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Parkinsonian Disorder

Parkinsonian Syndrome


Presentation

  • In the present study, the sensitivity for the diagnosis of PSP was 84.2%.[academic.oup.com]
  • Of these, another 69 were excluded: 24 patients who upon examination did not present with clear parkinsonian symptoms or who presented with drug-induced parkinsonism, as well as 45 patients (18.7%) who did not have a sufficient bone window for an adequate[peerj.com]
  • Atypical Parkinsonian disorders are progressive diseases that present with some of the signs and symptoms of Parkinson’s disease, but that generally do not respond well to drug treatment with levodopa.[hopkinsmedicine.org]
  • In the present study, the NPR was available from 1964 to 2009.[karger.com]
  • There are typical symptoms and signs that characterize this neurodegenerative disorder but the presentation is often variable and fairly unique from one person to another.[verywell.com]
Hypophonia
  • Patients often have one or several of the following signs: Tremor, or rhythmic unintentional movement Rigidity, or stiffness Bradykinesia, or a sense of slowing down in general Hypophonia, or softening of the voice Micrographia, or small handwriting Flexed[med.umich.edu]
  • Other common symptoms include: mask face, stooped posture, increased flexor tone, drooling, shuffling, seborrhea, orthostasis, decreased blinking, soft voice (hypophonia). It is often asymmetrical (especially at the onset). 26-4.[dartmouth.edu]
Falling
  • Backward falls are common and may occur during the early course of the disease. PSP is not usually associated with tremor, unlike Parkinson’s disease.[hopkinsmedicine.org]
  • […] in symptoms such as significant orthostatic hypotension (falling blood pressure when standing), erectile dysfunction and incontinence early in the disease.[verywell.com]
  • Impaired eye movement (downward gaze - damage to oculomotor nucleus) Prominent stare Slowed vertical saccades Falls, often backwards Neck hyperreflexia Hummingbird Sign in MRI due to atrophy of the midbrain tegmentum, with a relatively preserved pons.[quizlet.com]
  • Such balance problems in Parkinson’s disease are associated with a tendency to list or fall backward (retropulsion); in fact, a light push can cause the individual with Parkinson’s disease to continue stepping backward or to even fall down.[apdaparkinson.org]
  • Take Quiz Quiz Multiple sclerosis and pregnancy Take Quiz Comparing neuromyelitis optica spectrum disorder & MS Take Quiz Demyelination in myelocortical multiple sclerosis Take Quiz Clinical assessment of walking motion in patients with MS Take Quiz Fall[mdedge.com]
Fatigue
  • Women who complained of fatigue and sleepiness were more often diagnosed with depression than sleep apnea.[clinicaladvisor.com]
  • Fatigue Fatigue is a complex symptom of Parkinson’s disease that is not fully understood. It is known, however, that fatigue is significantly associated with depression and sleep disorders.[apdaparkinson.org]
  • Fatigue. Many people with Parkinson's disease lose energy and experience fatigue, especially later in the day. The cause isn't always known. Pain.[mayoclinic.org]
  • FATIGUE AND SLEEP DISTURBANCE Fatigue is present in one-third of patients with Parkinson disease at diagnosis, and is associated with severity of illness.[aafp.org]
  • MD, FRCP Professor, Clinical Ageing Reserach Unit Campus for Ageing and Vitality, Newcastle University Newcastle Upon Tyne, UK The defining feature of parkinsonism is bradykinesia, or slowness with decrement and degradation of repetitive movements (“fatigue[movementdisorders.org]
Difficulty Walking
  • Progressive supranuclear palsy Symptoms of PSP include: Difficulty walking Balance problems Recurrent falls that are often backwards Stiffness of the muscles – particularly the neck and trunk muscles Difficulty moving the eyes up and down – this may not[ftdtalk.org]
  • walking and frequent falls early in the course of the disease.[med.umich.edu]
Mask-like Facies
  • […] characterized by insidious onset of rhythmical muscular tremors at rest (pill-rolling tremor; 4-6 Hz), paucity and slowness of movement (hypokinesia, bradykinesia) and generalized rigidity (cogwheel and lead-pipe rigidity), festinant gait, stooped posture, mask-like[medical-dictionary.thefreedictionary.com]
Hypomimia
  • In addition to a general slowness of movement, the bradykinesia of Parkinson’s disease is typically demonstrated by a reduced or mask-like expression of the face (hypomimia or facial masking), a decreased blink rate of the eyes, and problems with fine[apdaparkinson.org]
Facial Muscle Rigidity
  • Facial muscle rigidity can also partly or completely account for the "masked facies."[dartmouth.edu]
