Parkinson's disease is the second most common degenerative disease of the central nervous system. It typically occurs in older adults around age 60 and is more common in males. The disease is characterized by degeneration of dopamine-producing neurons in the brain and presence of Lewy bodies. The main symptoms include bradykinesia, resting tremor, and rigidity. Levodopa is the most effective treatment for motor symptoms, but its long term use can cause dyskinesia and other side effects. Deep brain stimulation is an effective surgical treatment for some patients. Overall, Parkinson's disease is a progressive neurodegenerative disorder involving the extrapyramidal system.

1. Parkinson disease
Dr Bhupendra Shah
Assistant Professor
B.P.koirala Institute of Health Sciences

3. Difference in life?

4. Man behind Parkinson disease

5. Epidemiology of Parkinson diseases
• Second commonest degenerative disease of
CNS
• Mean age of onset:60 years
• More common in male
• 85-90% occur sporadically

6. Patho-physiology

7. LEWY
BODY

9. Parkinsonism
Bradykinesia
Resting
tremor
Rigidity
Parkinsons disease is degenerative disease diagnosed if fulfilled 2 out of
3 cardinal features.

10. Clinical features of Parkinson disease
Other non motor features
• Micrographia
• Soft voice
• Masked facies
Non motor featues
• Mood disorders
• Sleep disorders
• Autonomic disturbances

11. Atypical Parkinsonism disease
• more widespread neurodegeneration
• Early speech ,gait impairment and no
response to levodopa.
• Eg:multisystem atrophy, progressive
supranuclear palsy.

12. Secondary parkinsonism
• Post-infectious
• Drugs

13. Management

14. Anti –Parkinsonian drugs:how they
work?
• Levodopa--dopadecaboxylase----dopamine…MAO-
B/COMT……….3OMD/HVA

15. Levodopa
• Converted to dopamine by dopa decarboxylase
Side effects
• Acute: nausea , vomiting, postural hypotension
• Chronic : dyskinesia, behavioral effects, wearing
off effect.

16. Classification of antiparkisonian drugs
• Pramipexole
• Ropinirole
Dopamine
agonist
• Seligilline
• Rasagilline
MAO-B
inhibitor
• Tolcapone
• Entacapone
COMT
inhibitor

17. Anti-Parkinsonian drugs

18. PARKINSON’S DISEASE
NON PHARMACOLOGICAL PHARMACOLOGICAL
NEUROPROTECTION;RASAGILINE
FUNCTIONAL DISABILITY
NOYES
LEVODOPADOPAMINE AGONIST
COMBINATION THERAPY
SURGERY /CDS

19. Surgical treatment
• Pallidotomy
• Deep brain stimulation

20. Deep brain stimulation

21. Newer experimental therapy

22. Take home message
• is a progressive neurodegenerative disease
involving extrapyramidal system.
• Resting tremor,rigidity and
hypokinesia:classical symptoms
• Levodopa is a drug of choice .

23. Thank you