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Parkinson's Disease is a disorder of the nervous system that occurs most commonly in the middle-aged and elderly, although approximately 10 percent of sufferers are under age 40. Parkinson's disease is progressive with symptoms become worse over time. But although Parkinson's may eventually be disabling, the disease often only progresses gradually. The main characteristic of Parkinson's Disease are:

Tremors, or the involuntary and rhythmic movements of the hands, arms, legs and jaw, is a primary feature.

Muscle rigidity, or stiffness of the limbs, occurs in all muscle groups but is most common in the arms, shoulders or neck.

Gradual loss of spontaneous movement, which often leads to a variety of problems such as “freezing”, decreased mental skill or quickness, voice changes, decreased facial expression.

Gradual loss of automatic movement, including eye blinking and decreased frequency of swallowing.

Unsteady walk (bradykinesia).

Impaired speech.

Difficulties in swallowing, but only common as the disease progresses.

Associated Features:

People with Parkinson's may also suffer from any of a long list of associated symptoms however it is important to note that different patients experience different symptoms.

Depression
Dementia
Sleep Disturbance
Speech Problems
Sexual Problems

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Dementia

Cause:

The cause of Parkinson's remains unknown. However, theories involving oxidative damage, environmental toxins, genetic factors, and accelerated aging have been put forward by researchers as potential causes for the disease. There are also a number of drugs which can emulated Parkinson's if taken excessively or over extended periods of time. These include:

Haloperidol (Haldol, Halperon)
Chlorpromazine (Thorazine, Sonazine),
Compazine
Compro
Valproate (Depacon)

Treatment:

Parkinson's disease is treatable. The drug levodopa, commonly known as L-dopa, has been the main treatment in the past. L-dopa however, can cause side effects, and tends to become less effective when taken for prolonged periods.

Counseling and Psychotherapy [ See Therapy Section ]:

Cognitive Behavioral Therapy may be used to assist in establishing coping patterns to overcome some of the symptoms of Parkinson's. However this will only give only a temporary solution.

Pharmacotherapy [ See Psychopharmacology Section ] :

Besides levodopa the following drugs are being utilized in Parkinson's treatment:

Amantadine
Bromocriptine
Pergolide
Pramipexole
Ropinirole
COMT Inhibitors
Selegiline
Trihexyphenidyl
Benztropine

Direct Medical Procedures involve:

Deep Brain Stimulation:

The brain is stimulated using small electrodes implanted in the brain. These electrodes are connected to a small devise which generates a pulse sending continuous, high frequency electrical stimulation to the brain via the implanted electrodes, positioned in the thalamus. This form of stimulation helps control messages in the brain, thereby suppressing tremor.

Thalamotomy:

In thalamotomy, a radiofrequency energy current is used to destroy a small, but specific, portion of the thalamus. The objective is to permanently stop tremors by placing a small lesion in a specific nucleus of the thalamus.
  

 


DSM Code

294.1x Dementia Due to Parkinson's Disease

G20 Parkinson's Disease

Disorder Sheets

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Recommended Book

Parkinson's Disease: A Complete Guide for
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