INTERNAL MEDICINE

Parkinson's disease

Def: Parkinson's disease is a degenerative disorder of

the central nervous system that often impairs the sufferer's motor skills, speech, and other functions.

Parkinson's disease

Causes: Idiopathic Drugs- reserpine, tetrabenazine Toxins- manganese, carbomonoxide Viral infection- post encephalitic condition Truma- repeated head injury Rarely neurosyphilis

Parkinson's disease

Clinical feature: Trembling of hands, arms, legs, jaw and face Stiffness of the arms, legs and trunk Slowness of movement (bradykinesia) Poor balance and coordination

Parkinson's disease

Investigation: Serological test for syphilis CT

Parkinson's disease

Management: A)Any identifiable causes should be treated B)Drug therapy- Anticholinergic agent- Benzhexol 1-5 mg 8 hrly or

Phenadrine 50-100 mg 8 hrly Selegiline 10 mg in morning L-dopa+carbidopa 4:1 Bromocriptine(Dopamine receptor agonist)

Parkinson's disease

Management: C)Surgery- stereotatic thalamotomy D)Physiotherapy E)Rehabilitation