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- a neurological
syndrome.
EPIDEMILOGY








In India there is a low prevalence of
Parkinson’s disease. We find it in Parsi
community of Mumba...
ETIOLOGY:They are of following types:1.primary75%
2.secondary.25%
1.Primary:
a) They may due to genetic causes. The
mutati...
Secondary causes:1.vascular diseases:-
2.Infectious and post infectious.
Eg:- lyme disease is caused by 3
types of bacteria belonging to
genus borrelia.
Neurosyphilis and AIDS.
 Some toxins such as Mn, cyanide,
methanol, carbon monoxide, pesticides.
 And some medications s...
PATHOPHYSIOLOGY:Basal ganglia consists of:1.corpus sriatum(caudate nucleus
and putamen).
2.Globus pallidus.
3.Substantia n...
Basal ganglia
Extrapyramidal surface of brain:
The cerebral
cortex and the
substantia nigra
both project
towards corpus
straitum.
The corpus
striatum(caudat
e nucleus and
putmen)
projects into
globus pallidus
to thalamus and
they regulates
involuntary
...
 The

nigro striatal neurons make motor
connections to corpus striatum by 2
types of neurons which contain D1
(excitatory...
 D1=excitatory

receptors=
acetylcholine as
transmitter=direct.
 D2=inhibitory
receptors=dopamine as
transmitter=indirec...
WHAT HAPPENS IN
PARKINSONISM?
Inhibitory component dopamine is
deficient and its concentration on basal
ganglia is low.
 ...
Dopamine
deficiency
PICTURE SHOWING
SUBSTANTIA NIGRA
DEGENERATION.
As the dopaminergic
neurons have their
cell bodies in
substantial nigra. An...
So eventually
Parkinsonism is due
to imbalance
between
acetylcholine and
dopamine.
Normal
levels of
dopamine
and
acetylcholi
ne
balanced.
SIGNS AND SYMPTOMS:
 Tremor

when sitting and in rest and
may be present only to one side.
 Stiff muscles and aching mus...
Person
showing
Parkinson's
disease
symptoms.
Weakness of face and throat muscles
making it harder to talk or to swallow.
 Difficulty with walking called gait
instabil...
COMPLICATIONS OF
PARKINSON’S :
 Depression

and anxiety.
 Sexual dysfunction
 Sleep disorders.
 Urinary incontience.
Parkinsonism
Parkinsonism
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Parkinsonism

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parkinson's disease is a neurological syndrome characterized by bradykinesia, tremor

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Transcript of "Parkinsonism"

  1. 1. - a neurological syndrome.
  2. 2. EPIDEMILOGY      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 life.
  3. 3. ETIOLOGY:They are of following types:1.primary75% 2.secondary.25% 1.Primary: 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. 
  4. 4. Secondary causes:1.vascular diseases:-
  5. 5. 2.Infectious and post infectious. Eg:- lyme disease is caused by 3 types of bacteria belonging to genus borrelia.
  6. 6. 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. 
  7. 7. PATHOPHYSIOLOGY:Basal ganglia consists of:1.corpus sriatum(caudate nucleus and putamen). 2.Globus pallidus. 3.Substantia nigra. *They mediate the extrapyramidal motor activity. 
  8. 8. Basal ganglia
  9. 9. Extrapyramidal surface of brain:
  10. 10. The cerebral cortex and the substantia nigra both project towards corpus straitum.
  11. 11. The corpus striatum(caudat e nucleus and putmen) projects into globus pallidus to thalamus and they regulates involuntary movement.
  12. 12.  The nigro striatal neurons make motor connections to corpus striatum by 2 types of neurons which contain D1 (excitatory) and D2(inhibitory) receptors.  The D1 (excitatory) are glutaminergic and D2 (inhibitory) are GABAminergic.
  13. 13.  D1=excitatory receptors= acetylcholine as transmitter=direct.  D2=inhibitory receptors=dopamine as transmitter=indirect.
  14. 14. WHAT HAPPENS IN PARKINSONISM? 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 degeneration.  The dopamine is deficient so D2 receptors are less stimulated. 
  15. 15. Dopamine deficiency
  16. 16. PICTURE SHOWING SUBSTANTIA NIGRA DEGENERATION. As the dopaminergic neurons have their cell bodies in substantial nigra. And as the corpus striatum receives dopamine from substantia nigra degeneration of these neurons causes decrease in the functional amount of dopamine.
  17. 17. So eventually Parkinsonism is due to imbalance between acetylcholine and dopamine.
  18. 18. Normal levels of dopamine and acetylcholi ne balanced.
  19. 19. SIGNS AND SYMPTOMS:  Tremor 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 body.  Slow limited movement i;e bradykinesia.  Insomnia and nightmares are seen at very early stage before tremor.
  20. 20. Person showing Parkinson's disease symptoms.
  21. 21. Weakness of face and throat muscles making it harder to talk or to swallow.  Difficulty with walking called gait instability and postural instability. 
  22. 22. COMPLICATIONS OF PARKINSON’S :  Depression and anxiety.  Sexual dysfunction  Sleep disorders.  Urinary incontience.
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