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Parkinsonism:see Parkinson's diseaseParkinson's disease
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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(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.
REFERENCESKandel’, E. I. Parkinsonizm i ego khirurgicheskoe lechenie. Moscow, 1965. (Bibliography.)
Cooper, J. Parkinsonism: Its Medical and Surgical Therapy. Springfield, Ill., 1961.
E. I. KANDEL’