Parkinsonism disorder

1. Parkinsonism
Prepared BY:
Mohammed Tareq Aziz
Student’s ID: 201611227027
Batch No: 27th
Department of Pharmacy,
Bangladesh University,
Iqbal road, Mohammadpur,
Dhaka-1207, Bangladesh.

2. 1
Index
S/N Content Page no.
00 Parkinsonism 01
01 Different form of parkinsonism 01
1.1 Multiple system atrophy (MSA). 02
1.2 Progressive supranuclear palsy (PSP) 02
1.3 Normal pressure hydrocephalus 03
1.4 Vascular or arteriosclerotic parkinsonism 03
1.5 Drug-induced parkinsonism 03
2.0 Signs & symptoms of parkinsonism
03
3.0
Etiology of parkinsonism
04
4.0
Diagnosis of parkinsonism
04
4.1
Investigating symptoms.
04
5.0 Treatment & management of parkinsonism 05
5.1 Other steps can be taken 05

3. 2
Parkinsonism
Parkinsonism is an umbrella term used to cover a range of conditions.
These conditions include the symptom of slow movement, sometimes with
tremor, rigidity and problems with walking.
Or, Parkinsonism is a clinical syndrome characterized by tremor,
bradykinesia, rigidity, and postural instability. It is found in Parkinson's
disease (PD), it is a movement disorder that involves disfunctions in the
basal ganglia and the related brain structures.
It is also called
 Parkinson’s Syndrome.
 Atypical parkinson’s
 Secondary Parkinson’s
(01)Different forms of parkinsonism
Most people with a form of parkinsonism have idiopathic Parkinson’s
disease, also known as Parkinson’s. Idiopathic means that the cause is
unknown.
Forms of parkinsonism that are currently recognised, other than
Parkinson’s, include the following:
(1.1) Multiple system atrophy (MSA).
Both multiple system atrophy and Parkinson’s cause stiffness and
slowness of movement in the early stages. People with multiple system
atrophy can also develop symptoms such as incontinence, difficulty with
swallowing and dizziness.
(1.2) Progressive supranuclear palsy (PSP)
Progressive supranuclear palsy affects eye movement, balance,
mobility, speech and swallowing. It is sometimes called Steele-Richardson-
Olszewski syndrome.

4. 3
(1.3) Normal pressure hydrocephalus
The symptoms of normal pressure hydrocephalus mainly affect the
lower half of the body. The common symptoms are walking difficulties,
urinary incontinence and memory problems. Removing some cerebrospinal
fluid can help with these symptoms in the short term.
If there is improvement after this procedure, an operation to divert the
spinal fluid permanently (known as lumbar puncture) can help in the long
term.
(1.4) Vascular or arteriosclerotic parkinsonism
Vascular parkinsonism affects people with restricted blood supply to the
brain, usually older people who have problems such as diabetes. The
symptoms of vascular parkinsonism are often the same as normal pressure
hydrocephalus (above), but they can’t be improved by lumbar puncture.
Some people with vascular parkinsonism may swing their arms less than
those with Parkinson’s. Sometimes, people who have had a stroke, often
one so mild that they didn’t notice it, may experience this form of
parkinsonism.
(1.5) Drug-induced parkinsonism
Some drugs can cause a form of parkinsonism, which is usually
reversible.
(02)Signs & symptoms of parkinsonism
 Slowness of the movement (bradykinesia)
 Resting tremor
 Unsteady gait
 Rigidity
 Muscle stiffness
 Masked face
 Walking difficulties
 Speech problems
 Swallowing difficulties
 Constipation
 Limb pain
 Depression
 Dementia

5. 4
(03)Etiology of parkinsonism
Not everyone who has parkinsonism has Parkinson's disease.
There are many other causes of parkinsonism (secondary
parkinsonism), including:
 Medications, such as those used to treat psychosis, major psychiatric
disorders and nausea
 Repeated head trauma, such as injuries sustained in boxing
 Certain neurodegenerative disorders, such as multiple system
atrophy, Lewy body dementia and progressive supranuclear palsy
 Exposure to toxins, such as carbon monoxide, cyanide and organic
solvents
 Certain brain lesions, such as tumors, or fluid buildup
 Metabolic and other disorders, such as chronic liver failure or Wilson's
disease
(04)Diagnosis of parkinsonism
There is no definitive test to detect Parkinson’s disease or parkinsonism.
For diagnosis, doctors take a thorough medical history and may request a
number of movement tests. Because of the observational nature of the
diagnosis, Parkinson’s can sometimes be confused with parkinsonism
You should be referred to a Parkinson’s specialist for diagnosis. They
will look at your medical history, carry out a detailed neurological interview
and medical examination.
(4.1) Investigating symptoms.
Specialists who see a lot of people with parkinsonism may notice
unusual symptoms that lead them to diagnose a form of parkinsonism that
is not Parkinson’s. But differentiating between types of parkinsonism is not
always easy, because,
 The first symptoms of the different forms of parkinsonism are so
similar.
 In many cases, parkinsonism develops gradually. Symptoms that
allow your doctor to make a more specific diagnosis may only appear
as your condition progresses.
 Everyone with parkinsonism is different and has different symptoms

6. 5
(05)Treatment & management of parkinsonism
 For drug-induced parkinsonism, discontinuing the medications that
cause the condition may reverse it.
 For other forms of parkinsonism, taking Parkinson's disease
medications typically a carbidopa-levodopa combination drug (Sinemet,
Duopa, Stalevo) can help.
However, these drugs are n' t likely to be as effective for some forms
of parkinsonism as they are for Parkinson's disease. Levodopa which
occurs naturally in the body and is always taken as a combination drug
replenishes brain dopamine, and brain dopamine loss is fundamental to
Parkinson's disease. However, in other parkinsonian disorders,
additional brain pathways may be affected.
(5.1) Other steps can be taken
Certain lifestyle changes also may help you cope with parkinsonism.
 Stay physically active. To the extent you're able, try to sustain your
normal daily activities, exercise regularly, and incorporate physical and
occupational therapy as needed.
 Create a safe environment. If gait and balance become impaired,
consider modifying your environment. For example, install grab bars
next to your toilet or in your shower; remove obstacles, such as throw
rugs; and keep frequently used items within reach.