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Parkinson was first discribed by this man in 1817 and he wrote an essay called "The Shaking Palsey"
the test he did was drawing back blood from the neck |
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| Age group that is striked in parkinsons |
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| how many new cases a year/ how many are living with PD? |
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| What is the disease deficient in? |
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| Dompamine dificiency disease |
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| inhibitory impact on cells 80% of domapine neurons are loss, the neurons are constantly firing when they should not be. patient can not direct movement. |
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| there is a loss of these in the substantia Nigra of the basal ganglia |
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| Where can Lewy bodys be found? |
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| these can be found in catecholaminergic neurons but also in other neuronal populations. also can be found in the cerebral cortical neurons and in certain cholinergic regions |
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| Diffuse Lewy Body Disease |
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| when the number of the Lewy bodys in the cortex are considerable and patient present with dementia, they are diagnosised with this? |
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| the substantia Nigra transmit signals to this next relay station. |
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individuals with PD also lose nerve endings that produce this neurotransmitter, which is closely related to dopamine
it is a chemical messenger of the SNS that controls autonomic body function. |
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| Drugs that cause PD symptoms |
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Regian- given for nausea and vomiting
compazine
some hypertensives (thorozine)
MPTP |
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| when people take this drug, it can cause irreversible parkinsons diease |
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| Environmental exposures linked with PD |
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manganese- welding dust
cyanide
chronic carbon monoxide
pesticides
herbicides |
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| PD, Alzheimers, Huntington and ALS |
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| theses diseases all share the same problems- aggrestion and accumulation of abnormal proteins. the inclusions and locations are different but all seem to have the same underlying problem |
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| this his an inhibitory effect on movement while the cerebellum's effect is excitatory, in PD one loses the inhibitory effect on movement. |
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| what has an excitatory affect |
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| what percent of all excitatory synape are stimulated by neuron transmitter glutamate |
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| this plays a big role during learning of new things and pulling up memories of long term and short term--increased levels of this |
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| Over stimulation(glutamate) and Lack of dopamine |
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| the main things in Parkinsons disease |
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| These are usually found pos mortem, and are clumps of proteins. They can be seen in the substantia Nigra, and cerebral cortex |
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| Chromosome 3-aceruloplasminemia-mutation of ceruloplasmin gene |
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| Ceruloplasmin helps remove iron from cells normally; but defects can lead to iron deposits that can result in parkinsons |
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| Chromosome 4 and the alpha synuclein gene |
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| these genes give directions, some familes have 3 copies of this gene and higher incidence of developing this disease |
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| this is seen in east Europe Jewish people, can be a defect in another gene that occurs in basil ganglia area |
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| These are the 4 cardinal clinical manifestations |
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| tremor at rest, rigidity, Bradykinesia, Postural instability |
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| caused by loss of inhibitory influence of dopamine (most recognizable and less disabling) in hands, pill rolling, these decrease when diease progress |
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involentary contraction of all skeletal muscles. are very jerky movements, short, start complaining of cramping and stiffness, pain, impedes active and passive movement. May start unilaterally and move bilaterally
increase as disease progresses |
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| slowness of movement, very disabling, what causes the most deaths, very wooden and stiff,hard time swallowing and patiet eventually has no movement at all |
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change in balance and equilibrium
biggest thing is safety- take short steps and don't swing arms when stepping
biggest predictor is if they have fallen before. |
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| short, acelerted steps to maintain upright position |
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| some other symptoms of parkinsons |
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| impairment of manual dexterity, visual abnormalities, dysphagia, freezing, pain, tired, sleep disorder |
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| bilateral with postural instability |
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levadopa/carbidopa- sinemet: lots of nausea and vomiting
madopar
on/off effect
wearing off effect |
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medication; stimulate action of dopamine receptors in the brain decrease the amount of sinemet that is needed- link this and pathological gambling
parlodel
permax
neupro |
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Medication; blocks enzyme catechol-omethyl transferase which breaks down dopamine--> slow the destruction of dopamine in body
comtess
tasmar
stalevo |
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| amantadine (symmetral)- when treating for a viral infection with person wiht parkinsons and found to help keep dopamine longer in the brain/ found accidentally |
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this decrease Sx of exacerbation of parkinsons
patient is hospitalized for 5-10 days taken off all meds
temporarily withdrawn from PD meds
Resume Levodopa Rx- increase mobility and increase mental ability |
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| perosn sits up in a frame and have beans that beem into the brain. can tell where different areas inthe brain are,patient is awake and burholes are plaved in patient. Lesion areas in the brain that are excitatory and helps to minimize it when it lacks dopamine |
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| either side helps decrease tremors and hemi bolismu |
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| violent flinging movments |
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| helps mimic effect of dopamine and suppress cells from firing |
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