Parkinson’s Disease
Pathophysiology of Parkinson’s Disease
Parkinson’s disease is a neurodegenerative disease marked by:
1) progressive slowing of all voluntary movements
2) muscular “cogwheel” rigidity
3) tremors at rest
4) mask-like facies
5) emotional lability
Signs and Symptoms
1) tremors disappear with voluntary movement
2) drooling
3) dementia (15%)
4) depression
5) micrographia
6) “pill rolling”
7) hesitancy when rising from chair
8) short shuffling gait
9) decreased blink rate
10) diminished arm swing
11) stooped posture
12) loss of postural righting reflexes
13) autonomic problems (constipation, impotence, hypotension, impaired thermoregulation
14) loss of smell (anosmia) oftern first presenting sign
15) can present with unilateral motor symptoms
Histology and Gross Pathology
1) loss of dopaminergic neurons in basal ganglia, substantia nigra, and locus ceruleus
2) eosinophilic sphere-shaped inclusions in cytoplasm (Lewy bodies)
3) end stage of disease – destruction of dopaminergic nigrostriatal pathways in striatum and putamen
Lewy body seen in Parkinson’s disease (circular structure at tip of arrow)
Associated Conditions
1) reported to have occurred after ingestion of MPTP
2) some physicians report Parkinson-like symptoms with tick borne infections such as Lyme Disease
Biochemistry
1) possibly related to damage to cells in substantia nigra during auto-oxidation of catecholamines during the synthesis of melanin (increased oxidative stress...
Source: Inside Surgery - Category: Surgeons Authors: Editor Tags: Neurology cogwheel rigidity dopaminergic neurons Lewy bodies mask like face pill rolling shuffling gate substantia nigra tremor tremors at rest Source Type: blogs
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