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PARKINSONS DISEASE
BY NAWA .M.S
• 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
• PROTECTIVE FACTORS
• caffeine
• cigarette
• nsaids
• use of calcium channel blockers
• 2.) GENETIC FACTORS
• HLA 6
• mutations in:
• SNCA
• GBA
• LRRK 2
• 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
• LRRK2
• tremor is more, typically leg tremor
• incomplete penetrance
• better prognosis
• SPINK1/PARKIN
• responsible for early onset and juvenile parkinsons disease
• PHYSIOLOGY OF
BASAL GANGLIA
• PATHOGENESIS
• Dopamine denervation
• ↑(INCRESED) firing of neurons in STN & GPi
• ↑(INCREASED) inhibition of thalamus
• ↓(DECREASED) activation of cortical motor system
• Development of Parkinsonian features
• 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)
• PARKISONS DISEASE TREATMENT (DRUGS USED IN
PARKISONS)
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
• 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...

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Parkinson's disease

  • 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
  • 7.
  • 8.
  • 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
  • 10.
  • 11.
  • 12. • 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)
  • 13.
  • 14. • PARKISONS DISEASE TREATMENT (DRUGS USED IN PARKISONS)
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20. 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
  • 21. • 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...