Parkinson Disease Presented by S .M.Homam

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Parkinson DiseasePresented by S .M.Homam
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Famous Faces of Parkinson
Michael J. Fox
Katharine Hepburn
Muhammad Ali
Mao Tse Tung
Pope John Paul II
Johnny Cash
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PARKINSONS DISEASE

• WHAT IS IT?
• WHAT ARE THE CAUSES?
• WHAT AFFECTS DOES IT HAVE ON THE BODY?
• ARE THERE ANY TREATMENTS AVAILABLE?
• WHO IS AT RISK OF DEVELOPING THE DISEASE?
• These questions, and more, will be answered in
  this presentation

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WHAT IS IT?

• Parkinsons Disease (PD) affects the brains
  ability to produce dopamine.
• Dopamine is a chemical messenger responsible for
  transmitting signals within the brain.
• Loss (or low levels) of Dopamine causes the
  Brains critical nerve cells (in the substantia
  niagra) to fire out of control. This is why
  patients have sporadic muscle movements.

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Dopamine Pathways in the Brain
Red arrows functional suppression Blue arrows
normal function

• Courtesy of Wikipedia.org

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Mechanism

• . ACH DOPA
• ACH DOPA
• 
  ACH
  DOPA

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What causes PD?

• The exact cause of PD is not known, but most
  researchers believe that it is a combination of
  both environment and genetic factors.
• Environmental toxins
• Incidences seem to vary by geographical
  locations. For example, more cases are reported
  in locations where certain pesticides and
  transition-series metals are present.
  Wikipedia.org

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What causes PD?

• Other risk factors
• Head trauma sufferers are 4 times more likely to
  develop PD than those without head traumas. (J.H.
  Bower study)
• Antipsychotic medications can induce symptoms of
  PD by lowering dopamine levels.

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SYMPTOMS OF PD

• MOST-COMMON SYMPTOMS
• Tremors
• Rigidity
• Slowness of Movement
• Postural Instability
• It should be noted that symptoms usually
  increase in severity over time.

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SYMPTOMS OF PD

• TREMORS
• Maximal during muscular rest
• Minimal during muscular movement
• Uncontrollable
• Sporatic

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SYMPTOMS OF PD

• RIGIDITY
• Increased muscular tone, which leads to
  stiffness.
• The muscles become inflexible, or rigid

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SYMPTOMS OF PD

• POSTURAL INSTABILITY
• Muscular rigidity leads to inflexibility, which
  leads to the body having difficulty maintaining a
  fully-erect posture.
• This impaired posture leads to balance problems,
  and an increase in falls.

Photo courtesy of Wikipedia
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LESSCOMMON SYMPTOMS OF PD

• The following symptoms have been reportedly
  linked with Parkinsons Disease. However, they
  seem to occur with less frequency as the ones
  listed prior.
• Shuffling gait (short, quick steps, with the feet
  barely lifting from the ground)
• Decreased arm swing
• Speech problems
• Swallowing Chewing disturbances
• Mood disturbances (Depression)
• Sleep disturbances (possibly due to muscle
  movements during REM sleep)
• Skin Problems
• Urinary Intestinal disturbances

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DIAGNOSIS OF PD

• Diagnosing PD can be difficult due to the nature
  of the disease.
• Blood tests currently are not available for
  diagnosis.
• Advanced testing needs to be performed for
  accurate evaluation of symptoms. One such test is
  known as the PET.

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PET scan Parkinson's Disease
A PET scan can show patterns in the brain which
aid the physician in diagnosing and treating
Parkinson's Disease. wikipedia.org
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TREATMENT OF PD

• Unfortunately, there isnt currently a cure for
  PD. Although, several organizations are working
  diligently to provide a medical breakthrough.
  (thru stem cell research)
• Consequently, drug therapy is the only current
  therapy available to PD sufferers.

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TREATMENT OF PD

• 1.L dopa
• 2-anticholinergic
• 3-amantadin
• 4-selegeline
• 5-dopamin agonists

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PD TREATMENT

• 1-LEVODOPA is the most-widely used form of
  treatment for PD. Levodopa is transformed into
  Dopamine in the affected neurons.
• While this treatment is good in some ways, it
  also has a variety of side affects. Not all of
  the Dopamine is taken in by the affected area.
  Consequently, it is delivered to other areas of
  the body.

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PD TREATMENT

• CARBIDOPA Is another drug that is used in PD
  treatment.
• Works by slowing the bodys conversion of
  Levodopa to Dopamine. This helps aid the uptake
  of Dopamine to affected cells, thus decreasing
  the amount of Dopamine secreted to other areas of
  the body.
• Consequently, this process usually leads to a
  decrease in side affects.

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2-Amantadin

• AvailableCap 100 mg
• Mechanism Dopami. Agonist-anti.cholin
• Doseage one to 2 Cap daily
• Adventagefirst line drug-decres dose of L Dopa
• DisadventagesLivedo reticularis-Vomiting-nausea

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3-Anticholinergics

• AvailableBipiridine-artan 2 mg
• Mechanism anti.cholinergic
• Doseage one to 2 Tab daily maximum 8 mg
• Adventagereduce tremor
• DisadventagesHypotension/glaucoma/reduce
  memory/BPH/salivation
• Never use after 70 yers what
• Antidepressant

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4-Selegeline

• AvailableTab 5 mg
• Mechanism MAO inhibitor
• Doseage one to 2 Tab daily
• AdventagePreventsa progress of PD
• DisadventagesArythmia/dizziness/vomiting

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5-Dopamine agonists

• Available 1-bromocrip tine 5mg
• 2-pramipexoloe.18-.7 mg
  
  
• 3-requipe.25-1 mg
• Mechanism Dop agonist
• Doseage one to 2 Tab daily
• AdventageLowering dose of l dopa/reduce
  Dyskinesia
• Disadventagesvomiting/lower BP

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6-Others

• 1-Never use D2 Antagonists
• 2-Cisapride for constipation
• 3-Ssris and tricyclics
• 4-low meat
• 5-Falling
• 6- Eff tab Vitc

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PD TREATMENT

• THALAMOTOMY Surgical destruction of the
  thalamus.