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1、Parkinson’sDiseaseDr.YahyaIbnIliasParkinson’sDiseaseParkinson’sdisease(PD)istypicallyconsideredachronic,progressiveneurodegenerativemovementdisorder.AKA“theshakingpalsy”.FirstdescribedbyBritishdoctorJamesParkinson.Characterizedbyneuronalaccumulationofthepresynapticproteinα-sy
2、nuclein.However,itisnowknowntohavevarietyofnonmotorsymptomsaswell.EtiologyIdiopathic—majorityofcasesGeneticDruginduced:ClozapineToxinsHeadTraumaCerebralAnoxiaCOREBIOCHEMICALPATHOLOGYDecreaseDOPAMINEneurotransmissioninBASALGANGLIA.MostPDhavedegenerationoftheNIGROSTRIATALDOPAMI
3、NESYSTEMwithmarkedlossofstriataldopamin.Insomecases,striataldegenerationwithlossofDopaminereceptorsoccurs.PathophysiologyDecreasedstimulationofthemotorcortexbythebasalganglia,usuallyduetotheinadequateproductionandactionofdopamine(producedinthedopaminergicneuronsofthebrain.)Th
4、especificregionaffectedseemstobetheparscompactainthesubstantianigrawherethereisamarkedlossindopaminergiccells.WealsoseeaconsiderablyhighactivityinthecellsoftheSubthalamicnucleus,whichinhibitsmovement.HighpresenceofLewybodiesindopaminergiccells.Dopamineisresponsibleforthetrans
5、missionofsignalsassociatedwithsmooth,controlled,muscularactivityfromthesubstantianigratothecorpusstriatum.PD“occurs”whentheseneuronsdieorfailtofunctionproperly.Withoutenoughdopamine,neuronsinthecorpusstriatumdonotfunctionintheusualcoordinatedmanner.Theresultisaninabilitytodir
6、ectorcontrolthebody’smovementsnormally.AlthoughtheetiologyofParkinsondiseaseisstillunclear,mostcasesarehypothesizedtobeduetoacombinationofgeneticandenvironmentalfactors.EnvironmentalfactorsIncludeuseofpesticides,livinginaruralenvironment,consumptionofwellwater.MPTP(methyl-phe
7、nyltetrahydropyridine)interferencewithmitochondrialfunction.GeneticfactorsGeneticmutationcausessynthesisofmisfoldedprotein.ClinicalFeaturesAdiagnosisofPDcanbemadeinpatientswhopresentwithatleasttwoofthethreecardinalsigns:ResttremorRigidityandBradykinesia.Tremorisparticularlyim
8、portant,asitispresentin85%ofpatientswithtruePD.Difficulttodiagnosisw
