PARKINSON’S DISEASE

By:

AARUSHI JAIN

AMRUTA KAMBLE

ANNETT MARY JACOB

AVANTI DEO

M.Sc. PRIST (09-11)

HISTORY• It is referred to as Kampavata in the ancient

Indian medical system of Ayurveda.• In Western medical literature it was described

by the physician Galen as "shaking palsy“ in AD 175.

• In 1817, a detailed medical essay was published by London doctor James Parkinson.

• In 1960s, the chemical differences in the brains of Parkinson's patients were identified.

INTRODUCTION

PARKINSON’S DISEASE is a brain disorder which occurs when neurons in the Substantia nigra die or become impaired.

These cells produce a vital chemical known as “DOPAMINE”

DOPAMINE allows smooth, co-ordinated function of the body’s muscles and movement

Parkinson’s symptoms appear when 80% of dopamine producing cells are damaged.

EPIDEMIOLOGY• Average incidence is 20 per 1,00,000 in North

America

• 1 million affected in United states

• 50,000 new cases per year

• Cost estimated to exceed $5.6 Billion annually

• Men and Women affected equally

SYMPTOMSMajor symptoms

• Tremor

• Rigidity

• Bradykinesia

• Postural instability

• Difficulty with balancing

Other symptoms• Small, cramped handwriting

• Stiff facial expression

• Shuffling walk

• Muffled speech

• Depression

RISK FACTORS

• Genetic factors

• Age

• Exposure to environmental toxin

• Reduced estrogen levels

CAUSES

Combination of several factors including• Free radicals • Accelerated aging• External or internal toxins• Genetic predisposition• In rare instances,viral infection• Certain health disorders • Poor nutrition

PATHOPHYSIOLOGY

• Imbalance of dopamine and acetylcholine

• Loss of 80% to 90% of dopaminergic production in the substantia nigra

• Lewy bodies

PROGNOSIS AND COMPLICATIONS• Pneumonia• Urosepsis• Hip fractures 27% life time risk• Falls –brain trauma• Malnutrition 4 times more likely to have 10

pound weight loss• 2-3 fold increase in early mortality which

depends on duration, age and presence of dementia

STAGES Stage Description

0 No clinical signs evident

I Unilateral involvement

II Bilateral involvement but no postural abnormalities

III Bilateral involvement with mild postural imbalance on examination or history of poor balance or falls; patient leads independent life

IV Bilateral involvement with postural instability; patient requires substantial help

V Sever, fully developed disease; patient restricted to bed or wheelchair

MANAGEMENT GENERAL:• Nutrition

• Exercising

• Performing activities

• Complementary therapies

• Finding support

MEDICAL: Based on the severity of symptoms and their

impact on quality of life.

• Levodopa with Carbidopa

• Levodopa with benserazide

• COMT inhibitors

• Dopamine agonists

CASE STUDY

Female, Age 66 years, Parkinson's Disease This 66-year-old female noticed the onset of Parkinson's symptoms, including rigidity, jerky movements, and loss of hand coordination, at 58 years of age. Other health complaints included neck pain, hand numbness, low back pain, and sciatica. During her initial evaluation, her most severe Parkinson's symptoms included loss of motivation, poor handwriting, difficulty swallowing, slurred speech, difficulty turning in bed, loss of facial expression, rigidity in her neck, arms, and legs, and bradykinesia. After upper cervical care, this subject reported complete correction of neck pain, substantial reduction in rigidity, and a decrease in low back pain and sciatica. She also reported improved ability to turn in bed, improved flexibility in her neck, arms, and legs, and improved movement overall

The Effects of Vitamin D and Bone Loss in Parkinson's Disease (PDVD)

• Verified by Memorial Medical Center, October 2009• First Received: May 22, 2009 Last Updated: October 13, 2009 • Sponsor: Medical Center • Collaborator: Department of Defense• Information provided by: Memorial Medical Center• ClinicalTrials.gov Identifier: NCT00907972

Condition - Parkinson Disease

Intervention - Dietary Supplement: Vitamin D3 Other: Placebo

Phase - Phase II

CONCLUSION• Although Parkinson’s disease was first described almost

two centuries ago, it is only recently that we have begun to understand the complex nature of the functional deficits.

• The pace of discovery is quickening.

• The development of new technologies such as the use of stem cells and viral vectors in its treatment.

• With advanced treatment and better understanding about Parkinsonism, there is hope for patients in nearby future.

World Parkinson's Day Is Held Annually on

April 11th

•http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.html

•http://www.nlm.nih.gov/medlineplus/parkinsonsdisease.html

•http://www.holisticonline.com/remedies/parkinson/pd_home.html

• http://www.parkinson.org

REFERENCES