Friday, 29 June 2012

parkinsonism


An intro to parkinsonism
Parkinson’s disease develops as a result of the inability of nerves to carry signals within the brain due to diminished excretion of chemical called dopamine which normaly regulate body movement due to death of cell making it..
The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease.Symptoms of Parkinson’s disease
Alternative Names

Parkinsonism - secondary OR Atypical Parkinson’s disease


The Primary Symptoms :
Tremor – in limbs as well the head, neck, face and jaw in up to 25% of people with Parkinson’s disease

Rigidity - (stiffness) in the muscles leads to rigidity mostly  during movement. A mask-like expression of the face is caused by rigidity in some Parkinson’s disease sufferers.

Bradykinesia (slowness of movement). This is caused by the nerves in the brain . Therefore the afflicted person is slow to respond and slow to carry out tasks.

Poor Balance - Falls are often caused by a sudden change in position of the body after the muscle receives a message from the brain.

Walking Problems - People with Parkinson’s disease often use short, shuffling steps with reduced arm swings. Some may have sudden freezing spells due to a lapse in nerve transmission.

Secondary parkinsonism
Secondary Parkinson disease is similar to Parkinson's disease, but it is caused by certain medicines, a different nervous system disorder, or another illness.

Whats the Causes:
Parkinson's disease is one of the most common nervous system disorders affecting the elderly.

Secondary parkinsonism

Secondary Parkinson disease is similar to Parkinson's disease, but it is caused by certain medicines, a different nervous system disorder, or another illness.

Whats the Causes:

Parkinson's disease is one of the most common nervous system disorders affecting the elderly.

it may be caused by health problems, including:
  • AIDS
  • Encephalitis
  • Meningitis
  • Stroke
  • Diffuse Lewy body disease
  • Multiple system atrophy
  • Progressive supranuclear palsy
Certain medications can cause secondary parkinsonism, including:
  • Antipsychotics (haloperidol)
  • Metoclopramide
  • Phenothiazine medications
Other causes of secondary parkinsonism include:
  • Brain damage caused by anesthesia drugs (such as during surgery)
  • Carbon monoxide poisoning
  • Mercury poisoning and other chemical poisonings
  • Overdoses of narcotics
There have been cases of secondary parkinsonism among IV drug users who injected a substance called MPTP, which can be produced when making a form of heroin. These cases are rare and have mostly affected long-term drug users.
Common Symptoms:
Common symptoms include:
  • Decrease in facial expressions
  • Difficulty starting and controlling movement
  • Loss or weakness of movement (paralysis)
  • Soft voice
  • Stiffness of the trunk, arms, or legs
  • Tremor
Confusion and memory loss may be more likely in secondary parkinsonism. This is because the diseases that cause secondary parkinsonism often lead to dementia.
For a more detailed description of symptoms, see Parkinson's disease.
Daignosis Tests
The health care provider may be able to diagnose secondary parkinsonism after performing a physical exam and asking questions about your medical history and symptoms. However, the symptoms may be difficult to assess, particularly in the elderly.
Examination may show:
  • Difficulty starting or stopping voluntary movements
  • Increased muscle tone
  • Problems with posture
  • Slow, shuffling walk
  • Tremors
Reflexes are usually normal.
Tests may be used to confirm or rule out other disorders that can cause similar symptoms.
Treatment
If the condition is caused by a medication, your doctor may recommend changing or stopping the medicine. However, the benefits of the medication should be weighed against the severity of symptoms. Medications should be stopped or changed if the risks outweigh the benefits.
Treating underlying conditions such as stroke or infections can reduce symptoms.
If your symptoms make it hard to do everyday activities, your doctor may recommend medication. Many of the medications used to treat this condition can cause severe side effects. It is important that you see your doctor for check-ups. Secondary parkinsonism tends to be less responsive to medical therapy than Parkinson's disease. However, medications are worth trying if the cause of the condition is not treatable.
For a more detailed description of treatment, see Parkinson's disease.
Support Groups
See: Parkinson's disease - support group
Outlook (Prognosis)
Secondary parkinsonism caused by antipsychotics or other medications is usually reversible if identified soon enough. However, it may not be reversible if it is caused by:
  • Drug-related brain damage
  • Infections
  • Toxins
All other causes are not reversible and tend to get worse over time.
Possible Complications
  • Difficulty performing daily activities
  • Difficulty swallowing (eating)
  • Disability (varying degrees)
  • Injuries from falls
  • Side effects of medications
Side effects from loss of strength (debilitation):
  • Aspiration
  • Deep vein thrombosis
  • Malnutrition
When to Contact a Medical Professional
Call your health care provider if:
  • Symptoms of secondary parkinsonism develop, come back, or get worse
  • New symptoms appear, including:
    • Changes in alertness, behavior, or mood
    • Delusional behavior
    • Dizziness
    • Hallucinations
    • Involuntary movements
    • Loss of mental functions
    • Nausea or vomiting
    • Possible side effects of medications
    • Severe confusion or disorientation
Discuss the situation with your health care provider if you are unable to care for the person at home (after treatment begins).
Prevention
Treating conditions that cause secondary parkinsonism may decrease the risk.
People with conditions that require long-term use of antipsychotics should be carefully monitored to prevent the development of secondary parkinsonism. Newer antipsychotic medications are less likely to cause secondary parkinsonism.

Medication

most  of the medications used to treat the condition are aimed at replacing this chemical.


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