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Parkinson's
Parkinson's disease (PD), or simply Parkinson's, is a neurodegenerative disease primarily of the central nervous system, affecting both motor and non-motor systems. Symptoms typically develop gradually and non-motor issues become more prevalent as the disease progresses. The motor symptoms are collectively called parkinsonism and include tremors, bradykinesia, rigidity as well as postural instability (i.e., difficulty maintaining balance). Non-motor symptoms develop later in the disease and include behavioral changes or neuropsychiatric problems such as sleep abnormalities, psychosis, anosmia, and mood swings. Most Parkinson's disease cases are idiopathic, though contributing factors have been identified. Pathophysiology involves progressive degeneration of nerve cells in the substantia nigra, a midbrain region that provides dopamine to the basal ganglia, a system involved in voluntary motor control. The cause of this cell death is poorly understood but involves the aggreg ...
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Deep Brain Stimulation
Deep brain stimulation (DBS) is a type of neurostimulation therapy in which an implantable pulse generator is stereotactic surgery, surgically implanted subcutaneous tissue, below the skin of the chest and connected by Lead (electronics), leads to the brain to deliver controlled electrical charge, electrical impulses. These charges therapeutically disrupt and promote dysfunctional nervous system circuits bidirectionally in both ante- and retrograde signaling, retrograde directions. Though first developed for Parkinsonian tremor, the technology has since been adapted to a wide variety of chronic neurologic disorders. The usage of electrical stimulation to treat neurologic disorders dates back thousands of years to ancient Greece and Early Dynastic Period (Egypt), dynastic Egypt. The distinguishing feature of DBS, however, is that by taking advantage of the portability of lithium-ion battery technology, it is able to be used long term without the patient having to be Electrical wir ...
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Dementia With Lewy Bodies
Dementia with Lewy bodies (DLB) is a type of dementia characterized by changes in sleep, behavior change (individual), behavior, cognition, movement, and dysautonomia, regulation of automatic bodily functions. Unlike some other dementias, memory loss may not be an early symptom. The disease progressive disease, worsens over time and is usually diagnosed when cognitive impairment interferes with activities of daily living, normal daily functioning. Together with Parkinson's disease dementia, DLB is one of the two Lewy body dementias. It is a common form of dementia, but the prevalence is not known accurately and many diagnoses are missed. The disease was first described on autopsy by Kenji Kosaka (psychiatrist), Kenji Kosaka in 1976, and he named the condition several years later. REM sleep behavior disorder (RBD)—in which people lose the muscle paralysis (atonia) that normally occurs during Rapid eye movement sleep, REM sleep and act out their dreams—is a core feature. RBD ...
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Dopamine Agonist
A dopamine agonist is a compound that activates dopamine receptors. There are two families of dopamine receptors, D1-like and D2-like. They are all G protein-coupled receptors. D1- and D5-receptors belong to the D1-like family and the D2-like family includes D2, D3 and D4 receptors. Dopamine agonists are primarily used in the treatment of the motor symptoms of Parkinson's disease, and to a lesser extent, in hyperprolactinemia and restless legs syndrome. They are also used off-label in the treatment of clinical depression. Impulse control disorders are associated with the use of dopamine agonists. Medical uses Parkinson's disease Dopamine agonists are mainly used in the treatment of Parkinson's disease.  The cause of Parkinson's is not fully known but genetic factors, for example specific genetic mutations, and environmental triggers have been linked to the disease. In Parkinson's disease dopaminergic neurons that produce the neurotransmitter dopamine in the brain slowly ...
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Bradykinesia
Hypokinesia is one of the classifications of movement disorders, and refers to decreased bodily movement. Hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Hypokinesia is a symptom of Parkinson's disease shown as muscle rigidity and an inability to produce movement. It is also associated with mental health disorders and prolonged inactivity due to illness, amongst other diseases. The other category of movement disorder is hyperkinesia that features an exaggeration of unwanted movement, such as twitching or writhing in Huntington's disease or Tourette syndrome. Spectrum of disorders Hypokinesia describes a variety of more specific disorders: Causes The most common cause of hypokinesia is Parkinson's disease, and conditions related to Parkinson's disease. Other conditions may also cause slowness of movements. These include hypothyroidism and severe depression. These conditions need to be ruled out before ...
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Levodopa
Levodopa, also known as L-DOPA and sold under many brand names, is a dopaminergic medication which is used in the treatment of Parkinson's disease (PD) and certain other conditions like dopamine-responsive dystonia and restless legs syndrome. The drug is usually used and formulated in combination with a peripherally selective aromatic L-amino acid decarboxylase (AAAD) inhibitor like carbidopa or benserazide. Levodopa is taken by mouth, by inhalation, through an intestinal tube, or by administration into fat (as foslevodopa). Side effects of levodopa include nausea, the wearing-off phenomenon, dopamine dysregulation syndrome, and levodopa-induced dyskinesia, among others. The drug is a centrally permeable monoamine precursor and prodrug of dopamine and hence acts as a dopamine receptor agonist. Chemically, levodopa is an amino acid, a phenethylamine, and a catecholamine. The major reason for enhanced risks for levodopa induced dyskinesia (LID) and OFF phases durin ...
