Parkinson's Disease.jpg
Parkinson's Disease 1892. Fixed Walking Posture.

Definition

[1]
Parkinson's Disease (also Parkinsonism) is a neurological condition causing tremor, rigidity and bradykinesia that results from a reduction in the neurotransmitter dopamine.

Prevalence

[2]
1%

Age

>65

Gender

1.5 times more likely in males

Aetiology

[3]

Risk Factors

[4]
  • Age
  • Family History

Signs and Symptoms

[5]

Pathophysiology

[6]
The pathophysiology of Parkinson's Disease is not well understood. Loss of dopaminergic neurons in the substantia nigra along with findings of Lewy bodies occurs. Loss of dopamine to the Basal Ganglia accounts for the presentation of motor symptoms. The basal ganglia are important in the selection of voluntary movements as well as the suppression of involuntary movements. Postural instability is likely due to abnormal postural correction reflexes

Investigations

[7]
  • Dopamine agent trial - improved symptoms

Diagnosis

[8]
Diagnosis is made clinically and confirmed with empirical treatment trial.

Differentials to rule out

Treatment

[9] [10]

Non-Pharmacological

  • Physical activity

Pharmacological

Surgical

  • Deep Brain Stimulation

Management

[11]
Patients should be followed up every 6 months to monitor the progression of the disease. They should be followed up by a movement disorder clinic, rehabilitation clinic, physiotherapy, dietician and district nursing services.

Complications

[12]

Prognosis

[13]
Parkinson's Disease is incurable and prognosis involves gradual progression of symptoms

See Also

Oxford Handbook of Clinical Medicine - 9th edition p498
BMJ Best Practice - Parkinson's Disease

Citation

1892 Parkinson's image: "Paralysis agitans-Male Parkinson's victim-1892" by Albert Londe (1858-1917) - http://ihm.nlm.nih.gov/luna/servlet/detail/NLMNLM~1~1~101435392~139330:-Paralysis-agitans---Male-Parkinson. Licensed under Public Domain via Commons - https://commons.wikimedia.org/wiki/File:Paralysis_agitans-Male_Parkinson%27s_victim-1892.jpg#/media/File:Paralysis_agitans-Male_Parkinson%27s_victim-1892.jpg
  1. ^ Oxford Handbook of Clinical Medicine - 9th edition p498
  2. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  3. ^ Oxford Handbook of Clinical Medicine - 9th edition p498
  4. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  5. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  6. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  7. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  8. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  9. ^ Oxford Handbook of Clinical Medicine - 9th edition p498
  10. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  11. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  12. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html
  13. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/147/follow-up/prognosis.html