Brief medical knowledge of Parkinsonism and Parkinson's disease

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The triad hypokinesia, tremor and rigidity, producing a typical Syndrome was described by Sir Parkinson in 1819. Parkinsonism is caused by disorders of the basal ganglia. Cosy and direct connections between neurons in the substantia nigra in the midbrain and corpus stratum to and fro exist. These are called the nigrostriatal and striatonigral roads.

In the nigrostriatal pathway dopamine (striatopetal) acts as a neurotransmitter, while underway (striatofugal) striatonigral acetylcholine is the neurotransmitter. The normal functioning of the basal ganglia system depends on the action balanced between striatopetal and striatofugal systems. The result of an imbalance between these systems as a result of the depletion of dopamine in the presence of normal acetylecholine smounts parkinsonism. Akinesia and stiffness probably the result of the decreased dopamine. Hyperactivity of the acetylcholine system produces features such as excessive sweating, tremor, Seborrhea, orthostatic hypotension. You know now that other neurotransmitters such as enkephalins and gamma aminobutyric acid also have a role in the normal operation of the system of basal ganglia. It is likely that with the accumulation of new evidence, the concept of basal ganglia disease need to modify. More coherent pathological finding is loss of pigment in the substantia nigra and cellular. The disease is not uncommon, the majority of cases are over the age of 40. Both sexes are equally affected. Startup is insidious for a period of two to three years for the condition may become only clinically evident in his appearance, at the latest.

Clinical classification
Parkinsonism syndrome can occur several disorders that affect the basal ganglia.
1. Main Parkinsonism (Parkinson's disease): in this condition, there is no primary degeneration of neurons in the substantia nigra.
2 Secondary Parkinsonism:
(a) drug induced-butyrophenones, phenothiazines, reserpine.
(b) Postencephalitic-Parkinsonism observed to develop after several years in subjects which have suffered from encephalitis lethargica. Other types of encephalitis can also lead to parkinsonism. Addition of the basal ganglia, other parts of the nervous system can also be affected.
3. Tertiary Parkinsonism: among them include disorders such as Wilson's disease, Huntington's disease, poisoning by carbon monoxide, manganese, etc.

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