Diagnosis of Parkinson’s Disease
It was James Parkinson who described the disease in 1817 under the name of paralysis agitans. “The etiology is unknown but pathophysiologically related to a deficiency of dopamine in the striatum, resulting from neuronal degeneration that mainly affects the compact zone of the substantia nigra (locus niger), the locus coeruleus and other properties in catecholamine-containing which are eosinophilic inclusions known as Lewy bodies “(JC Fustinoni).
The extrapyramidal motor system is the set of motor pathways that exert a major influence on spinal motor circuits, brain stem, cerebellum and cortex. Has fibers from the motor cortex that connect with the basal ganglia, particularly the caudate and putamen, as well as bulbar nuclei (red nucleus, substantia nigra and reticular formation) or midbrain and terminate in the anterior horn of the spinal cord.
Several hypotheses attribute the disease to genetic factors (genes have been identified as responsible mutants), metabolic (oxidative stress) or environmental (pesticides, aluminum). 10% of patients exhibit genetic predisposition. One out of every thousand people with the disease is less common in blacks and Japanese.
The onset of the disease is insidious and, retrospectively, patients may report having suffered from hyposmia, pain erratic confused as arthritic origin, dysesthesias burning sensations, depression, mental or seborrheic dermatitis, which can not always be taken into account as a prodrome.
The fall in the content of dopamine in the striatum will generate later, the symptoms suffered three out of four patients: resting tremor that typically is unilateral in its infancy (hands have made the movement of currencies .) In almost all cases the upper limbs are involved.
When will this disease progresses to muscle rigidity and bradykinesia (delay in the initiation of an involuntary movement or sudden inhibition during the same), the amimia and bradilalia. When walking there is a lack of arm swing.
Neurovegetative symptoms are also characteristic: seborrhea, excessive salivation, sweating, feeling hot, flushing.
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