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Essential Tremor
Essential tremor (ET), also called benign tremor, familial tremor, and idiopathic tremor, is a medical condition characterized by involuntary rhythmic contractions and relaxations ( oscillations or twitching movements) of certain muscle groups in one or more body parts of unknown cause. It is typically symmetrical, and affects the arms, hands, or fingers; but sometimes involves the head, vocal cords, or other body parts. Essential tremor is either an ''action'' (intention) tremor—it intensifies when one tries to use the affected muscles during voluntary movements such as eating and writing—or it is a ''postural'' tremor, which occurs when holding arms outstretched and against gravity. This means that it is distinct from a resting tremor, such as that caused by Parkinson's disease, which is not correlated with movement. Unlike Parkinson's disease, essential tremor may worsen with action. Essential tremor is a progressive neurological disorder, and the most common movement di ...
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James Parkinson
James Parkinson (11 April 1755 – 21 December 1824) was an English surgeon, apothecary, geologist, palaeontologist and political activist. He is best known for his 1817 work ''An Essay on the Shaking Palsy'', in which he was the first to describe "paralysis agitans", a condition that would later be renamed Parkinson's disease by Jean-Martin Charcot. Early life James Parkinson was born on 11 April 1755 in Shoreditch, London, England. He was the son of John Parkinson, an apothecary and surgeon practising in Hoxton Square in London, and the oldest of five siblings, including his brother William and his sister Mary Sedgwick. In 1784 Parkinson was approved by the City of London Corporation as a surgeon. On 21 May 1783, he married Mary Dale, with whom he subsequently had eight children; two did not survive past childhood. Soon after he was married, Parkinson succeeded his father in his practice in 1 Hoxton Square. Politics In addition to his flourishing medical practice, Parkins ...
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Parkinson's Disease Dementia
Parkinson's disease dementia (PDD) is dementia that is associated with Parkinson's disease (PD). Together with dementia with Lewy bodies (DLB), it is one of the Lewy body dementias characterized by abnormal deposits of Lewy bodies in the brain. Parkinson's disease starts as a movement disorder, but progresses in most cases to include dementia and changes in mood and behavior. The signs, symptoms and cognitive profile of PDD are similar to those of DLB; DLB and PDD are clinically similar after dementia occurs in Parkinson's disease. Parkinson's disease is a risk factor for PDD; it speeds up decline in cognition leading to PDD. Up to 78% of people with PD have dementia. Delusions in PDD are less common than in DLB, and persons with PD are typically less caught up in their visual hallucinations than those with DLB. There is a higher incidence of tremor at rest in PD than in DLB, and signs of parkinsonism in PDD are less symmetrical than in DLB. Parkinson's disease dementia can ...
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Progressive Supranuclear Palsy
Progressive supranuclear palsy (PSP) is a late-onset neurodegenerative disease involving the gradual deterioration and death of specific volumes of the brain, linked to 4-repeat tau pathology. The condition leads to symptoms including Balance disorder, loss of balance, Hypokinesia, slowing of movement, Ophthalmoparesis, difficulty moving the eyes, and cognitive impairment. PSP may be mistaken for other types of neurodegeneration such as Parkinson's disease, frontotemporal dementia and Alzheimer's disease. It is the second most common tauopathy behind Alzheimer's disease. The cause of the condition is uncertain, but involves the accumulation of tau protein within the brain. Medications such as L-DOPA, levodopa and amantadine may be useful in some cases. PSP was first officially described by Richardson, Steele, and Olszewski in 1963 as a form of progressive parkinsonism. However, the earliest known case presenting clinical features consistent with PSP, along with pathological co ...
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COMT Inhibitor
A catechol-''O''-methyltransferase inhibitor (COMT inhibitor) is a drug that inhibits the enzyme catechol-O-methyl transferase, catechol-''O''-methyltransferase. This enzyme Methylation, methylates Catecholamine, catecholamines such as dopamine, norepinephrine and epinephrine. It also methylates L-DOPA, levodopa. COMT inhibitors are indicated for the treatment of Parkinson's disease in combination drug, combination with levodopa and an aromatic L-amino acid decarboxylase inhibitor (e.g. carbidopa or benserazide). The therapeutic benefit of using a COMT inhibitor is based on its ability to prevent the methylation of levodopa to 3-O-Methyldopa, 3-''O''-methyldopa, thus increasing the bioavailability of levodopa. COMT inhibitors significantly decrease off time in people with Parkinson's disease also taking carbidopa/levodopa. List of COMT inhibitors * Marketed ** Entacapone (Comtan, Comtess, Stalevo) ** Opicapone (Ongentys) ** Tolcapone (Tasmar) * Not marketed ** Nebicapone (BIA 3 ...
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Tremor
A tremor is an involuntary, somewhat rhythmic muscle contraction and relaxation involving neural oscillations, oscillations or twitching movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the hands. In some people, a tremor is a symptom of another neurological disorder. Types Tremor is most commonly classified by clinical features and cause or origin. Some of the better-known forms of tremor, with their symptoms, include the following: * Cerebellar tremor (also known as intention tremor) is a slow, broad tremor of the extremities that occurs at the end of a purposeful movement, such as trying to press a button or touching a finger to the tip of one's nose. In classic cerebellar tremor, a lesion on one side of the brain produces a tremor in that same side of the body that worsens with directed movement. Cerebellar damage can also produce a "win ...
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Aspiration Pneumonia
Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs. Signs and symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess, acute respiratory distress syndrome, empyema, parapneumonic effusion, and pneumonia Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs. Infection can be due to a variety of bacteria. Risk factors include decreased level of consciousness, problems with swallowing, alcoholism, tube feeding, and poor oral health. Diagnosis is typically based on the presenting history, symptoms, chest X-ray, and sputum culture. Differentiating from other types of pneumonia may be difficult. Treatment is typically with antibiotics such as clindamycin, meropenem, ampicillin/sulbactam, or moxifloxacin. For those with only chemical ...
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