Presentation
It presents new perspectives and rules regarding expert testimony and evidence admissibility occasioned by Daubert and related Supreme Court cases. [books.google.de]
Clinical and pathological evidence for this conclusion is presented. Key words Postencephalitic parkinsonism Aging Basal ganglia Encephalitis lethargica This is a preview of subscription content, log in to check access. [link.springer.com]
Due to almost total extinction of PEP, repository archival material represents the only source for modern investigations, that up to the present, failed to identify a causaive or transmissible agent. [alzheimer-europe.org]
However, autonomic dysfunction may not always be the presenting feature of MSA. Patients with MSA may also present with in coordination or difficulties with balance (called cerebellar ataxia) or early bulbar and swallowing difficulty. [parkinsonssocietyindia.com]
Entire Body System
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Falling
Symptoms and course Bradykinesia, rigidity, hypomimia, postural instability, gait disorders with falls and sialorrhea. Ophthalmoplegia and oculogyric crises. [alzheimer-europe.org]
However, the key to establishing the diagnosis of PSP is the identification of early gait instability, with frequent backward falls and difficulty moving the eyes, which are considered the hallmark of the disease. [parkinsonssocietyindia.com]
WARNINGS AND PRECAUTIONS Falling Asleep During Activities of Daily Living and Somnolence: Patients treated with levodopa (a component of RYTARY) have reported falling asleep while engaged in activities of daily living, including the operation of motor [rytaryhcp.com]
It is especially important to stand behind the patient in case they should fall backwards so that the examiner can catch the patient and prevent a fall. [thebigl.co]
Patients with progressive supranuclear palsy have a marked tendency to fall and usually do not experience tremor. [healthcommunities.com]
Respiratoric
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Hypophonia
Lack of facial expression Slowed activities of daily living (for example, eating, dressing, and bathing) Difficulty turning in bed Remaining in a certain position for a long period of time Nonmotor symptoms Diminished sense of smell Low voice volume (hypophonia [columbianeurology.org]
Treatment of Parkinson hypophonia with percutaneous collagen augmentation. Laryngoscope. 1999 Aug. 109(8):1295-9. [Medline]. Kim HJ, Jeon BS, Paek SH. Effect of deep brain stimulation on pain in Parkinson disease. [emedicine.medscape.com]
Face, Head & Neck
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Hypomimia
Symptoms and course Bradykinesia, rigidity, hypomimia, postural instability, gait disorders with falls and sialorrhea. Ophthalmoplegia and oculogyric crises. [alzheimer-europe.org]
PARKINSON’S DISEASE Parkinson’s disease is characterized by a characteristic pill rolling tremor, bradykinesia, mask-like facies with a reduced blinking frequency (hypomimia), simian posture, cogwheel rigidity, gait disturbances, and impaired postural [thebigl.co]
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Mask-like Facies
PARKINSON’S DISEASE Parkinson’s disease is characterized by a characteristic pill rolling tremor, bradykinesia, mask-like facies with a reduced blinking frequency (hypomimia), simian posture, cogwheel rigidity, gait disturbances, and impaired postural [thebigl.co]
Neurologic
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Tremor
[…] the body Passive suicide: killing oneself through indirect action or inaction, such as no longer taking life-prolonging medications Parkinsonian syndromes: disorders related to PD in that they are characterized by bradykinesia and sometimes rigidity, tremor [books.google.de]
Initial symptoms include hand tremors, limb rigidity, and problems walking. As the disease progresses, cognitive problems may develop and advance into dementia. Dietary sources of nicotine may prove protective. [washington.edu]
No diagnostic test available.Diff. diagnosis: mainly against PD, but significant differences: 1. onset of symptoms in younger age, including children and adults aged 25-40 yrs; 2. rare occurence of rest tremor; 3. progression of disease in discontinous [alzheimer-europe.org]
G25 Other extrapyramidal and movement disorders G25.0 Essential tremor Familial tremor Excludes: tremor NOS ( R25.1 ) G25.1 Drug-induced tremor Use additional external cause code (Chapter XX), if desired, to identify drug. [apps.who.int]
A resting pill rolling tremor is often noted. The tremor is often noted early in disease onset and is often unilateral at first. It is important to distinguish the pill rolling tremor from essential tremor. [thebigl.co]
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Bradykinesia
[…] paralyzed in (usually) the lower half of the body Passive suicide: killing oneself through indirect action or inaction, such as no longer taking life-prolonging medications Parkinsonian syndromes: disorders related to PD in that they are characterized by bradykinesia [books.google.de]
