This work was done by 2nd year student in faculty of medicine,Menoufia University under supervision of staff of anatomy and embryology department

1. Parkinsonism

2. Prof. Dr. Hanaa
Nooh
Dr. Lobna Taher
Dr. Engy
Abd El- Azeem
Project team
Mahmoud
Abdelhafz
Mahmoud
Eisa
Mohamed
Elshanawany
Mohamed
Hawas
Mohamed
Abuelneil
Ahmed
Samir
Ali
Mustafa
Mohamed
Riad
Mohamed
Abuelala
Mustafa
Zayda
Supervisors

3. 1-Neuroanatomy of basal ganglia
2- Neurophysiology of basal ganglia
3-parkinsonism:
-Definition
- Historical background
-Histopathology
-Epidemilogy
-Causes
-Risk factors
-Diagnosis; clinical picture, examination &investigation
-Treatment
- Prognosis
4-Home massage
contents

4. The basal ganglia or basal nuclei
are large masses of grey matter
located within the central core
of white matter of the cerebral
hemispheres.
It is composed of:
-Caudate nucleus
-Lentiform nucleus
-Amygdaloid nuclear complex (or
Amygdala)
-Claustrum
-Substantia nigra (within the
midbrain)
-Subthalamic nucleus

5. Basal ganglia is important in coordination of movement

7. Historical background
• It was described by the physician
Galen as ''shaking palsy" in 175 AD.
• In 1817 a detailed medical essay
was published on the subject by
London doctor James Parkinson.
• Jean-Martin Charcot was the first
to truly recognise the importance
of Dr.Parkinson's work and
renamed the disease which was
formerly named paralysis agitans
(shaking palsy) after him.
Mohamed Ali; the legend of
boxing

8. Definition
• It is a chronic degenerative
disorder that primarily affects
the neurons of the basal
ganglia.
• It is a syndrome that consists
of slowing down in the
initiation and execution of
movement (brady kinesia),
increased muscle tone
(rigidity), tremor and impaired
postural reflexes.

9. Epidemiology of Parkinson’s disease
• The disease is found in all ethnic groups, but with geographical
differences in prevalence.
• It is more common in developed countries were people live longer.

10. The basal ganglia is the most affected
structure in parkinsonism.
The main pathological characteristics of
parkinsonism disease is cell death in substania
nigra and specially the ventral part of pars
compacta affecting up to 20% of the cells by
the time death occurs .
• substania nigra shows;
neuronal loss accompanied by death
of astrocytes (star-shaped glial cells)
and activation of microglia ( another
type of glial cells)
lewy bodies are key of pathological
feature of PD .

11. Risk
factor
Increase aging
Environmental risk
factors
Personality
Caucasian
Male
Family history
Risk factors

12. Hereditary Neurotoxins Drug;
antsychotic
Arteriosclerosis ischemia
Etiology

13. Encepalisis hydrocephalus trauma tumor
Etiology (cont.)

14. Pathophysiology
Antipsychotic drugs ,
encephalitis and
other causes
Affects the
substantia nigra
Destruction of
dopamine producing
neurons within
basal ganglia
Reduces the amount
of available striatal
dopamine (inhibitory
effects)
There’s increase in
acetylcholine
(excitatory effects
Excitatory activity of
Ach is inadequately
balanced
Difficulty in
controlling and
initiating voluntary
movements

15. Clinical manifestation
beginning
stages
Mild tremor
Slight limb
Decreased arm
swing
later
Propulsive gait
with arms flexed
Loss of postural
reflexes
change in speech
pattern

16. • Facial appearance
• Speech problems
• Visual problems
• Fine motor function
• Autonomic disturbance
• Cognitive/behavioral
2ry manifestations:

17. Treatement
Pharmacological
Anti-cholinergics
Anti-histaminics
Dopaminergics
Dopamine agonists
MAO inhibitors
Surgical
Thalamotomy
Pallidotomy
vector mediated gene transfection

18. Prevention
Antioxidants, as vitamins C and D
Estrogens and anti-inflammatory drugs
Caffeine