Tremor
  • The tremor (shaking body parts) of Parkinson disease appears during rest of the limb and disappears or weakens during active movement. Additionally, Parkinson's disease cause walking problems and slow movements.[medical-dictionary.thefreedictionary.com]
  • PSP is not usually associated with tremor, unlike Parkinson’s disease.[hopkinsmedicine.org]
  • Genetic bases of MS risk Take Quiz MS diagnosis & McDonald criteria Take Quiz AAN Guidelines: MS & psychiatric disorders Take Quiz MS Coalition Recommendations: Disease-modifying therapy Take Quiz Albumin and MS Take Quiz Benign MS factors Take Quiz Tremor[mdedge.com]
  • The tremors are usually rhythmic or pendulous in nature. Essential tremor usually affects the hands and feet, but voice tremors and head tremors are also seen. The condition may be severely disabling in the long term.[news-medical.net]
Bradykinesia
  • […] certain antipsychotic drugs (e.g. perazine, phenothiazines, butyrophenones and depot preparations); characterized by insidious onset of rhythmical muscular tremors at rest (pill-rolling tremor; 4-6 Hz), paucity and slowness of movement (hypokinesia, bradykinesia[medical-dictionary.thefreedictionary.com]
  • Bradykinesia Greek for “slow movement,” bradykinesia is a frequent symptom of Parkinson’s disease and related movement disorders.[apdaparkinson.org]
  • Bradykinesia and rigidity are additive in hindering movement and are usually present together. Bradykinesia is, however, not dependent on or necessarily proportional to rigidity, and vice versa.[dartmouth.edu]
  • Subtle “bradykinesia” has been reported to occur in the “normal elderly” population, but this may reflect a non-specific slowness rather than bradykinesia as defined above.[movementdisorders.org]
Postural Instability
  • Postural Instability More pronounced in the later stages, postural instability includes the inability to maintain a steady, upright posture or to prevent a fall.[apdaparkinson.org]
  • Patients with the parkinsonian presentation typically have an asymmetrical tremor, bradykinesa, rigidity and postural instability. Men often develop impotence; both men and woman often experience urinary urgency and incontinence.[pdcenter.neurology.ucsf.edu]
  • Parkinson disease (PD) is a neurological malady that causes tremors, bradykinesia, muscle rigidity, and postural instability. It affects about 1-2% of adults over the age of 60. Idiopathic Parkinson disease is more commonly seen in males.[clinicaladvisor.com]
  • Cerebellar ataxia was assessed using the Parkinson’s plus scale [ 34 ] and postural instability using the Postural Instability and Gait Disorder (PIGD) scale [ 35 ] ( Table 1) .[journals.plos.org]
Resting Tremor
  • Parkinsonism is a broad term that refers to a group of neurological conditions that present with combinations of motor problems including resting tremor, rigidity, flexed posture, “freezing”, loss of postural reflexes and slowness of movement.[verywell.com]
  • The cardinal motor signs and symptoms of PD, include the characteristic clinical picture of resting tremor, rigidity, akinesia, and impairment of postural reflexes. It evolves slowly.[movementdisorders.org]
  • Typically beginning in the sixth or seventh decade of life, it is characterized by the unilateral onset of resting tremor in combination with varying degrees of rigidity and bradykinesia.[clevelandclinicmeded.com]
Akinesia
  • Keywords: Atypical parkinsonian disorders, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, dementia with lewy body, nocturnal manifestations, REM behavioral disorder, nocturia, nocturnal akinesia, hallucinations DOI[content.iospress.com]
  • […] antiparkinsonian drugs Spinocerebellar ataxias (usually type 2 or 3) Usually first manifests with imbalance and poor coordination Responds poorly to antiparkinsonian drugs Other disorders Cerebrovascular disease Manifests with rigidity and bradykinesia or akinesia[msdmanuals.com]
  • The cardinal motor signs and symptoms of PD, include the characteristic clinical picture of resting tremor, rigidity, akinesia, and impairment of postural reflexes. It evolves slowly.[movementdisorders.org]
  • Sometimes the main symptom may be hypokinesia or paucity of movement; akinesia, or lack of movements; and bradykinesia, or slowing of movements. These are all commonly seen in Parkinson’s disease and other similar conditions.[news-medical.net]
  • […] and targets being assessed for treatment using focused ultrasound include: Parkinsonian tremor – target in the thalamus (thalamotomy) Parkinsonian dyskinesia – target in the globus pallidus (pallidotomy) or subthalamic nucleus Parkinsonian tremor or akinesia[fusfoundation.org]

