| Background: A syndrome characterized by tremor, muscular rigidity, akinesia, and loss
of postural reflexes.
Classification and Etiology:
The constellation of symptoms described below
occurs in both primary parkinsonism (Parkinson's disease) and secondary
parkinsonism (Parkinson's syndrome).
Primary parkinsonism:
When no cause can be distinguished, the
condition is designated as primary parkinsonism. Most cases of parkinsonism belong in this
category. The disease most frequently appears between the ages of 50 and 79 yr, but the
incidence declines beyond the eighth decade.
Secondary parkinsonism:
Secondary parkinsonism is distinguished from
primary parkinsonism by having a known cause.
CAUSES OF SECONDARY PARKINSONISM |
Infections
Atherosclerosis of cerebral vessels
Drugs and toxins
Metabolic disorders
Tumors
Head trauma
Degenerative disorders |
Symptoms and Signs:
The most common initial symptom is tremor,
usually in one hand or sometimes in both and involving the fingers in a pill-rolling
motion. The tremor is present at rest (resting tremor).
Muscular rigidity is usually
readily evident on passive movement of a limb.
Gait becomes shuffled with
short steps, and the arms fail to swing. Postural abnormalities are
evident in the erect and sitting positions.
The face can become masklike, with lack of
expression and diminished eye blinking.
Mood abnormalities, usually
depression or anxiety, are common and may be the heralding symptoms.
Treatment:
Physical Medicine Rehabilitation
Surgery/Surgical Treatment : A
new approach to replenishing the dopamine deficit by transplantation or grafting
of fetal nigral cells to the corpus striatum shows promise.
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