PARKINSON DISEASE

MUSTAFA JUMA PHIRI

MODERATED BY DR MUSONDA

MULUNGUSHI UNIVERSITY SOMHS, MBChB IV IMED

OUTLINE

o Introduction
o Classification
o Epidemiology
o Clinical features
o Pathophysiology
o DDx
o Workup
o Treatment
OBJECTIVES
o Define PD.
o Understand types of PD and etiology.
o Understand the prevalence.
o Know the common causes of death in PD.
o Recall the Basal nuclei and relate with pathogenesis.
o Explain the clinical presentation.
o Be able to diagnose PD clinically.
o Know the principles of management.
INTRODUCTION
o Progressive ND
o Melanin containing dopa neurons
o Substantia nigra, pars compacta
o Hypo and hyperkinetic
o Common
CLASSIFICATION/ETIOLOGY

o Idiopathic
o Hereditary
o Acquired
o Parkinson’s plus
 Protective factors
EPIDEMIOLOGY

o Most common worldwide

o 1-2 % risk after age 60
o 1-3% risk after age 80
o 4.5-21 cases per 100 000 per year
o M:F 1.5 : 1
PATHOPHYSIOLOGY
o Loss of dopa neurons, pars compacta
o Presence of lewy bodies and neurites
 CLINICAL FEATURES
NON MOTOR MOTOR
 Anosmia  Resting tremor
 Depression  Rigidity
 REM sleep  Bradykinesia (Face, truncal
 Autonomic features & extremity)
 Restless leg syndrome  Postural instability
DDX

o Alzheimer
o Chorea
o Huntington
o Cortical basal syndrome
o Lewy body dementia
WORKUP

o Clinical Dx
o No lab biomarker
o CT and MRI findings unremarkable
o Physical examination
o 2 out of 3 ( resting tremor, rigidity, bradykines
ia)
TREATMENT

o Control S & S
o Minimize side effects
o Symptomatic and neuroprotective therapy
o Levodopa coupled with carbidopa
o Dopamine agonists (ropinirole)
o MAO Inhibitors (rasagiline)
o Anticholinergics
REFERENCE

o Kumar and clark 10th ed

o Parkinson Disease Dr Mubeen Youtube Vide
o
o Parkinson Disease article by Dr Robert, Med
scape