PARKINSONS DISEASE

: Management

PREDISPOSING FACTORS:
Age Gender
: Drug of choice

PRECIPITATING FACTORS:
Occupational exposure Air pollution Passive smoker

: Signs and symptoms

Basal ganglia affects the autonomic nervous system Excess and uncontrolled sweating, sebaceous gland, secretion and saliva Severe dehydration

Exposure to toxins such as manganese and carbon dioxide Dopamine loss in the other brain areas including the brainstem, thalamus, and cortex

Progressive death of cell in the substancia nigra and basal ganglia

Imbalance of dopaminergic (Inhibitory) and cholinergic (excitatory) in the caudate and putamine basal ganglia

Low blood volume Sudden drop in blood volume Hypovolemic shock Coma

Degeneration of the dopamine nigrostriatal pathway

Affects the autonomic nervous system

Dopamine depletion in the basal ganglia

Underactivity of the indirect motor pathway

Relative excess of cholinergic activity in the feedback circuit involving the cerebral, basal ganglia, and thalamus Overactivity of the indirect motor loops Inhibits movement Voluntary production of smooth motion at different speed

Degeneration of acetylcholine containing neurons in the region of nucleus basalis of meynert

Facilitates movement

Less production of cholinergic innervations of the cerebral cortex

>Ibuprofen >Naproxen >NSAIDS

Instatibility of feedback from the basal ganglia to the cerebral cortex

Involuntary muscle contraction of all skeletal Impedes passive and active movement

Dementia

Educating and providing emotional support Lowering hemocysteine Lowering cholesterol levels Lowering blood pressure Exercise Controlling inflammation

>decreasing or discontinuing a drug >More complex treatment needed. >physical >Beta blockers >Anticholinerg ic >Diazepam >Promidone

Oscillation in the normal feedback cycles of the cycles of the motor outflow feedback circuit

Impedes passive and active movement Rigidity

Failure of programming movement pattern Failure of programming movement pattern

Increase strength Proper education ROM Baclofen Zanaflex Neuronin Pantrium Optimize gait Improve balance Improve postural awareness

Tremor

Resistance to passive muscle stretching

Inc. tremor in the fingers during anxiety and stress Pill rolling Uniform (lead pipe rigidity) Jekrey (loop wheel)

Kamadrin Atropine Biperiden

Loss of balance Fatal fall

Bradykenisia Loss of postural and blinking reflexes

Akinesia Gait and movement disturbed

 Excessive blinking and spasm Uncontrolle d contraction or twitches of eye muscle Dryness of the eyes Sensitive to the sun and

Blepharospasm

Shuffling gait

Magnesiu m chloride Botulinus toxin

Loss of postural reflexes

Bulos cannot
propelled by the tongue to the throat Sensation of swallowed food is sticking Coughing choking

Shaking shills Chest pain Cough Nausea Vomiting Muscle ache Rapid heartbeat and breathing

Masklike facial expression

Difficulty swallowing (dysphagia) Aspiration of food in the lungs Pneumonia

penicillin naproxen acetaminophe n

Death

Fatal pulmonary condition