Workup

  • To determine if blood neurofilament light chain (NfL) protein can discriminate between Parkinson disease (PD) and atypical parkinsonian disorders (APD) with equally high diagnostic accuracy as CSF NfL, and can therefore improve the diagnostic workup of[ncbi.nlm.nih.gov]
  • Blood-based NfL might consequently be included in the diagnostic workup of patients with parkinsonian symptoms in both primary care and specialized clinics.[lup.lub.lu.se]
  • If the twins remained suspects after the second screening, they were invited to a clinical workup (phase III, see below).[karger.com]
  • "This easily accessible biomarker of axonal degeneration may improve the diagnostic workup of patients with parkinsonian symptoms in specialized clinics as well as in primary care settings."[medpagetoday.com]

Treatment

  • […] for MS Take Quiz ECTRIMS/EAN Guideline: Pharmacologic treatment of MS Take Quiz Symptoms of new MS relapse in the emergency department Take Quiz Treatments for refractory urinary symptoms in multiple sclerosis Take Quiz Optic neuritis in patients with[mdedge.com]
  • RBD was fully or substantially controlled with nightly clonazepam treatment in 89% (24/27) of patients in both groups. Thus, RBD can be the heralding manifestation of Parkinson's disease in a substantial subgroup of older male RBD patients.[ncbi.nlm.nih.gov]
  • Atypical Parkinsonism Treatment Although research is deepening medical understanding of these disorders, atypical Parkinsonian disorders are progressive and as yet there are no treatments that effect a cure.[hopkinsmedicine.org]

Prognosis

  • […] treatment Take Quiz Falls & mobility device use among patients with MS Take Quiz Diet & gut microbiota in multiple sclerosis Take Quiz MS symptoms and the cerebellum Take Quiz Vitamin D as a factor in MS Take Quiz Cerebellar dysfunction in MS Take Quiz Prognosis[mdedge.com]
  • What is the prognosis for Wolff-Parkinson-White syndrome? The prognosis for Wolff-Parkinson-White syndrome is excellent. Discussion with your physician can help navigate the treatment options that are available.[medicinenet.com]
  • Urinary Biomarker of Parkinson Disease Identified By Dinko Kranjac, PhD, Medical Editor To date, there are no validated biomarkers to independently assess Parkinson Disease diagnosis and prognosis, or to measure disease severity. more »[psychiatryadvisor.com]
  • They do not respond as well to dopaminergic treatments and generally have a worse prognosis compared to typical Parkinson’s disease.[movementdisorders.org]
  • While symptoms of Parkinson's disease and atypical parkinsonian disorders may overlap, the prognosis is very different , they noted.[medpagetoday.com]

