Neurotransmitter Dopamine.

Parkinson's disease (English : paralysis agitans , Parkinson's disease) is a neurological degenerative disease first discovered in 1817 ( An Essay on the Shaking Palsy) by Dr . James Parkinson . with symptoms such as tremors at rest, difficulty to start the movement and muscle stiffness . Parkinson's affects about 1 in 250 people over the age of 40 years and about 1 in 100 people over the age of 65 years .

Pathophysiology .

The cause of Parkinson's disease is the lack of the neurotransmitter dopamine in the nervous system .

If the brain ordered an activity ( eg, lifting the arm ) , the nerve cells in the basal ganglia will help soften the movement and regulating changes in posture . Basal ganglia signal processing and delivering the message to the thalamus , which will convey the information that has been processed back to the cerebral cortex .
Overall the signals delivered by chemical neurotransmitters as electrical impulses along nerve pathways and between nerves . Primary neurotransmitter is dopamine in the basal ganglia .
In Parkinson's disease , nerve cells in the basal ganglia deteriorated resulting in the formation of dopamine is reduced and relations with other nerve cells and muscles are also less. The cause of the deterioration and loss of dopamine nerve cells often is not known . This disease tends to be lowered , although sometimes genetic factors do not play a major role .
Sometimes the cause is unknown . In some cases , Parkinson's is a very advanced complications of encephalitis due to the virus ( an infection that causes inflammation of the brain ) . Another case occurs if other degenerative diseases , drugs or toxins affect or hinder the work of dopamine in the brain . For example, anti- psychosis medications are used to treat severe paranoia and schizophrenia inhibit the action of dopamine in nerve cells .

Diagnosis .

Clinical simtoma .

Parkinson 's disease begins as a vague and slow to develop .
From inspection can reveal any gait abnormalities ( slow and rude ) . Usually people complain tangnnya vibrating when resting , but not when then performed ativitas . In some patients found that hard tngan fingertips and bend into the rank is not normal ( which can be removed with common antiparkinsonian drug administration )
In many patients , the first Parkinson's appear as tremors ( shaking ) when the hand is at rest , the tremors will be reduced if the hand is moved deliberately and disappear during sleep . Emotional stress or fatigue may aggravate tremor . At first tremor occurred on one hand , on the other hand will eventually , arms and legs . Tremor also be on the jaw , tongue , forehead and eyelids .
In one third of patients , tremor is not an early symptom ; another tremor in patients with diminishing returns in line with the development of disease and the remainder had never experienced tremors .
Patients have difficulty in initiating a movement and muscle stiffness occur . If the forearm bent backward or straightened out by others, the movement feels stiff. Stiffness and immobility can cause muscle pain and fatigue . Stiffness and difficulty in starting a movement could cause trouble . Small muscles in the hand are often impaired , so that daily work ( eg, buttoning a shirt , writing and tying shoes ) more difficult.
Patients have difficulty in moving and often hobbled where his arm is not in accordance with the swinging stride . If the patient has started to walk , they find it difficult to stop or turn around . His pace quickened so as to encourage them to run small so as not to fall . Her posture becomes stooped and difficult to maintain a balance so that tends to fall forward or backward .
The patient's face becomes less expressive because the facial muscles to form the expression is not moving . Sometimes reduced facial expression is mistaken for depression , although there are many people with Parkinson's who end up depressed . The view looks empty with mouth open and his eyes rarely blink . Patients often ileran or choking because of stiffness in the muscles of the face and throat causing difficulty swallowing . Patients spoke very quietly and without accent (monotonic) and stutter because of difficulties in articulating his thoughts. Most of the patients had normal intellectual , but there also are becoming senile .

Treatment .

Potent drug (default) for Parkinson's is levodopa until now, its use has begun, although reduced because the side effects were found.
The drugs available options can not cure Parkinson 's disease , Amen can reduce symptoms or extend the time for people to be free from symptoms .
Following the discovery of kinom in humans , protein kinases have become the second most important priority in the effort to cure , therefore can be modulated by small molecule ligands . The role of kinases in the molecular trajectory neurons continue to be studied , but some of the main path has been found .
A protein kinase , CK1 and CK2 , was found to have a role that has not been known , the molecular pathology of several neurodegenerative disorders, such as Alzheimer's, Parkinson's disease and amyotrophic lateral sclerosis . Search specific organic compounds inhibiting this enzyme works on both , now has become a challenge in the treatment of the above diseases .
Parkinson's disease can be treated with various drugs , such as levodopa , bromocriptine , pergolide , selegiline , anticholinergics ( benztropine or triheksifenidil ) , antihistamines , antidepressants , propranolol and amantadine . None of these drugs that cure the disease or stop its development , but these drugs cause patients more easily perform a movement and prolong survival .
In the brain levodopa is converted into dopamine . These drugs reduce tremors and muscle stiffness and improve movement . Patients with mild Parkinson's I went back to normal activities and patients were previously bedridden became independent again .
The basic treatment for Parkinson's is levodopa - carbidopa . The addition of carbidopa is intended to improve the effectiveness of levodopa in the brain and to reduce the undesirable effects of levodopa outside of the brain . Consuming levodopa over the years can cause movement of the tongue and lips are not dikehendakik , grinning face , head nodding and arm and leg circles. Some experts believe that adding or replacing levodopa with bromocriptine during the first years of treatment could delay the emergence of movements that are not desired .
Nerve cells producing dopamine from human fetal tissue transplanted into the brains of Parkinson's patients can improve chemical abnormalities but not yet enough data on these measures .
To maintain mobility , patients are encouraged to keep doing their daily activities as much as possible and follow a regular exercise program . Physical therapy and the use of mechanical aids (eg wheelchairs) can help people remain independent.
Foods rich in fiber can help to overcome constipation due to lack of activity , dehydration and some medications . Additional food and stool softeners can help facilitate defecation . Feeding should be properly addressed because it can cause muscle stiffness sufferers have difficulty swallowing so can suffer from malnutrition ( malnutrition ) .

Levodopa .

Levodopa combined with carbidopa is the main treatment for Parkinson Provided with carbidopa to increase the effectiveness and reduce the side effects Start with a low dose , which further enhanced to the greatest effect was obtained after several years of use , its effectiveness can be reduced bromocriptine or pergolide At the beginning of treatment is often added to levodopa administration to improve the working of levodopa or given later when the side effects of levodopa raises new problems rarely given alone . Seleglin Often given as an adjunct to levodopa usage could increase the activity of levodopa in the brain . Anticholinergic drugs ( benztropine & triheksifenidil ) , certain antidepressants , antihistamines ( diphenhydramine ) In the early stages the disease can be administered without levodopa , in an advanced stage is given in conjunction with levodopa , began to be given in low doses can cause some side effects . Amantadine is used in the early stages of the disease who light In later stages is given to enhance the effects of levodopa may become ineffective after several months used alone

Adult stem cells .

Adult stem cells can be used to treat Parkinson's disease / Parkinson ' s disease ( PD ) for example is adult stem cells derived from bone marrow cells to replace neurons ( nerve ) of the brain damaged by Parkinson's disease .
Thank you for reading this article. Written and posted by Bambang Sunarno. sunarnobambang86@gmail.com
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DatePublished: March 07, 2014 at 16:09

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Tag : Parkinson Disease.