Part Of Health Life

Parkinson's disease

definition

abnormalities of the brain benefits that were due to progressive degenerative system with respect to system aging in cells - cells substantia nigra pars compacta (snc) and the characteristic tremor is characterized by breaks, muscle and joint stiffness (rigidity), slowness of motion and speech (bradykinesia), and instability upright position (postural insability).




etiology

genetic factors
environmental factors
age (aging system)
race
kranioserebral injury
emotional stress


classification

Primary or idiopathic

unknown triggers
some of these are Parkinson's disease
there comes the role of environmental toxins
no role genetic factors, sporadic form

Secondary or akuisita

develop after exposure to a disease / agent
infection and post-infection of the brain (encephalitis)
critically exposed by toxins like manganese, carbonmonoksida, cyanide, and others - others
side effects of dopamine receptor inhibitors (some of the anti-psychotic drugs), and drugs that reduce dopamine reserves (reserpine)
post-stroke (vascular)
Other - Other: hypothyroid, hipoparatiroid, tumor / brain trauma, normal pressure hydrocephalus

Parkinson's plus syndrome

Parkinson signs arise concurrently neurolig signs another progressive like supraneural palsy, multiple system atrophy, cortical - basal ganglionic degeneration, parkinsonism - dementia - als complex of guam, palidal progressive atrophy, diffuse Lewy body disease (dlbd).

revealed degenerative disorders (disorders heredodegenerative)

signs of parkinsonism accompanies disease - a disease thought to be associated with other neurological diseases heredity as an etiologic role, like Alzheimer's disease, wilson disease, hutington disease, frontotemporal dementia on chromosome 17q21, time - linked dystonia parkinsonism.

primary parkinsonism
secondary parkinsonism, because:

post-encephalitis virus
Another post-infection, syphilis meningovascular example, tuberculosis, atherosclerosis.
iatrogenic or drug induced, for example drugs - drugs known as phenothiazines, reserpine, tetrabenazin.
toxic, for example due to carbon monoxide intoxication, karbondisulfida, manganese, cyanide.
others - others, for example due to post-traumatic cerebral hemorrhage petekial repeated - repeated on boxers, lacunar infarction, cerebral tumor, hipoparatiroid, calcification.

paraparkinson syndrome

risk factors

brain aging system
oxidative stress
exposure to pesticides / herbicides or anti fungal long enough
infection
caffeine
alcohol
head trauma
depression
smoke


clinical picture

overview

signs began on one side (hemiparkinsonism)
tremor breaks
not obtained other neurological signs
found no laboratory abnormalities and radiological
slow changes
rapid response to levodopa and dramatic
postural reflex problems not found in early disease

specific picture

 tremor; latent, rest periods, rest periods survive, when there is motion in addition to tremor time off.
rigidity
akinesia / bradykinesia ; wink shrink, face like a mask, hipofonia (small pitch), saliva dripping, akathisia / takikinesia (fast motion is not monitored), mikrografia (note the smaller), small step goes a step - a small, motor restlessness ( difficulty sitting or standing).
loss of postural reflexes

tremor: resting tremor (rest tremor) is a typical sign of a very clear, there are often early in the disease, and easily identified by the patient or his family own. The rest tremor rough shape (approximately 4 cycles / sec), as well as movements like scavenged pills (pill-rolling) or calculate money like metal. tremor of the extremities can be initiated only at the beginning of the signs and can spread to the rest of the body (arms, jaw, tongue, eyelids, limbs) are also much less tone. tremor may disappear when the muscle relaxation with the whole or do voluntary movement. Physical and emotional factors may trigger the emergence of this tremor. there is another type of tremor with a frequency of 7-8 cycles / min. not like that 4 cycles / min, the tremors could continue to exist on voluntary movement and is not associated with the rest of the parts of motion (not just rest tremor) and more easily lost in muscle relaxation position. the patient may show signs of the 2nd tremor or just in between.
rigidity: stiffness, increased muscle tone. combined with rest tremor, rigidity led to the phenomenon of the cog-wheel driven by passive limb time. This subject is also very clearly be felt by step mempalpasi muscle relaxes patients especially in situations
bradykinesia / akinesia: the reduction or absence of movement though. rapid movements, repetitive movements produce something disritmik and reduction movement capabilities.
postural instability (postural instability): a lack of postural reflexes to cause a sense of balance and falling pingin

diagnosis

requirements of the clinical diagnosis

2 of 3 marks obtained cardinal motor problems: tremor, rigidity, bradykinesia, or
tida of 4 motor signs: tremor, rigidity, bradykinesia, postural instability

the diagnosis requirement modifications

diagnosis of possible (maybe)

any of the signs: tremor, rigidity, akinesia or bradykinesia, postural reflex problems.
sign - a sign of minor help towards possible clinical diagnosis: Myerson sign, disappearing or shrinking of the swing arm, grasping reflex.

diagnosis of probable (most likely)

combination of the two signs mentioned above (as of postural reflexes problem), among the signs of the first three asymmetric

definite diagnosis (of course)

each combined 3 of 4 signs. Another option: two each with one of the three first signs appear asymmetric.

Koller diagnosis requirements

2 of 3 marks obtained cardinal motor problems: resting tremor or postural reflex problems, rigidity, bradykinesia running 1 year or more
response to levodopa therapy are obtained through refinement middle (minimal. 000mg/hari throughout the month.), as well as repair old or older

Gelb diagnosis requirements

diagnosis of possible (maybe)

there are 2 of the 4 cardinal signs (resting tremor, bradykinesia, rigidity, asymmetric onset). no picture toward other diagnoses accounted hallucinations unrelated to drugs, dementia, supranuclear gaze palsy or disotonom. had a good response to levodopa or dopamine agonists.

diagnosis of probable (most likely)

there are 3 of the 4 cardinal signs, no signs that point to other diagnoses within 3 years, there is a good response to levodopa or dopamine agonists

definite diagnosis (of course)
probable withdrawal coupled with positive histopathologic control.