Text Book Reading Parkinson Disease

7/25/2019 Text Book Reading Parkinson Disease

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Text Book ReadingPARKINSON DISEASE : Management in on-of

phase

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dr . Untng! Sp.S

Dissn o"eh:

A"i# $di%ani A

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*AKU+,AS KEDOK,ERAN UPN E,ERAN/AKAR,A

KEPANI,ERAAN K+INIK DEPAR,EMEN SARA*

DA+AM RUMA0 SAKI, MAR1ONO SEOKAR/O

PERIODE


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Defnition

Parkinsons Disease is a progressiveneurodegenerative disordercharacterized by bradykinesia,tremor at rest, and rigidity


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Cassifcation

Duus Topica Diagnosis !euroogy,"#$$


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%ign and %ymptomThey a&ect the

cranio'aciamuscuature to produce amas2"i2e #a3ies4hypomimia),

de'ective mouthcosure, reduced

binking,dysphagia,saivation

4droo"ing5,(mpairment o' fne

motor contro impairsactivities o' daiy iving

such as 'asteningbuttons, 6riting4micrographia),

eating )ith kni'e and

+evated musce toneis 'et by the patient as

musce tension orspasm and by theexaminer as increasedresistance to passive

movement across the


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Postural changes incude stooped posture, a midy-exed and adducted posture o' the arms, and postura

instabiity or "oss o# ba"an3e. Reated phenomena

incude invountary acceeration o' the gait .festination),di73"t in sto in 6a"2in ! ait instabi"it ! and


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Depression.The range o'depressive mani'estationsincudes )orry, anxiety,avoidance o' socia contact,

genera unhappiness,istessnessAn9iet%.Tension, )orry,menta agitation, ack o'concentration, and dizziness

are reativey commoncompaints/,he dee"opment o#dementia in PD iscorreated )ith an increase

in the number o' 0e)ybodies$"ood pressre 3hanges side e&ect o'antiparkinsonian medications

;onstipation as a mani'estation o' the

disease, or asa side e&ect o' medication .antichoiner ic


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Patofsioogi

0oss o' pigment in thesubstantia nigra can be seenma3ros3opi3a""%/ The mostprominentneurochemicalabnormality is a defciencyo dopamine in thestriatum,

0e)y bodies is an eosinophiicintracytopasmic incusions inneurons


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patophysioogy


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diagnostic

+ncycopedia o'

2erantoogy,"#$3


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The higher the score the greater thedisease severity and disabiity

+ary iness $* $#, 4oderate $$* "#%evere "$ * 5#


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the Scientic Advisory Board'or the Michael J. Fox Foundation for Parkinsons esearch .6ankovic, "#$71/

S3reening


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Treatment

S%mptomati3 ,reatment

,ransp"ant Srger%

Stereota3ti3 Nerosrgi3a"Pro3edres! Deep $rainStim"ation

1eneti3s o# PD


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Drug +&ect in ParkinsonDiseases

=! T(4+

=>> T(4+

?+@R(!2 =>> D+0@A+D =!

ON-O** P0ENOMENON

>R++(!2 +P(%=D+%


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*"3tations in drg efe3t 4=on>ofphases! end-o#dose akinesia1 can o'tenbe improved by the use o' sustained*

reease 0*D=P@ preparations, division o'the daiy dose into smaer individuadoses at more 'reuent intervas.perhaps )ith the use o' iuid

preparations1, and:or the addition o'dopamine agonists or C=4T inhibitors/

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Text Book Reading Parkinson Disease