Etiology

  • Population-based national health registers are valid data sources in epidemiological studies of PD or parkinsonian disorder etiology but are less suitable in studies of incidence or prevalence.[ncbi.nlm.nih.gov]
  • […] of back pain: Part 2 Take Quiz Etiology of back pain: Part 1 Take Quiz Understanding severe brain injury Take Quiz Treatment options for pain Take Quiz Pain assessment and management Take Quiz Pain assessment Take Quiz The physiologic aspects of pain[mdedge.com]
  • Research on prodromal symptoms of Parkinson’s disease (PD), including olfactory impairment and RBD, helps dissect disease etiology in this open access review by Honglei Chen in: J. Parkinsons Dis. , Vol 8:1, 2018.[journalofparkinsonsdisease.com]
  • Sinrdom parkinson dengan beragam etiologi gambaran gejala klinis hampir serupa. Kriteria untuk menggolongkannya ke dalam sindrom Parkinson adanya rigiditas, tremor, dan bradikinesia.[medlinux.blogspot.com]
  • The etiology of parkinsonian disorders is complex, and the causative factors are largely unknown [ 1 ]. Diagnoses are primarily clinical as there are no diagnostic biomarkers.[karger.com]

Epidemiology

  • Swedish population-based national health registers are widely used data sources in epidemiological research. Register-based diagnoses of Parkinson's disease have not been validated against clinical information.[ncbi.nlm.nih.gov]
  • References de Lau LM, Breteler MM: Epidemiology of parkinson’s disease. Lancet Neurol 2006;5:525–535. Sorensen HT, Sabroe S, Olsen J: A framework for evaluation of secondary data sources for epidemiological research. Int J Epidemiol 1996;25:435–442.[karger.com]
  • […] stroke subtypes Take Quiz Thrombectomy & intravenous thrombolysis for stroke management Take Quiz Stroke and risk of familial late-onset Alzheimer disease Take Quiz Strokelike episodes in MELAS mitochondrial syndrome Take Quiz Poststroke depression epidemiology[mdedge.com]
  • In an epidemiologic study of patients with parkinsonism, Schrag et al (2000) found that 65% had PD 18% had drug-induced parkinsonism 7% had vascular parkinsonism 6% had atypical but non-specific features 2.5 % had progressive supranuclear palsy 2% had[pdcenter.neurology.ucsf.edu]
  • Epidemiology [ 4 ] Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • […] subtypes Take Quiz Thrombectomy & intravenous thrombolysis for stroke management Take Quiz Stroke and risk of familial late-onset Alzheimer disease Take Quiz Strokelike episodes in MELAS mitochondrial syndrome Take Quiz Poststroke depression epidemiology & pathophysiology[mdedge.com]
  • Advancing Pain Management: Human Studies By Tori Rodriguez, MA, LPC Research on monogenic disorders has made vital contributions to all aspects of medical care, including our understanding of pain pathophysiology.[psychiatryadvisor.com]
  • Pathophysiology Although the exact cause of MSA evades understanding, many pathophysiologic mechanisms have been uncovered. Iron and ferritin levels appear to be increased in the substantia nigra and striatum.[emedicine.medscape.com]
  • P values of Results Patient characteristics We allocated patients who were eventually diagnosed with essential tremor (ET) in the group of parkinsonism, because of the pathophysiologic resemblance with PD ( Fekete & Jankovic, 2011 ; Louis & Ottman, 2013[peerj.com]
  • Because it is reversible and not progressive or fatal, very little is known of the pathophysiology.[dartmouth.edu]

Prevention

  • Take Quiz Stroke in patients with nonvalvular atrial fibrillation Take Quiz Emergency management of stroke Take Quiz Stroke risk & smoking in young adult males Take Quiz AHA/ASA Guidelines: Stroke management & prevention Take Quiz Spastic arm paralysis[mdedge.com]
  • This is encouraging news as the need for a reliable, accurate and affordable biomarker is essential in order to make real headway towards a cure or at least a drug regime which could prevent progression (if we could diagnose PD before any damage becomes[eastmidlands-rsn.org]
  • Can Wolff-Parkinson-White syndrome be prevented? Wolff-Parkinson-White syndrome cannot be prevented, but can be treated in the vast majority of people.[medicinenet.com]
  • Prevention Because the cause of Parkinson's is unknown, proven ways to prevent the disease also remain a mystery. Some research has shown that regular aerobic exercise might reduce the risk of Parkinson's disease.[mayoclinic.org]
  • They are unable to make the appropriate kinetic-postural adjustment necessary to prevent them from falling.[dartmouth.edu]

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