PATHOPHYSIOLOGY OF PARKINSONS DISEASE

PATHO-PHYSIOLOGY: -

There is depletion of dopamine secreting neurons in globus pallidus area of

Substantial nigra of the brain. Because of this deficiency the neuro impulses are not transmitted

across the synapsis. The above said factors results in uncontrolled involuntary movements in the

distal areas of the limbs. These are called as tremors at rest. However during sleep there are no

tremors. Any kind of stress may aggravate the symptoms.

CONSERVATIVE THERAPY:-

There are only few drugs which decrease the symptoms to a little extent either by imitating the

dopamine or inhibiting the  antagonist enzymes in  the Dopamine pathway. However, these drugs

are not the permanent solution to the problem . The brain get used to the synthetic dopamine and

its effect vanishes within a span of five years. Since this is a progressive disorder the underwater

current takes the shape of whirlpool. These anti Parkinson drugs on the other hand have shown

lot of adverse effects which include Dystonia (increased rigidity in all the four limbs), dyskinesia

(slowness and impaired body movements), insomnia (sleep disorder) and psychiatric symptoms

(obsessive compulsive disorders and hyper sexuality). Because of dystonia the distal muscles of

his arms and legs become rigid and the patient is painful and helpless in accomplishing his day to

day routine tasks like brushing the teeth, ablution in toilet, taking bath, combing his hair,

fastening the buttons of his shirt, and so on. Hypokinesia results in loss of swinging of hands

while walking, imbalance on walking, slowness of  speech, and awkward movements of the

limbs. The incoordination of skeletal and smooth muscles may even lead difficulty in speech,

difficulty in swallowing and difficulty in defecation.