brain through different
approaches. The increase in dopamine provided by these approaches can result in improved
motor function control.
2. ANTICHOLINERGICS

These drugs block a different neurotransmitter (acetylcholine) that also regulates movement.

3.SURGICAL THERAPIES

Brain surgery that can supplant or supplement drug therapies for Parkinsonism disease in
some patients. Therapies include deep brain stimulation and pallidotomy.

4. EXERCISE

While no studies have proven the effect of exercise on slowing Parkinsonism progression,
strength and balance from regular exercise can help overall health. You should talk to your
physician about a safe exercise program and about how allied care professionals such as
physical, occupational and speech therapists can help manage your symptoms.