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Pembimbing:

dr. Tutik Ermawati, Sp.S, M.Si.Med

Oleh:

Andika PratPratiwi G4A01404

Anni!aa Auli"aa G4A0140#4

$i!ka Praktika % G4A01#0&4

'ndri Pu!pa!ari G4A01#1()

PARKINSONS DISEASE

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A*ST+A

1-0 th "llParkin!n/! i!ea!e P2 diperkenalkan leh 3ame! Parkin!n P 5 pen"akit neurdegenerati6

i!6ung!i7hilangn"a neurn "g memprduk!i dpamin di takgangguan mtrik 8gangguan nn mtrik

P : 12 Parkin!n primer idipatik2, (2 parkin!n !ekunder, &2 !indrm parkin!n

P peringkat kedua pen".degenerati6 !etelah Al9heimer Angka keadian P akan melebihi pen".kanker pd tahun (040

;!ia ~ risiko PD

Tria! parkin!n : re!ting tremr, rigidita!, bradikine!ia < : anamne!i!, P$, pemerik!aan penunang

Manaemen tatalak!ana : nn 6armaklgi!, 6armaklgi!, perati6

Mdalita! terapi untuk men"embuhkan P belum diketahui

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OVERVIEW OF PARKINSONS

DISEASE

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PATOPHYSIOLOGY OF MOTOR

SYMPTOM IN PARKINSONS

DISEASE

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IMPORTANT QUESTION IN

ANAMNESIS TO DIAGNOSE

MOTOR SYMPTOMS INPARKINSONS DISEASE

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Kuesioner Screening

The Michael J. Fox Foundation for Parkinsons Research

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CLINICAL DIAGNOSIS CRITERIA

OF PARKINSONS DISEASE

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A=AM=ES'S

Cardinal sign:

Tremr bia!a mun>ul awal2,

+igidita!,

*radikine!ia,

Postural and gait impairment rnlgi! dari gealan"a : unilateral bilateral

Prgre!i6ita!

*er!i6at genetik : keluhan !erupa di keluargan"a

Elimina!i : riw. pen"akit lain, trauma, in6ek!i, kn!um!i bat

tertentu

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GE3A?A A= TA=A

GE3A?A MOTO+'

1. +e!ting tremr

. gerakan ritmik in@lunter

!aat !antai

. pill rolling type

. tremor moements

. tremr p!tural

. Selain di tangan uga

di tungkai bawah, rahang dan lidah

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(. +igidita! :

. cog!heel phenomenon

. Froments maneuer

. &. *radikine!ia, penampakan klini!:

. hypomimia

. hypophonia

. micrographia

". Postural and gait impairment

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e>ema!an

Serangan panik

Gangguan md

alu!ina!i

'lu!i eru!akan kgniti6

Sembelit

i!6ung!i !ek!ual

eringat berlebihan

Sialrrhea

'n!mnia

ip!mia "aitu, hilangn"a

indera pen>iuman2 Pare!te!ia "aitu, ke!emutan2

+a!a !akit

elelahan

GE3A?A =O= MOTO+'

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OTHER MODALITIES TO

DIAGNOSE PARKINSONS

DISEASE

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membantu menegakkan diagn!i! parkin!n, akan tetapi han"adipa!arkan di Erpa dilakukan dengan !"arat pa!ien haru! terdiagn!i! klini! pa!tiParkinson #isease

SPEBTaT!>an2

menunukkan abnrmal pada pa!ien parkin!natr6imulti!i!tem,proggressie supranuclear palsy, degenera!ikrtikba!ali!, atau$e!y %ody inklu!i !itpla!mik

e!in6ilik2 penelitian Ga"ed et al(01#2 mendapatkan ha!il >t !>anabnrmal pada () pa!ien (C2 dari #D pa!ien dengandiagn!i! klini! pa!ti parkin!n

a!il !>an dapat dikategrikan menadi 0 nrmal2, 1mild2, ( mderate2, & marked2, dan 4 ab!ent2 "angdiambil dari bagian uung >audatu! dan putamen.

BT S>an

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MANAGEMENT OF MOTOR

SYMPTOMS IN PARKINSONS

DISEASE

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Terapi Farmakologi

Obat pengganti dpamine ?e@dpa,Barbidpa2

Agni! pamin

Antiklinergik

Penghambat Mnamin

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Terapi Pembedahan

Memperbaiki7mengembalikan !eperti !emula pr!e! patlgi! "angmenda!ari neurre!tra!i2.

3arang dilakukan dan ma!ih kntr@er!ial untuk dilakukan.

3eni! pembedahan "aitu terapi abla!i le!i di tak, #eep %rain(timulation *S2, dan tran!planta!i.

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THANK YOU