2. Parkinson's Disease
• Parkinson’s disease is a
progressive, neurodegenerative disorder that
affects movement, muscle control, and balance
as well as numerous other functions. It is part
of a group of conditions known as motor
systems disorders. Parkinson's disease was
named for James Parkinson, a general
practitioner in London during the 19th century
who first described the symptoms of the
disease.
3. Cont…
There are three types of Parkinson's
disease and they are grouped by age
of onset:
1. Adult-Onset Parkinson's Disease -
This is the most common type of
Parkinson's disease. The average age
of onset is approximately 60 years
old. The incidence of adult onset PD
rises noticeably as people advance in
age into their 70's and 80's.
4. Cont…
2. Young-Onset Parkinson's Disease - The age of
onset is between 21-40 years old. Though the
incidence of Young-Onset Parkinson's Disease
is very high in Japan (approximately 40% of
cases diagnosed with Parkinson's disease), it
is still relatively uncommon in the U.S., with
estimates ranging from 5-10% of cases
diagnosed.
3. Juvenile Parkinson's Disease - The age of
onset is before the age of 21. The incidence
of Juvenile Parkinson's Disease is very rare.
5. Pathophysiology and Etiology
• Parkinson's disease result from deficiency of the
neurotransmitter dopamine. Depletion of the
dopamine in the brain results in movement
disorders. dopamine acts as a messenger
between two brain areas - the substantia
nigra and the corpus striatum - to produce
smooth, controlled movements. Most of
the movement-related symptoms of
Parkinson's disease are caused by a lack of
dopamine due to the loss of dopamine-
producing cells in the substantia nigra.
6. Cont…
• When the amount of dopamine is too low,
communication between the substantia nigra and
corpus striatum becomes ineffective, and
movement becomes impaired; the greater the
loss of dopamine, the worse the movement-
related symptoms.
• In most cases of Parkinson's disease no cause
can be found for dopamine depletion.
• The symptoms of Parkinson's disease are
associated with exposure to environmental
toxins such as insect sides and herbs sides.
7. Cont…
• Self administration of an illegal synthetic
form of horian known as MPTP an can
occur as sequella of head injuries and
encephalitis. Phenothiazine a category of
anti psychotic drugs and other psychotic
drugs used to treat schizophrenia, but the
symptoms are reversible when the drug is
discontinued. Manifestations of disorders
progress slowly that years may elapse
between the first symptom and diagnosis.
• The symptoms are initially unilateral but
eventually whether quickly or slowly,
became bilateral.
8. Clinical Manifestations
• Early signs include stiffness, referred to
as rigidity, and tremors of one or both
hands described as pill rolling( arrhythmic
motion of the thumbs against the fingers).
• The hand tremors is obvious at rest and
typically decrease when movement is
voluntary, such as picking up an object
• Bradikansia slowness in performing
spontaneous movements, develop.
•
9. Cont…
• Weight loss occurs, a shuffling gait is
apparent and the client has difficult turning
or redirecting forward motion.
• Arms are rigid while working. In late stages
the disease effect jaw tongue and larynx
,speech is slurred ; chewing and swallowing
became difficulty. Rigidity can lead
contractures. Salivation
increases, accompanied by drooling. In small
percentage of clients, the eyes roll upward
or down ward stay there involuntary for
several hours or even few days
10. Diagnosis
• Diagnosis based on typical
symptoms and neurologic
examination. There are no specific
tests for this disorder
11. Treatment
• There is no known cure for Parkinson's disease.
The goal of treatment is to control symptoms.
• Medications control symptoms, mostly by
increasing the levels of dopamine in the brain.
• Many medications can cause severe side
effects, including hallucinations, nausea,
vomiting, diarrhea, and delirium. Monitoring and
follow-up by the health care provider is
important.
• Medications used to treat movement-related
symptoms of Parkinson's disease include:
13. Cont…
Lifestyle changes may be helpful for Parkinson's
disease:
Surgery may be an option for some patients with
Parkinson's disease. These surgeries do not cure
Parkinson's, but may help ease symptoms.
• Deep brain stimulation involves placing electrical
stimulators in specific areas of the brain that
control movement.
• Another type of surgery destroys brain issues
that cause Parkinson's symptoms.
• Stem cell transplant and other clinical trials are
currently ongoing in the USA.
14. Complications
• Difficulty performing daily activities
• Difficulty swallowing or eating
• Disability (differs from person to
person)
• Injuries from falls
• Pneumonia from breathing in (aspirating)
saliva
• Side effects of medications
