Parkinson's disease is caused by degeneration of nerve cells responsible for dopamine release in the brain. It causes difficulties with facial expressions, muscle stiffness, slowed movements, speech changes, and tremors. Parkinsonism is secondary to medications or head injuries. Diagnosis is based on clinical symptoms and tests like DaT-SPECT scans and MRIs. Treatment focuses on replacing dopamine through medications like levodopa, dopamine agonists like bromocryptine, and monoamine oxidase-B inhibitors like selegiline.

2. Parkinson’s disease and parkinsonism
• Parkinson’s disease: degeneration of nerve
cells responsible for dopamine release in
the brain.
• Parkinsonism: secondary to
1. side effects of medications
2. chronic head traumas (accidents/boxing)

3. Parkinson’s causes

4. Parkinson’s causes
Natural equilibrium between acetyl choline and dopamine
Acetyl choline is tool of parasympathetic
system and has receptors on autonomic
muscles( muscarinic) and skeletal muscles
(nicotinic)

5. Parkinson’s symptoms
• difficulty showing facial
expressions
• muscle stiffness
• slowed, affected
movements
• speech changes
• tremor, especially of one
hand

6. diagnosis
• Important to differentiate from peripheral
neuropathy.
• Based mainly on clinical symptoms.
• History of dementia or brain malfunction.
• test that tracks the movement of dopamine in
the brain. This is known as the DaT-SPECT test.
• MRI on mid brain.

7. Parkinson’s treatment
Dopamine
• Three main types of medication are commonly
used:
• levodopa
• dopamine agonists
• monoamine oxidase-B inhibitors

8. 1. levodopa
• Levodopa is absorbed by the nerve cells in
your brain and turned into the chemical
dopamine.
• Oral l- dopa

9. 1. levodopa
• Solution: levodopa + carbidopa combination
• Carbidopa is a dopa decarboxylase inhibitor.
• Dose: 300-600 mg/day (usually divided 3 or 4
times daily)

10. 2. Dopamine agonists
1. bromocryptine (Elonda®, Dostinex®) used for
hyperprolactinemia
2. ropinirole (Tremodect®) 3. pramipexole
( (Ramixole ®
(

11. 3. MOAIs
• They block the effects of an enzyme or brain
substance that breaks down dopamine
(monoamine oxidase-B), increasing dopamine
levels.
• Selegiline (parkineast® , Jumex® ),
• Rasagiline (Parkintreat® , dopaminect)

13. references
• https://davisphinneyfoundation.org/parkinsons-vs-
parkinsonism/
• https://scienceofparkinsons.com/2020/01/18/dormant/
• https://www.medicalnewstoday.com/articles/320601#treat
ments
• https://www.nhs.uk/conditions/parkinsons-
disease/treatment/#:~:text=Most%20people%20with%20P
arkinson's%20disease,and%20nerves%20that%20control%
20movement.
• https://www.medscape.com/answers/1831191-9932/what-
is-the-recommended-dosage-for-levodopa-and-a-dopa-
decarboxylase-inhibitor-in-the-management-of-parkinson-
disease-pd
• https://www.healthline.com/health/parkinsons-
disease/dopamine-agonist#how-they-work