Parkinson's Disease : Causes & living with disease progression - Dr. Guruprasad Hosurkar скачать в хорошем качестве

Parkinson's Disease : Causes & living with disease progression - Dr. Guruprasad Hosurkar

Parkinson’s disease is a progressive neurogenetic disorder. What happens in Parkinson’s disease is that there is progressive degeneration of the niagral strial neurons which is situated in the motor circuit area. There is a progressive loss of these neurons and dopamine is a neurotransmitter which is very essential for our motor movements. So there is a motor deficiency in Parkinson’s disease Brains, there are different kind of Parkinson’s disease . The most common type if the idiopathic Parkinson’s disease. Idiopathic means we know that there is no specific reason. We know for sure that there is a genetic predisposition in these patient and there is some environmental influence e and then the patients develop Parkinson’s disease. there is some, amount of clustering in the family but this is not familial cases, but if you take Parkinson’s disease below the age of 20 years then there is a clear cut genetic predisposition and we know genetic mutation can cause Parkinson’s disease . The common type of Parkinson’s disease, we still don’t know the reason. There is Parkinson’s mutation Parkinson’s disease, which starts at younger age and there are definite identifiable genetic mutations which can explain the reason for Parkinson’s disease. In secondary Parkinsonism the reason for Parkinson’s disease may be certainly different, but there is a definite etiology. You can have drug induced Parkinsonism, hyponatremia causing Parkinsonism like features or here are other progressive degenerative cases like MSA where the progression is more widespread, it is not that the dopaminergic neurons are degenerated, there are other neurons and other cholinergic neurons are also degenerated and the non motor symptoms are all very high, the progression is more faster, the prognosis is more severe in terms of the recovery from medications. So how do these patients cope up with Parkinson’s disease? Idiopathic Parkinson’s disease is the commonest type of Parkinson’s disease is usually amenable to medical treatment. Usually we start with dopa agonists or anticholinergic medications especially if there is a tremor predominant Parkinson’s disease, they respond really well. But as the disease progresses, you require levodopa, which is a gold standard for patients with Parkinson’s disease. They respond really well, the tremors, the slowness, the stiffness, all the features of Parkinson’s disease will respond to these medications, but 90% of the patients will do progress after time after 5 years, 6 years, the disease become bilateral, they develop axial symptom they can have recurrent falls. They can be freezing, they can be motor fluctuations. There can be wearing of effects of these medications. The effect of the medicines may not last long. They may require frequent medications, they may require optimation of doses. That is the time where we look for alternative treatment. The good thing is a lot of research has gone in the last 20 to 30 years. They have alternative treatment le surgical treatment or different route of administration of medicines to bypass the gut and have effective control of Parkinson’s symptoms.