Parkinsons disease Parkinsonism is a neurological syndrome characterized by tremor, rigidity, postural instability, and hypokinesia (decreased bodily movement). Parkinsons disease is the second most common neurodegenerative disorder and the most common movement disorder. It is characterized by progressive loss of muscle control, which leads to trembling of the limbs and head while at rest, stiffness, slowness, and impaired balance.
Etiology A male has a 50% higher risk of developing Parkinsons disease than a female Increases with age Normally occurres after 50 yrs of age Parkinsons disease occurs in approximately 1% of individuals aged 60 years and in about 4% of those aged 80 years
Clinical manifestationsThe primary symptoms of Parkinsons disease are all related to voluntary and involuntary motor function and usually start on one side of the body. Symptoms are mild at first and will progress over time. Some individuals are more affected than others. Characteristic motor symptoms include the following
Contd.. Tremors: Trembling in fingers, hands, arms, feet, legs, jaw, or head. Rigidity: Stiffness of the limbs and trunk, which may increase during movement. Rigidity may produce muscle aches and pain Bradykinesia: Slowness of voluntary movement Postural instability: Impaired or lost reflexes can make it difficult to adjust posture to maintain balance
Secondary symptoms ofParkinsons disease anxiety, insecurity, and stress confusion, memory loss, and dementia (more common in elderly individuals) constipation, depression, male erectile dysfunction Weakness Confusion Personality changes
Diagnostic studies History collection and physical examination Neurologic examination CT scan MRI scan Blood routine
Medical management Levodopa has been the most widely used treatment for over 30 years. L-DOPA is converted into dopamine in the dopaminergic neurons Anticholinergics may be useful as treatment of motor symptoms Antihistamine drugs Antibiotics to reduce any infection Antidepression drugs
Contd.. There is some evidence that speech or mobility problems can improve with rehabilitation Palliative care Palliative care is often required in the final stages of the disease when all other treatment strategies have become ineffective. The aim of palliative care is to maximize the quality of life for the person with the disease and those surrounding him or her.
Nutritional management Give foods that are easily chewable Diet should include fruits to reduce constipation Food should be given in an atrractive manner Small frequent diets
complications Infection, such as urinary tract infection and pneumonia Falls and broken bones Loss of ability to function or care for self Loss of ability to interact Comma Death