Parkinsons 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. Parkinsons disease was named for James Parkinson, a general practitioner in London during the 19th century who first described the symptoms of the disease.
Cont… There are three types of Parkinsons disease and they are grouped by age of onset: 1. Adult-Onset Parkinsons Disease - This is the most common type of Parkinsons 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 70s and 80s.
Cont…2. Young-Onset Parkinsons Disease - The age of onset is between 21-40 years old. Though the incidence of Young-Onset Parkinsons Disease is very high in Japan (approximately 40% of cases diagnosed with Parkinsons disease), it is still relatively uncommon in the U.S., with estimates ranging from 5-10% of cases diagnosed.3. Juvenile Parkinsons Disease - The age of onset is before the age of 21. The incidence of Juvenile Parkinsons Disease is very rare.
Pathophysiology and Etiology• Parkinsons 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 Parkinsons disease are caused by a lack of dopamine due to the loss of dopamine- producing cells in the substantia nigra.
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 Parkinsons disease no cause can be found for dopamine depletion.• The symptoms of Parkinsons disease are associated with exposure to environmental toxins such as insect sides and herbs sides.
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.
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.•
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
Diagnosis• Diagnosis based on typical symptoms and neurologic examination. There are no specific tests for this disorder
Treatment• There is no known cure for Parkinsons 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 Parkinsons disease include:
Cont… Lifestyle changes may be helpful for Parkinsons disease: Surgery may be an option for some patients with Parkinsons disease. These surgeries do not cure Parkinsons, 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 Parkinsons symptoms.• Stem cell transplant and other clinical trials are currently ongoing in the USA.
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