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
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JOURNAL ARTICLES:
Biomarkers to detect central dopamine deficiency and distinguish Parkinson disease from multiple system atrophy. (Parkinsonism Relat Disord. 2008)
Hippocampal head atrophy predominance in Parkinson's disease with hallucinations and with dementia. (J Neurol. 2008)
How do patients with parkinsonism present? A clinicopathological study. (Intern Med J. 2008)
Onset Of Parkinson's Disease May Be Signalled By A Fading Sense Of Smell Many individuals with Parkinson's disease are able to recall losing their sense of smell well before the onset of more commonly recognized symptoms such as tremors, impaired dexterity, speech problems, memory loss and decreased cognitive ability.
Parkinson's disease: clinical features and diagnosis. (J Neurol Neurosurg Psychiatry. 2008)
Technology Insight: Imaging Neurodegeneration in Parkinson's Disease (Nat Clin Pract Neurol. 2008) The definitive diagnosis of idiopathic Parkinsons disease (PD) requires the demonstration of intracellular Lewy body inclusions via histological examination of brain tissue, which is not a viable approach in living individuals. Retrospective clinico pathological studies have shown that a clinical diagnosis of PD during life correlates with a postmortem finding of brainstem Lewy body disease in, at best, 85% of patients.[1] Atypical parkinsonian disorders, such as multiple system atrophy (MSA) and progressive supra nuclear palsy (PSP), can mimic PD, as can severe essential and dystonic tremors. Patients with early-stage disease, in which the full constellation of parkinsonian symptoms and signs are not yet manifest, can be the most difficult to diagnose. Consequently, the ability to detect or exclude loss of nigral dopaminergic neurons or striatal dopamine terminal function by use of non invasive imaging approaches would be a valuable tool that could not only help physicians to increase diagnostic specificity, but could also enable the appropriate management decisions to be made at the initial stages of the disease.
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