Parkinson's Syndrome, Atypical
Parkinson's, or Parkinsonism:
Parkinson's disease is also called primary parkinsonism or idiopathic Parkinson's
disease. (Idiopathic is the term for a disorder for which no cause has yet
been identified).
In the other forms of parkinsonism, either the cause
is known or suspected, or the disorder occurs as a secondary effect
of another primary neurological disorder that may have both primary
and secondary symptoms of Parkinson's disease. These disorders, described
as Parkinson's Syndrome, Atypical Parkinson's, or, simply, parkinsonism,
may include the following:
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drug-induced parkinsonism - prolonged
use of tranquilizing drugs, such as the phenothiazines, butyrophenones,
reserpine, and the commonly used drug, metoclopramide for stomach
upset. |
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toxin-induced parkinsonism - manganese and carbon
monoxide poisoning. |
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repeated head trauma |
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parkinsonism that accompanies other neurological
conditions - such as Multiple System Atrophy (Shy-Drager syndrome,
oliviopontocerebellar atrophy, cortico-basal ganglionic degeneration),
progressive supranuclear palsy, Wilson's disease, Huntington's
disease, Hallervorden-Spatz syndrome, Alzheimer's disease, Creutzfeldt-Jakob
disease, olivopontocerebellar atrophy, and post-traumatic encephalopathy. |
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postencephalitic parkinsonism - a viral disease
that causes "sleeping sickness." |
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tumors in the brain (rarely) |
What are the four primary symptoms of Parkinson's?
The following are the most common symptoms of Parkinson's disease. However,
each individual may experience symptoms differently. Symptoms may include:
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rigidity - stiffness when the arm, leg, or neck
is moved back and forth. |
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resting tremor - tremor (involuntary movement from
contracting muscles) that is most prominent at rest. |
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bradykinesia - slowness in initiating movement. |
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loss of postural reflexes - poor posture and balance
that may cause falls; gait or balance problems. |
As the disease progresses, walking may become affected, causing the patient
to stop in mid-stride or "freeze" in place, and maybe even fall
over. Patients also may begin walking with a series of quick, small steps
as if hurrying forward to keep balance, a practice known as festination.
The symptoms of Parkinson's disease may resemble other
conditions or medical problems. Always consult your physician for a
diagnosis.
How is Parkinson's disease diagnosed?
Currently, there are no specific tests for diagnosing
PD. Instead diagnosis is based upon neurological examination. Making
an accurate diagnosis in the early stages of Parkinson's disease can
be difficult, and may require observation of the patient for some time.
There are times, if indicated, your doctor may order diagnostic studies
such as MRI imaging to rule out secondary causes.
Treatment for Parkinson's disease:
Specific treatment for Parkinson's disease will be determined by your physician
based on:
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your age, overall health, and medical history |
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extent of the condition |
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type of condition |
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your tolerance for specific medications, procedures,
or therapies |
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expectations for the course of the condition |
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your opinion or preference |
With today's medicine, we have yet to find a cure for Parkinson's disease.
However, based upon the severity of the symptoms and medical profile, the
physician will establish an appropriate treatment protocol. Treatment for
Parkinson's disease may include medications or surgery.
Medication for Parkinson's disease:
Once the diagnosis of PD has been made, the next decision is whether a patient
should receive medication. No two patients react the
same way to a given drug, therefore, it takes time and patience to find an
appropriate medication and dosage to alleviate symptoms. Proper treatment of
PD is truely individualized therapy.
Surgery for Parkinson's disease:
Based on the severity of the condition and the medical profile, the physician
may recommend surgery as one treatment option for Parkinson's disease.
There are several types of surgery performed that may
help patients with Parkinson's disease. Most of the treatments are
aimed at helping the tremor or rigidity that comes with the disease.
In some patients, surgery may decrease the amount of medication that
is needed to control the symptoms of PD. Currently there are 2 types
of surgical procedures approved for the treament of PD:
deep brain stimulation (DBS)
With this type of surgery, a small electrode is placed in the critical parts
of the brain that help to control movement. The electrode is attached to
a small battery in the chest wall and is connected by wires that are placed
under the skin. The stimulator is then turned on and interrupts the normal
flow of information in the brain and can help to decrease symptoms of Parkinson's
disease.
lesion surgery (burning of tissue, ablation)
In this procedure, deep parts of the brain are targeted and small lesions are
made in critical parts of the brain that help control movement. The surgery
may be done while the patient is awake to help determine the exact placement
of the lesion. The lesion is placed to help control, or stop, the area of the
brain that is causing the tremor.
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