Anti-Parkinson Drugs | Dr. Soham Kale

Parkinsonism is a syndrome consisting of akinesia and bradykinesia, rigidity and tremors. Usually associated with abnormalities in postural righting reflexes Pathology: - loss of pigmented cells in substantia nigra with deposition le lewy bodies - degeneration of nigro-striatal pathway - dopamine level in striatum gets depleted which is normally synthesised by pigmented cells Clinical features: - both sexes equally affected - sixth decade 1) Tremors: - Tremors at rest which decreases with action - occurs at wrist and fingers - may occur at head, jaw or lower limbs - tremors are characteristically pill rolling 2) rigidity: - lead pipe hypertonia. Hypertonia is due to rigidity 3) hypokinesia/akinesia: - difficulty in initiating a motor act 4) bradykinesia: - paucity of movements - reduced movements - expressionless 'mask like face' 5) disturbed postural reflexes: - bent posture with tendency to fall easily - difficulty in maintaining balance - glabellar tap becomes positive - may develop depression, dementia - autonomic symptoms like sweating, sebaceous secretions, urinary urgency and constipation - low volm, monotonous speech, stance is stooped, shuffling gait with absent arm swinging, turning about becomes slow - with advancement pt assumes flexed posture, unable to move, death occurs due to infections