1.) Provides understanding of clinical knowledge of neurodegenerative disorders (parkinson's disease). 2.) To help health professionals to be to identify parkinson's disease 3.) Gives an understanding of the development of parkinson's disease and it's effects as well as treatment. 4.) Also help health professionals in research to gain more understanding of parkinson's disease.

1. PARKINSONS DISEASE
BY NAWA .M.S.

2. • INTRODUCTION
• 2nd Most common age related neurodegenerative disease
• Mean age of onset ~60 yrs
• Frequency increases with age
• Lifetime risk:~3% for Men and ~2% for Women
• risk factors
• 1.) ENVIRONMENTAL FACTORS
• exposue to MPTP
pesticide exposure
• rural living
• farming
• drinking well water

3. • PROTECTIVE FACTORS
• caffeine
• cigarette
• nsaids
• use of calcium channel blockers
• 2.) GENETIC FACTORS
• HLA 6
• mutations in:
• SNCA
• GBA
• LRRK 2

4. • SNCA
• leads to:
• early age of onset
• faster progression of symptoms
• patients are responsive to levo dopa
• prominent cognitive impairment
• maybe a prion
• GBA
• imports protein glucocerebrosidase
• if decreased, it leads to impaired lysosomal function
• leads to increased activity of SNCA

5. • LRRK2
• tremor is more, typically leg tremor
• incomplete penetrance
• better prognosis
• SPINK1/PARKIN
• responsible for early onset and juvenile parkinsons disease

6. • PHYSIOLOGY OF
BASAL GANGLIA

9. • PATHOGENESIS
• Dopamine denervation
• ↑(INCRESED) firing of neurons in STN & GPi
• ↑(INCREASED) inhibition of thalamus
• ↓(DECREASED) activation of cortical motor system
• Development of Parkinsonian features

11. RESTING TREMOR(play slide)

12. COGWHEEL RIGIDITY(PLAY SLIDE)

13. AKINESIA/BRADYKINESIA(play slide)

14. POSTURAL INSTABILITY(play slide)

15. SHUFFLING GAIT(play slide)

16. MICROGRAPHIA
• definition: Abnormally small hand writting

18. • PATHOLOGY
• HALL MARK FEATURES INCLUDE:
• Degeneration of dopaminergic neurons in SNPC
• Reduced striatal (Caudate nu. + Putamen) dopamine
• Intraneuronal inclusions stain for alpha-synuclein (Lewy Bodies)

20. • PARKISONS DISEASE TREATMENT (DRUGS USED IN
PARKISONS)

26. REFERENCES
• HARRISON’S MANUAL OF MEDICINE(20TH EDITION) BY
FAUCI, E’TAL..
• KUMAR AND CLARK’S CLINICAL MEDICINE(10TH EDITION)
BY PROFESSOR DAME PARVEEN J KUMAR, E’TAL..
• STEP UP TO MEDICINE(5TH EDITION) BY STEVEN AGABEGI
• NEUROLOGY PART 3 BY DR SHUBHAM UPADHYAY
• PATHOMA-FUNDAMENTALS OF PATHOLOGY(1ST EDITION)
BY HUSAIN A. SATTAR

27. • I KNOW YOU ARE TIRED KAH
• DO NOT WORRY, YOU WILL ONLY
REST IF YOU ARE ABLE TO LICK YOUR
ELBOW WITH YOUR TONGUE,
OTHERWISE LOVE THE MEDICINE.
• THANK YOU...