Parkinson's Disease

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Parkinson's Disease

NIH - Medical Encyclopedia Parkinson's disease

"Parkinson's disease is a disorder of the brain characterized by shaking (tremor) and difficulty with walking, movement, and coordination. The disease is associated with damage to a part of the brain that is involved with movement. … Some people with Parkinson's disease become severely depressed. This may be due to loss of dopamine in certain brain areas involved with pleasure and mood. Lack of dopamine can also affect motivation and the ability to make voluntary movements. Early loss of mental capacities is uncommon. However, persons with severe Parkinson's may have overall mental deterioration (including dementia and hallucinations). Dementia can also be a side effect of some of the medications used to treat the disorder. ...

Symptoms:

• Muscle rigidity • Unstable, stooped, or slumped-over posture • Loss of balance • Gait (walking pattern) changes • Shuffling walk • Slow movements • Difficulty initiating any voluntary movement • Small steps followed by the need to run to maintain balance • Freezing of movement when the movement is stopped, inability to resume movement • Muscle aches and pains (myalgia) • Shaking, tremors (varying degrees, may not be present) • Changes in facial expression • Reduced ability to show facial expressions • Voice or speech changes • Loss of fine motor skills • Frequent falls • Decline in intellectual function (may occur, can be severe) • A variety of gastrointestinal symptoms, mainly constipation.

… symptoms may be difficult to assess, particularly in the elderly. For example, the tremor may not appear when the person is sitting quietly with arms in the lap. The posture changes may be similar to osteoporosis or other changes associated with aging. Lack of facial expression may be a sign of depression. An examination may show "cogwheel" rigidity (jerky, stiff movements), tremors of the Parkinson's type, and difficulty initiating or completing voluntary movements. Reflexes are essentially normal. Tests are not usually specific for Parkinson's, but they may be required to rule out other disorders that cause similar symptoms. See also essential tremor."

Highlighted Article

[Clinical criteria of Parkinson's disease.] (Ther Umsch. 2007)

"The clinical criteria of Parkinson's disease are akinesia in combination with at least one of the following three symptoms: tremor (asymmetrical resting tremor), rigidity, impairment of posture, gait and balance. Symptomatic and atypical parkinsonian syndromes are ruled out by history, clinical examination, cranial CT, MRI, SPECT or PET. Patients with Parkinson's disease respond to levodopa or dopaminagonists throughout the course of the disease."

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Parkinson's Disease

Diagnosis, Imaging, and Screening

NEWS:

Patients With Early Parkinson's Exhibit Sleepiness, Hallucinations "Factors such as gender, age and overall health may help predict which people with early Parkinson's disease will experience hallucinations, sleepiness or swelling, a new study says. These symptoms are reported more frequently by people with early Parkinson's disease than the general population, the study authors said. "

ARTICLES:

JOURNAL ARTICLES:

Age and dementia-associated atrophy predominates in the hippocampal head and amygdala in Parkinson's disease. (Neurobiol Aging. 2007) "In conclusion, functionally meaningful age-associated hippocampal and amygdala atrophy occurs in PD."

Cerebral atrophy in Parkinson's disease patients with visual hallucinations. (Eur J Neurol. 2007) "Structural changes in these areas involved in higher visual processing may be important in understanding the VH and visual deficits in PD patients."

[Clinical criteria of Parkinson's disease.] (Ther Umsch. 2007) "The clinical criteria of Parkinson's disease are akinesia in combination with at least one of the following three symptoms: tremor (asymmetrical resting tremor), rigidity, impairment of posture, gait and balance. Symptomatic and atypical parkinsonian syndromes are ruled out by history, clinical examination, cranial CT, MRI, SPECT or PET. Patients with Parkinson's disease respond to levodopa or dopaminagonists throughout the course of the disease."

Clinical diagnostic criteria for dementia associated with Parkinson's disease. (Mov Disord. 2007)

Diagnostic pitfalls in Parkinson's disease: case report. (Arq Neuropsiquiatr. 2007) "Parkinson's disease (PD) is characterized by resting tremor, rigidity and bradykinesia. In 80% of cases, the disorder begins with upper limb resting tremor. However, there are some presenting atypical features that make the diagnosis even more difficult and intriguing. The disorder can have its onset below 40 years old, characterizing early-onset parkinsonism, which differential diagnosis possibilities are varied. Atypical presentations include a pure akinetic-rigid syndrome, the initial manifestations occurring in the lower limbs, and pain as the most important or sole manifestation. These atypical features are unusual, but can be seen in clinical practice."

Differentiating Parkinson's disease from other parkinsonian disorders. (Semin Neurol. 2007)

Gray matter atrophy in Parkinson disease with dementia and dementia with Lewy bodies (NEUROLOGY 2007)

Morphometric changes of gray matter in Parkinson's disease with depression: A voxel-based morphometry study. (Mov Disord. 2007) "These results suggest that depression in PD is related to gray matter decrease in the bilateral orbitofrontal and right temporal regions as well as the limbic system."

MR Imaging Index for Differentiation of Progressive Supranuclear Palsy from Parkinson Disease and the Parkinson Variant of Multiple System Atrophy. (Radiology. 2007)

Nonmotor symptoms as presenting complaints in Parkinson's disease: A clinicopathological study. (Mov Disord. 2007)

[Olfactory dysfunction in Parkinson's disease.] (Arq Neuropsiquiatr. 2007) "CONCLUSION:Among PD patients 80% had olfactory deficit and, therefore, smell evaluation may be a tool to make PD differential diagnosis."

[Olfactory dysfunction in Parkinson's disease : Its role as a new cardinal sign in early and differential diagnosis.] (Nervenarzt. 2007) "Olfactory dysfunction is a prominent symptom in Parkinson's disease (PD) and found in about 70-100% of patients. … Furthermore, olfactory testing may also prove to be a useful aid in the early or "preclinical" detection of PD, once effective disease-modifying therapies are found. Braak and coworkers have confirmed the widespread, extranigral pathology in PD and suggested that pathology in the anterior olfactory region may be one of the earliest appearances of neurodegeneration in PD."

Olfactory loss may be a first sign of idiopathic Parkinson's disease. (Mov Disord. 2007) "At the present neurological examination, 7% of the individuals with idiopathic hyposmia had developed clinical IPD. Altogether, 13% presented with abnormalities of the motor system. Our data suggest that a combination of olfactory testing and other tests may constitute a screening tool for the risk to develop IPD"

Variability in the clinical expression of Parkinson's disease. (J Neurol Sci. 2007)

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