PARKINSON DISEASE(PARKINSONISM) PD

PARKINSON DISEASE(PD)

• NEURODEGENARATIVE DISEASE
• Lets understand the defination of PD 
• PD IS A NEURODEGENENERATIVE DISEASE MARKED BY A PROMINENT HYPOKINETIC MOVEMENT DISORDER THAT IS CAUSED BY LOSS OF DOPAMINERGIC NEURONS FROM THE SUBSTANTIA NIGRA

Revolving aroud the statement and decoding it into simpler terms lets understand it 

1.  WHY NEURODEGENARATIVE?
2.  HOW IS THE LOSS OF NEURONS CAUSED?
3.  WHERE IS SUBSTANTIA NIGRA?

To understand the neurodegenarative we have understand the pathogenesis pathway clearly

                            NOW LETS SEE THE SUBSTANTIA NIGRA

                            WHAT IT CONTAINS AND WHAT ARE ITS

                             SURROUNDING STRUCTURES

                     And now the surrounding structures 

                                         

       so now with the clear idea of  where it is, lets understand 

                                     THE DISEASE 

DAMAGE TO THE NIGROSTRIATAL DOPAMINERGIC NEURON SYSTEM 

Why it is happening to the neurons we will learn in the pathogenesis!

CAUSE OF THE DISEASE

• IDIOPATHIC(MAIN CAUSE)
• DRUGS (OCCURS SECONDARY TO CHRONIC USE OF MANY DRUGS LIKE PHENOTHIAZINE ,D2 RECEPTOR BLOCKER)
• MPP (METHYL PHENYL PYRIDINIUM)this compond is formed from its precursor which we will discuss later toxic levels of this compond is seen in PD

SYMPTOMS OF THE DISEASE AND CLINICAL FINDINGS

HYPOKINETIC MOVEMENTS

• AKINESIA (DIFFICULTY IN INTIATING MOVEMENTS)
• BRADYKINESIA(SLOWNESS OF MOVEMENTS)
• DECREASED ASSOCIATED MOVEMENTS(EXPRESSIONLESS FACE OR MASK FACE)
• HYPERKINETIC MOVEMENTS                                           RIGIDITY                                                                        TREMOR (TREMOR IS OBSERVED ONLY AT REST ONCE MOVEMENTS STARTS TREMOR STOPS RESTING TREMOR)                                                                    FESTINANT GAIT (TRYING TO CATCH CENTER OF GRAVITY)
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SCHEMATIC REPRESENTATION OF THE SEQUENCE OF NEURONS INVOLVED IN PD

TOP IMAGE 

• DOPAMINERGIC NEURONS (RED)originating in the substantia nigra normally inhibit the GABAergic output from the straitum
• BOTTOM IMAGE There is selective loss of DOPAMINERGIC NEURONS (dashed RED)

PATHOGENESIS

• PD is associated with protien accumalation and aggregation ,mitochondrial abnormalities,and neuronal loss in the substantia nigra                                                                                           SINCE LETS BECOME FAMILIAR WITH SOME KEY WORDS ,THERE ARE LIST OF GENES WHERE WE HAVE TO BECOME FAMILIAR WITH 
• ALPHA SYNUCLEIN
• LRRK2(leucine rich repeat kinase 2)
• parkin gene 
• MPTP(1 methyl 4 phenyl 1,2,3,6 tetrahydropyridine)

FIRST PATHOGENESIS 

                                           

SECOND WAY 

                                    

THIRD WAY IS SUBSTANTIA NIGRA FOLLOWS EXPOSURE TO MPP IS HIGH ,MPP IS FORMED FROM MPTP BY THE ACTION OF (MAO -B) monoamine oxidase B CONVERSION OF THIS MAKES MPP ACCUMUALTES IN THE BASAL GANGLIA AND DESTROYS THEM(NEURONS)

TREATMENT

1. REPLACEMENT OF DOPAMINE
2. ANTICHOLINERGICS
3. DEPRENYL
4. TRANSPLANTATION OF ADRENAL
5. IMPLANTATION OF FETAL BASAL GANGLIA
6. TRANSPLANTATION OF GLOMUS CELLS

TREATMENT WILL BE DISCUSSED IN THE NEXT BLOG

LAST THING TO KNOW ABOUT IS LEWY BODIES

These are single or multiple cytoplasmic ,eosinophilic ,round to enlongated inclusions that often have a dense core surrounded by pale halo

DIAGNOSTIC HALLMARK OF DISEASE

accumalates in the parts of brain destroys the neurons leads to PD

THANKYOU