Symptoms and course Bradykinesia, rigidity, hypomimia, postural instability, gait disorders with falls and sialorrhea. Ophthalmoplegia and oculogyric crises. [alzheimer-europe.org]
Parkinson's disease is recognized by the presence of at least three of four cardinal signs: resting tremor, cogwheel rigidity, bradykinesia/akinesia, and postural reflex impairment. [parkinsonsmi.org]
Clinical features may include bradykinesia, rigidity, parkinsonian gait, and masked facies. In general, tremor is less prominent in secondary parkinsonism than in the primary form. [hon.ch]
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Resting Tremor
No diagnostic test available.Diff. diagnosis: mainly against PD, but significant differences: 1. onset of symptoms in younger age, including children and adults aged 25-40 yrs; 2. rare occurence of rest tremor; 3. progression of disease in discontinous [alzheimer-europe.org]
He has a rigid, mask-like expression on his face, a bent-forward, stooped posture and a resting tremor. [articles.latimes.com]
Parkinson's disease is recognized by the presence of at least three of four cardinal signs: resting tremor, cogwheel rigidity, bradykinesia/akinesia, and postural reflex impairment. [parkinsonsmi.org]
PD is characterized by the presence of resting tremor, rigidity, and bradykinesia, and a good response to levodopa. [enotes.tripod.com]
A resting tremor of one hand is often the first symptom. [msdmanuals.com]
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Dystonia
Elderly patients suffer from continuous deterioration of motor function with dysphagia, incontinence, Levo-Dopa induced psychoses, dystonia, and cognitive impairment. [alzheimer-europe.org]
Calne DB, Lang AE (1988) Secondary dystonia. Adv Neurol 50:9–33 Google Scholar 2. Calne DB, Langston JW (1983) Aetiology of Parkinson's disease. Lancet II:1457–1459 Google Scholar 3. [link.springer.com]
[…] supranuclear palsy and Guamanian parkinsonism-dementia complex. ( 8453463 ) Geddes JF...Daniel SE 1993 24 Anti-tau-positive glial fibrillary tangles in the brain of postencephalitic parkinsonism of Economo type. ( 8121623 ) Ikeda K...Ikeda K 1993 25 Cranial dystonia [malacards.org]
[…] divided into hypokinetic and hyperkinetic disorders: hypokinetic disorders are characterized by slow, impaired voluntary movements typified by parkinsonism; hyperkinetic disorders are characterized by involuntary movements, including chorea, ballismus, dystonia [what-when-how.com]
Symptoms are similar to those found in PD, including rigidity, impaired balance and coordination, and dystonia. [agingcare.com]
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Micrographia
A sample of the patient’s writing should be obtained and examined for micrographia (small print) which is often noted in patients with parkinson’s disease. [thebigl.co]
Incidentally, micrographia, clearly evident in Hitler's numerous written accounts, points towards the idiopathic nature of his illness. [annalsofian.org]
Motor symptoms: Tremor Bradykinesia (slow movement) Rigidity and freezing in place Stooped posture Shuffling gait Decreased arm swing when walking Difficulty rising from a chair Micrographia (small, cramped handwriting) Lack of facial expression Slowed [columbianeurology.org]
[…] cogwheel rigidity) resting tremor (pill-rolling) dementia in later phase & depression SX: Slowness of voluntary movements is noted, particularly in the initiation of such movements as walking, rolling over in bed, and fine finger dexterity leading to micrographia [enotes.tripod.com]
Hypokinesia and impaired control of distal muscles cause micrographia (writing in very small letters) and make activities of daily living increasingly difficult. [msdmanuals.com]
Workup
Other Pathologies
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Neurofibrillary Tangle
Keywords: astrocytes; encephalitis lethargica; multisytem degeneration; oculogyric crisis; postencephalitic parkinsonism; tauopathy (3R/4R tau); tuft-shaped neurofibrillary tangles Summary Postencephalitic parkinsonism is a progressive neurodegenerative [onlinelibrary.wiley.com]
The brain regions affected contain neurofibrillary tangles, similar to those seen in Alzheimer's disease. Nevertheless, the senile plaques common in Alzheimer's disease are not found. [en.wikipedia.org]
Neuropathology: multisystem neuronal degeneration and cell loss, with gliosisin many brainstem nuclei, in particular substantia nigra, locus ceruleus, and others with globous neurofibrillary tangles in residual neurons in many subcortical nuclei. [alzheimer-europe.org]
Ishii T, Nakamura Y (1981) Distribution and ultrastructure of Alzheimer's neurofibrillary tangles in postencephalitic Parkinsonism of Economo type. Acta Neuropathol (Berl) 55:59–62 Google Scholar 13. [link.springer.com]
Treatment
Thus, we decided that a handbook focusing on the outpatient treatment of mental disorders would be both timely and useful. [books.google.com]
[…] well as new drugs for symptom treatment. [books.google.de]
