Parkinson's disease | Mohammad Ali the great boxer | Parkinsonism | world's parkinson day | 11 April | disorder of basal ganglia

[Parkinson's disease]-
Parkinsonism
Paralysis agitans
Discoveror- James Parkinson.
World parkinson day- 11 april
* Mohammad Ali (the great boxer) is affected by this disease because of repeated blows he might have received on head that results in damage of brain cells which produces dopamine.



• it is a disorder of basal ganglia.
• it is a slowly progressive degenerative disease of nervous system associated with destruction of dopamine producing brain cells.

CAUSES OF PARKINSON DISEASE-
• it occurs due to lack of dopamine by damage of basal ganglia.
• mostly due to destruction of substantia nigra and nigrostriatal pathway because they have dopaminergic fibers.
> Damage of basal ganglia occurs because of followings-
a. Injury to basal ganglia.
b. Viral infections of brain (encephalitis)
c. Cerebral arteriosclerosis
d. Drug induced Parkinsonism
Destruction or removal of dopamine in basal ganglia due to long term treatment with antihypertensive drugs like reserpine.
e. Idiopathic parkinsonism
Parkinson occurs because of destruction of basal ganglia due to unknown reason.

SIGNS AND SYMPTOMS OF PARKINSONISM-
•Parkinson disease developes very slowly.
• Early signs and symptoms may be unnoticed for months , even for years.
• symptoms start with a mild tremor in just one hand.
• When the tremor remarkable the disease causes slowing or freezing of movements followed by rigidity.

COMMON SIGNS AND SYMPTOMS OF PARKINSONISM-
1. Tremor
>Static tremor
>Resting tremor
>Drum beating tremor
>Pill-rolling movement
•Tremors occurs during rest but it disappears while doing any work, so it is called static tremor (resting tremor).
• movements are similar to beating a drum so also called drum beating tremor.
• thumb moves rhythmically over the index finger and middle finger, these movements is called pill-rolling movement.

2. Gait
Gait is a manner of walking.
• gait in this disease is called festinant gait.
• the patients walks quickly in short steps by bending forward as if he is going to catch up the center of gravity.

3. Rigidity
Stiffness of muscles occurs in limbs.
• muscular stiffness occurrs because of increase in muscle tone (hypertonia), which is due to the removal of inhibitiory effect on gamma motor neurons.
It affects both extensor and flexor muscles equally. So the limbs become more rigid like pillars.
This condition is defined as lead pipe rigidity.

4. Poverty of movements
Loss of all automatic associated movements.
Statue like body-
• body becomes statue like because of loss of automatic associated movements.
Mask like face-
• face becomes mask like due to absence of appropriate expression like smiling, blinking of eyes.

5. Slowness of movements
(Bradykinesia)
Due to slow down movements it takes a long time even to perform a simple task.
• because of hypotonia of muscles patients becomes-
> Akinesia ( unable to initiate the voluntary action)
> Hypokinesia ( reduced voluntary movement)

6. Speech problems
Patients may speak very softly or sometimes rapidly.
Speech becomes slurred and patient hasitate to speak.

7. Dementia
In later stage some patients develop dementia ( memory loss)

8. Emotional changes
Patients are upset emotionally.

TREATMENT OF PARKINSON DISEASE-
It treated by Dopamine inj.
* Dopamine does not cross the BBB (blood-brain-barrier), so Levodopa (L-dopa) is injected because it can cross the BBB.
- Levodopa moves into brain and converted into dopamine.
* Levodopa (L-dopa) can be converted into dopamine in liver.
some side effects occur due to excessive dopamine content in liver and blood. So along with levodopa , carbidopa is also administered.
> Carbidopa prevents the conversion of levodopa in dopamine.
> Carbidopa can not cross the BBB.
Thus, levodopa moves into the brain tissues and converted into dopamine.