Wednesday, July 24, 2013

PARKINS0NISME SECONDARY / SYMPTOMATIC

PARKINS0NISME SECONDARY / 
SYMPTOMATIC

DEFINITIONS:
  • Parkinson Sindarioma a clear etiology, although caused by different mechanisms, but its final common pathway disorder-dopamine (DA) in GB.
  • Only partially discussed as an example.
PARKINSON DISEASE AFTER INFECTION
  • Post-infectious virus Von Economo (tahun. 1917 till 1928: A pandemic of encephalitis lethargica: 40% off, 5 years after infection 50% of Parkinson's disease, when it is 10 years old: 80%. Comorbid symptoms: oculogyric crises, and palilalia hiperkinesia.

L-dopa therapy results are good.
   Dx. histopathology: inflammation in the midbrain and paraventrikel. No viral infection was not proven, but suspected Vi influenza A.
  • Other viruses: Japanese encephalitis: lesions in the substantia nigra, and West Nile encephalitis with similar lesions and symptoms of Parkinson's disease is clear.
PARKINSON DISEASE OF MEDICINE
  • Most major cause of parkinsonism and Parkinson's disease are difficult to distinguish from the primary.
  • Users neuroleptika short (3 months) or long (at doses up)
  • The prevalence of Parkinson's disease neuroleptika users: 10-60%, influenced by: age (advanced), sex (female), there is a genetic predisposition (tremor)
  • 2/3 cases recovered after stop medication 7 weeks, but can be persistent up to 18 months.
TOXIN
  • Ok. MPTP toxin that damages the striatum, patofisiol Parkinson's disease more clearly.
  • CO (carbon monoxide), manganese (Mn), Hg, cyanide and other is ethyl. secondary Parkinson's disease.
VASCULAR PARKINSONISM:
  • Especially ok multiple infarcts often less responsive to the DA group
  • Leuco hypoxic ischemic encephalopathy ok more responsive to the DA group.
HEAD TRAUMA:
  • Rarely ok single trauma, but severe trauma after entry veg.stete
  • iron and repetitive head trauma ok (punch-dariunk) or pugilistic dementia in boxers.
NORMAL PRESSURE HYDARIOCEPHALUS (NPH)
  • Ok ICT is not always normal, it is called chronic Hidariosefalus
  • Symptoms: Impaired road (magnetic gait), bradykinesia, postural instability, incontinence and dementia. Shunting one of the treatment options.

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