Parkinsosn Disease
Parkinson Disease :PD
Parkinson's disease is a progressive neurodegenerative condition characterized by
the loss of dopamine-producing neurons in the substantia nigra of the brain.
It causes both motor and non-motor symptoms and is the world's second most
common neurodegenerative illness, after Alzheimer's.
§ loss of dopamine leads to --> Motor Neuron movemensts
Hallmark feature :-
• slowness (slow body movements )
• Stiffness in the limb
• affect one side of body more than other
Key Symptoms of Parkinson's Disease
A. Motor Symptoms (TR.A.P.)
§ Tremors: Typically a resting tremor (such as the "pill-rolling" movement).
§ Rigidity is muscle stiffness, sometimes known as "cogwheel" rigidity.
§ Akinesia/Bradykinesia: Slowness or lack of movement.
§ Postural Instability: Poor balance causes frequent falls.
B. Nonmotor Symptoms
§ Cognitive impairments include dementia, memory loss, and executive dysfunction.
§ Mood disorders include depression, anxiety, and apathy.
§ Autonomic Dysfunction: Constipation.
§ Sleep Disorders include REM sleep behavior disorder and insomnia.
§ Sensory symptoms include loss of smell (anosmia) and pain syndromes.
How to Differentiate PD from Alzheimer’s Disease
Parkinson’s Disease (PD): Alzheimer’s Disease (AD):
Motor symptoms predominate: tremors, It mostly impairs memory and
stiffness, and bradykinesia. cognitive processes.
speaking alterations include soft voice There were no motor symptoms early
(hypophonia) and monotonous speaking. on.
Cognitive decline is subcortical, impacting Pathology: The presence of beta-
problem solving and multitasking abilities. amyloid plaques and tau tangles.
The presence of Lewy bodies in neurons. Dopamine-based treatments have a poor
Improves with dopamine medication (for response rate.
example, Levodopa).
Medications for Parkinson's Disease
Main Medications:
1. Levodopa/Carbidopa (Sinemet):
§ Dopamine precursor; most effective for motor symptoms.
2. Dopamine Agonists (e.g., Pramipexole, Ropinirole):
§ Stimulate dopamine receptors.
3. MAO-B Inhibitors (e.g., Selegiline, Rasagiline)
§ Prevent dopamine breakdown.
4. COMT Inhibitors (e.g., Entacapone):
§ Extend the effect of Levodopa.
5. Amantadine:
§ Helps with dyskinesias (involuntary movements).
Surgical Treatments:
Deep Brain Stimulation (DBS):
It is the main types of surgery used in daignosis
of parkinson diease
Highly effectiove to improve motor movements
Pulse generator (pacemaker like) -placed under
the skin around the chest /stoamach area .
Electrodes implanted in the brain to reduce
motor symptoms when medication is insufficient.
Stages of Parkinson Disease
early stage Advanced Stage
Motor Symptoms: Motor Symptoms:
§ Mild tremors, usually unilateral (one side of the § Severe tremors, usually bilateral.
body). § Bradykinesia, which causes major movement
§ Slow movement (bradykinesia). difficulties.
§ Mild muscle stiffness or rigidity. § Movement is painful due to severe muscle rigidity.
§ Subtle alterations in posture or walking. § Postural instability might lead to frequent falls.
§ Freezing of gait (FOG) is the sudden inability to
Non-motor symptoms: move when walking.
§ Constipation. Non-motor symptoms:
§ Loss of smell (anosmia).
§ Sleep disturbances § Constipation and urinary problems
§ Cognitive deterioration, including memory loss and
Treatment : maybe dementia.
§ Medication frequently causes hallucinations or
Dopaminergic medicines, such as levodopa, or delusions.
dopamine agonists Treatment :
DBS is a surgical procedure to implant electrodes in
certain areas of brain to initiate neural activity by
sending electrical signals from pulse generator