The state of the art in treatment remains roughly the same as it was at the time of the events depicted, the 1960s, although patients with post-encephalitic Parkinsonism lose benefit from their medication far faster than do patients with Parkinson's disease [en.wikipedia.org]
Prognosis
Topics covered include challenges of correct diagnosis, variations in prognosis, investigations of causes including exciting progress in possible toxins and genetic factors that play a role, and different treatment options including natural remedies as [books.google.com]
Prognosis : Encephalitis lethargica was quickly recognized as a serious, lethal discase. Aside front a very high mortality rate, many patients were left with significant disabilities. [baillement.com]
Atypical parkinsonism refers to a group of neurodegenerative disorders that have some features similar to those of Parkinson disease but have some different clinical features, a worse prognosis, a modest or no response to levodopa, and a different pathology [msdmanuals.com]
Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 Apr 11. 66(7):968-75. [Medline]. [emedicine.medscape.com]
Etiology
The precise etiology of this disorder remains a conundrum. Most investigators suspect a viral etiology. [indiana.pure.elsevier.com]
Report of an acute case due to coxsackie virus type B 2 and re-examination of the etiologic concepts of postencephalitic parkinsonism. ( 5800856 ) Poser CM...Poland JD 1969 45 Distribution of the brain stem lesions in postencephalitic Parkinsonism. [malacards.org]
Furthermore, the symptomatic therapies used today are often effective irrespective of etiology. [what-when-how.com]
Sacks has recently been engaged with the etiology of some of the more mysterious diseases: postencephalitic Parkinson's and color blindness in island populations. [medical-dictionary.thefreedictionary.com]
There are many causes of parkinsonism, and although there is a specific pathology under the microscope associated with Parkinson's disease, its cause appears to involve multiple factors and there may in fact be more than one cause or etiology. [parkinsonsmi.org]
Epidemiology
The investigation of dietary sources of nicotine stems from the puzzling epidemiologic findings that repeatedly show that people who have regularly used tobacco have about half the risk of developing Parkinson’s disease, explained Searles Nielsen. [washington.edu]
Secondary parkinsonism, which includes drug-induced parkinsonism and postencephalitic parkinsonism Epidemiologic studies have associated early-life viral infections to postencephalitic PD; case reports, on the other hand, tend to relate viral infections [medical-dictionary.thefreedictionary.com]
Studies of identical twins show that most Parkinson's disease is not inherited, and epidemiological studies support a multifactorial model in which both genetic and environmental factors play a role. [parkinsonsmi.org]
Epidemiological work and animal experiments support the hypothesis that GPD is caused by a toxic amino acid in the seed of a cycad plant which is used to make flour and is a staple in the local diet. [neuropathology-web.org]
Epidemiology and etiology of Parkinson's disease: a review of the evidence. Eur J Epidemiol. 2011 Jun. 26 Suppl 1:S1-58. [Medline]. Anderson P. More Evidence Links Pesticides, Solvents, With Parkinson's. Medscape Medical News. Available at . [emedicine.medscape.com]
Pathophysiology
Several chapters examine the mechanisms and pathophysiology of neuropathological conditions and discuss the biomechanical basis for neurological injury. Where possible, aging and dating methodology is included for various processes. [books.google.de]
Nevertheless, major advances in the understanding of the genetics, molecular biology, and pathophysiology of these disorders have led to the availability of genetic testing for a selected few and to the development of effective pharmacologic and surgical [what-when-how.com]
They reflect functional organization, and it always hopeful to see that disease follows such patterns, raising the prospect that we can understand (and perhaps one day combat) its pathophysiology. [academic.oup.com]
“Should this finding be confirmed ... a particularly great importance would have to be attributed to dopamine's role in the pathophysiology and symptomology of idiopathic Parkinson's disease and postencephalitic parkinsonism.” H. Ehringer & O. [nature.com]
Prevention
Rosenbaum also explains research efforts to find a preventative drug, modern surgical options, and hopes for stem cell or gene therapy. [books.google.com]
Exercise and Stress Reduction Getting regular exercise and keeping stress levels low can help decrease inflammation levels and prevent brain cell deterioration. [draxe.com]
We commission world-class research and drug discovery to treat and prevent primary tauopathies like progressive supranuclear palsy, as well as secondary ones such as Alzheimer’s disease. [tauconsortium.org]
It is especially important to stand behind the patient in case they should fall backwards so that the examiner can catch the patient and prevent a fall. [thebigl.co]