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In India there is a low prevalence of
Parkinson’s disease. We find it in Parsi
community of Mumbai.
Even though we find early onset of PD and
may even be seen due to mutations.
In ancient India Mucuna pruriens was in used
in the treatment of PD.
But worldwide PD is found in 6 million people.
Neurological disorders reduce the quality of
ETIOLOGY:They are of following types:1.primary75%
a) They may due to genetic causes. The
mutation in alpha-synuclein, parkin,
UCH1, DJ1, PINK1, LRKK cause PD
cause oxidative stress on mitochondria.
This in turn leads to nigrostriatal death.
b) Some environmental factors.
2.Infectious and post infectious.
Eg:- lyme disease is caused by 3
types of bacteria belonging to
Neurosyphilis and AIDS.
Some toxins such as Mn, cyanide,
methanol, carbon monoxide, pesticides.
And some medications such as
methyldopa, CCB, lithium and dopamine
depleting agents such as reserpine.
Rarely it is also due hyoparathyroidsm
due to basal ganglia calcification,
repeated trauma , etc.
PATHOPHYSIOLOGY:Basal ganglia consists of:1.corpus sriatum(caudate nucleus
*They mediate the extrapyramidal motor
cortex and the
e nucleus and
to thalamus and
nigro striatal neurons make motor
connections to corpus striatum by 2
types of neurons which contain D1
(excitatory) and D2(inhibitory)
The D1 (excitatory) are glutaminergic
and D2 (inhibitory) are
WHAT HAPPENS IN
Inhibitory component dopamine is
deficient and its concentration on basal
ganglia is low.
There is a pathological lesion in basal
ganglia and corpus striatum.
This occurs due to dopaminergic neuron
The dopamine is deficient so D2
receptors are less stimulated.
As the dopaminergic
neurons have their
cell bodies in
substantial nigra. And
as the corpus
degeneration of these
decrease in the
functional amount of
Parkinsonism is due
SIGNS AND SYMPTOMS:
when sitting and in rest and
may be present only to one side.
Stiff muscles and aching muscles of
leg, neck, face and other muscles of
Slow limited movement i;e
Insomnia and nightmares are seen at
very early stage before tremor.