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PARKINSON’S DISEASE AYOADE ADEMOLA
DEFINITION Parkinson’s disease is a progressive degenerative disorder of the nervous system that affects the motor system Parkinson’s disease is the destruction of pars compacta of the substantia nigra that sends dopamine secreting nerve fibres to the caudate nucleus. Named after English doctor James Parkinson (1817) on his essay on the SHAKING PALSY .
Diagram
Typical presentation of a PD patient
Typical presentation of a PD patient
Dopamine is an inhibitory chemical neurotransmitter responsible for the transmission of impulses between the substantia nigra and the corpus striatum. The action of dopamine acts as a counterbalance to the excitatory neurotransmitter acetylcholine. The depletion of dopamine results in a lack of inhibition on the cholinergic neurones, leading to unopposed excitation. The normal balance between excitatory and inhibitory neurotransmitters acting on the neurones is lost. In the normal state this balance between excitation and inhibition of the motor cortex via the basal ganglia results in the production of smooth, purposeful muscle activity.
This loss of dopamine-producing ability, the reactive increase in acetylcholine and the subsequent degeneration of the pigmented neurones in the substantia nigra result in the lack of normal movement control. Patients are unable to direct or control their movements.
EPIDEMIOLOGY PD affects men and women in equal numbers and there are no known social, economic or geographic variations. It is a disease of late middle age - usually affecting people over the age of 50. The average age of onset is 60 years, but one in seven patients with PD are diagnosed under the age of 50 (Caird 1991)
EPIDEMIOLOGY 2 nd most common neurodegenerative disorder after Alzheimer’s disease

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