{"id":645,"date":"2020-09-04T05:43:46","date_gmt":"2020-09-04T05:43:46","guid":{"rendered":"https:\/\/apexuniversity.co.in\/LMS\/?p=645"},"modified":"2023-06-26T04:17:14","modified_gmt":"2023-06-26T04:17:14","slug":"parkinsonism-and-treatment","status":"publish","type":"post","link":"https:\/\/lms.apexedu.org\/index.php\/2020\/09\/04\/parkinsonism-and-treatment\/","title":{"rendered":"PARKINSONISM AND TREATMENT"},"content":{"rendered":"\r\n\r\nParkinsonism is a chronic, progressive, motor disorder characterized by rigidity, tremors and bradykinesia.\r\n\r\n \r\n\r\nOther symptoms include excessive salivation, abnormalities of posture and hait, seborrhea and mood change. It was described by James Parkinson in 1817 and is therefore named after him. The incidence is about 1% population of population above 65 years of age. It is usually idiopathic in origin but can also be drug induced.\r\n\r\n \r\n\r\nIn <strong><em><a href=\"http:\/\/apexuniversity.co.in\/pharmaceutical.php\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"idiopathic parkinsonism (opens in a new tab)\">idiopathic parkinsonism<\/a><\/em><\/strong>, there is degeneration of nigrostriatal neurons in the basal ganglia resulting in dopamine deficiency. The balance between dopaminergic neurons and excitatory cholinergic neurons is distributed. Parkinson\u2019s disease\u00a0itself refers to dysfunction and cell death of the portion of the brain that produces dopamine.\r\n\r\n \r\n\r\nDopamine is a neurotransmitter \u2014 a chemical that transmits signals between brain and nerve cells. It is partially responsible for making controlled movements in the body. Parkinson\u2019s disease\u00a0itself refers to dysfunction and cell death of the portion of the brain that produces dopamine. Dopamine is a neurotransmitter \u2014 a chemical that transmits signals between brain and nerve cells. It is partially responsible for making controlled movements in the body.\r\n\r\n \r\n\r\n<strong>COMMON SYMPTOMS:<\/strong>\r\n\r\n \r\n\r\nDifficulty showing facial expressions, muscle stiffness, slowed, affected movements, speech changes, tremor, especially of one hand, dementia, issues with the <strong>a<em><a href=\"http:\/\/apexuniversity.co.in\/pharmaceutical.php\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"utonomic nervous system (opens in a new tab)\">utonomic nervous system<\/a><\/em><\/strong>, such as problems with controlled movements or spasms, early problems with balance, rapid onset and progression of symptoms.\r\n\r\n \r\n\r\n<strong>CAUSES<\/strong> <strong>OF PARKINSONISM<\/strong>\r\n\r\n \r\n\r\nParkinsonism can be caused by Parkinson\u2019s disease itself as well as another underlying condition: Corticobasal degeneration, Dementia with Lewy bodies Multiple system atrophy and Progressive supranuclear palsy.\r\n\r\n \r\n<h2 class=\"wp-block-heading\"><strong>DIFFERENT FORMS OF PARKINSONISM<\/strong><\/h2>\r\n \r\n\r\n<strong>Idiopathic <\/strong>\r\n\r\n \r\n<ul>\r\n \t<li>Parkinson\u2019s. Idiopathic means the cause is unknown.<\/li>\r\n \t<li>tremor,\u00a0rigidity\u00a0and\u00a0slowness\u00a0of movement.<\/li>\r\n<\/ul>\r\n \r\n\r\n<strong>Vascular<\/strong>\r\n\r\n \r\n\r\n<strong>Drug-induced<\/strong>\r\n\r\n \r\n<h3 class=\"wp-block-heading\"><strong>DIAGNOSE OF PARKINSONISM<\/strong><\/h3>\r\n \r\n\r\nDiagnosis remains clinical and is based on motor manifestations. Brain MRI or CT and molecular imaging (ie of the dopamine transporter in the striatum) of the striatum may be performed to support clinical evaluation. The clinical features of PD include both the motor symptoms (described above), as well as non-motor issues. These non-motor symptoms include <strong><em><a href=\"http:\/\/apexuniversity.co.in\/pharmaceutical.php\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"neuropsychiatric symptoms (opens in a new tab)\">neuropsychiatric symptoms<\/a><\/em><\/strong> including mood disturbances and cognitive changes; autonomic dysfunction, pain and sleep issues.\r\n\r\n \r\n\r\nDoctors can perform a test that tracks the movement of dopamine in the brain. This is known as the DaT-SPECT test. The test uses radioactive markers designed to track dopamine in the brain. This allows a doctor to watch the release of dopamine in a person\u2019s brain and identify the areas of the brain that do or do not receive it.\r\n\r\n \r\n<h3 class=\"wp-block-heading\"><strong>TREATMENTS<\/strong><\/h3>\r\n \r\n\r\nLevodopa has remained the cornerstone of PD treatment for more than 50 years. However, after a few years of treatment and mainly due to the progression of the disease, the benefit of levodopa shortens and motor complications appear in many patients.\r\n\r\n \r\n\r\nThis had led to the introduction of many other medications including inhibitors of catechol-O-methyltransferase (COMT), monoamine oxidase type B (MAO-B) inhibitors and dopamine agonists. Enzyme blockers act by either extending levodopa or dopamine half-life while dopamine agonists mimic the action of dopamine on brain dopamine receptors.\r\n\r\n \r\n\r\nMore recently, surgical and infusion therapies have become available to improve management in selective patients with motor complications. Surgery includes the use of deep brain stimulation of the subthalamic nucleus and globus pallidus internus.\r\n\r\n \r\n\r\nThe use of drug infusions is based on the possibility to deliver continuously either levodopa or apomorphine (a dopamine agonist with high affinity to dopamine receptors), mimicking the natural tonic receptor stimulation in the basal ganglia. As a result, treatments for Parkinsonism depend upon the \u201cplus\u201d disease that a person has.\r\n\r\n \r\n\r\nFor example, if a person has corticobasal degeneration and related muscle spasms, a doctor may prescribe\u00a0antidepressants\u00a0and botulinum toxin A (BOTOX) injections. <strong><em><a href=\"http:\/\/apexuniversity.co.in\/pharmaceutical.php\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Treatments for Parkinsonism (opens in a new tab)\">Treatments for Parkinsonism<\/a><\/em><\/strong> usually aim to help reduce a person\u2019s symptoms whenever possible to help them maintain independence. Doctors often recommend physical and occupational therapy because they can help a person keep their muscles strong and improve balance.\r\n\r\n","protected":false},"excerpt":{"rendered":"<p>Parkinsonism is a chronic, progressive, motor disorder characterized by rigidity, tremors and bradykinesia. Other symptoms include excessive salivation, abnormalities of posture and hait, seborrhea and mood change. It was described by James Parkinson in 1817 and is therefore named after&#8230;<\/p>\n","protected":false},"author":1,"featured_media":646,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[136,141],"_links":{"self":[{"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/posts\/645"}],"collection":[{"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/comments?post=645"}],"version-history":[{"count":0,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/posts\/645\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/media\/646"}],"wp:attachment":[{"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/media?parent=645"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/categories?post=645"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lms.apexedu.org\/index.php\/wp-json\/wp\/v2\/tags?post=645"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}