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Parkinsonism

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

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Parkinsonism

  1. 1. Parkinsonism
  2. 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. 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. 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. 5. Basal ganglia is important in coordination of movement
  6. 6. 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
  7. 7. 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.
  8. 8. 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.
  9. 9. 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 .
  10. 10. Risk factor Increase aging Environmental risk factors Personality Caucasian Male Family history Risk factors
  11. 11. Hereditary Neurotoxins Drug; antsychotic Arteriosclerosis ischemia Etiology
  12. 12. Encepalisis hydrocephalus trauma tumor Etiology (cont.)
  13. 13. 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
  14. 14. 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
  15. 15. • Facial appearance • Speech problems • Visual problems • Fine motor function • Autonomic disturbance • Cognitive/behavioral 2ry manifestations:
  16. 16. Treatement Pharmacological Anti-cholinergics Anti-histaminics Dopaminergics Dopamine agonists MAO inhibitors Surgical Thalamotomy Pallidotomy vector mediated gene transfection
  17. 17. Prevention Antioxidants, as vitamins C and D Estrogens and anti-inflammatory drugs Caffeine

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