Parkinsonism


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Related to Parkinsonism: Parkinson's disease

Parkinsonism:

see Parkinson's diseaseParkinson's disease
or Parkinsonism,
degenerative brain disorder first described by the English surgeon James Parkinson in 1817. When there is no known cause, the disease usually appears after age 40 and is referred to as Parkinson's disease; a number of genes have
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.

Parkinsonism

 

(also Parkinson’s disease), a chronic progressive disease of the central nervous system characterized by motor disorders. First described in 1817 by the English physician J. Parkinson under the name “shaking palsy,” it is one of the most common neurological diseases, primarily of older people. Its causes are diverse and include encephalitides, cerebral atherosclerosis, head injury, and poisoning by barbiturates or carbon monoxide. The cause cannot be determined in almost half the cases.

In parkinsonism, there is a deficiency of dopamine, a product of catecholamine metabolism, in the subcortical structures of the brain, which results in disruption of the balance between the main systems of brain transmitter substances and in lack of control of movements. Morphological study of the brains of those afflicted reveals destruction of substantia negra cells in the subcortical structures. The principal symptoms are a constant tremor of arms and legs, a masklike facial expression, salivation, increased tonus of all the muscles and general rigidity, and slowness of movements, in particular, a slow gait with small steps.

Treatment with L-dopa, which normalizes the concentration of dopamine, is effective but causes side effects in some patients. Central-acting cholinolytics are used in the initial stages. Surgery is indicated if drug therapy is ineffective. Brain surgery is performed by the stereotaxic technique, which involves destruction of a small area in the subcortical structures. It is quite safe and usually relieves all symptoms of parkinsonism for many years.

REFERENCES

Kandel’, E. I. Parkinsonizm i ego khirurgicheskoe lechenie. Moscow, 1965. (Bibliography.)
Cooper, J. Parkinsonism: Its Medical and Surgical Therapy. Springfield, Ill., 1961.

E. I. KANDEL

parkinsonism

[′pär·kən·sə‚niz·əm]
(medicine)
A clinical state characterized by tremor at a rate of three to eight tremors per second, with “pill-rolling” movements of the thumb common, muscular rigidity, dyskinesia, hypokinesia, and reduction in number of spontaneous and autonomic movements; produces a masked facies, disturbances of posture, gait, balance, speech, swallowing, and muscular strength. Also known as paralysis agitans; Parkinson's disease.
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Clinical features of drug-induced Parkinsonism and Parkinson's disease (15) Variables Drug-induced Parkinsonism parkinsonism Symptoms at onset Bilateral and symmetric Unilateral or or asymmetric asymmetric Onset Acute or subacute Chronic Course with Regressive Progressive appropriate treatment Response to Evident Mild to moderate anticholinergic drugs Response to levodopa Poor Marked Akathisia Present Absent Other associated Oro-buccal dyskinesia Motor fluctuations features and rabbit syndrome Incidence of rest More evident Less evident tremor Gender More in females More in males Freezing Uncommon Common
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