Idiopathic parkinsonism

Kish, S.J. Shannak, K. and Homykiewicz, O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson s disease. Pathophysiologic and clinical implications. N Engl J Med 318 876-880, 1988. 

Braak H., Tredici K Bratzke H. et al. (2002). Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson s disease (preclinical and clinical stages). J. Neurol. 249(Suppl. 3), III/l IIII/5. 

Rye D., Daley J., Freeman A., Bliwise D. (2003). Daytime sleepiness and sleep attacks in idiopathic parkinson s disease. In Bedard M-A., Agid Y., Chouinard S. et al. editors. Mental and Behavioral Dysfunction in Movement Disorders. Totawa, NJ Humana Press pp. 527-38. 

TABLE 45-1 a-Synuclein diseases Idiopathic Parkinson s disease Dementia with Lewy bodies Pure autonomic failure REM sleep behavior disorder Lewy body dysphagia Incidental Lewy body disease Inherited Lewy body diseases Multiple system atrophy... 

Treatment of symptoms of idiopathic Parkinson s disease (paralysis agitans), postencephalitic parkinsonism, and sympathetic parkinsonism that may follow injury to the nervous system by carbon monoxide and manganese intoxication. 

Parkinson s disease As an adjunct to levodopa/carbidopa to treat patients with idiopathic Parkinson s disease who experience the signs and symptoms of end-of-dose wearing-off. The effectiveness of entacapone has not been systematically evaluated in patients with idiopathic Parkinson s disease who do not experience end-of-dose wearing-off. ... 

Another form of parkinsonism is drug-induced, that is, iatrogenic parkinsonism, which often is a comphca-tion of antipsychotic therapy, especially following the use of the butyrophenone and phenothiazine drug classes (see Chapter 34). Unlike idiopathic parkinsonism, striatal content of dopamine is not reduced by administration of these drugs. In contrast, they produce a functional decrease in dopamine activity by blocking the action of dopamine on postsynaptic dopamine receptors. 

Reid WGJ, Broe GA, Morris JGL, et al The role of cholinergic deficiency in neuropsychological deficits in idiopathic Parkinson s disease. Dementia 3 114-120, 1990... 

It is indicated for the treatment of signs and symptoms of idiopathic Parkinson s disease. 

It is used in prophylaxis of influenza A virus, idiopathic parkinsonism and drug-induced extrapyramidal reactions. 

Postmortem studies of patients with idiopathic Parkinson s disease demonstrate cell loss in the striatal system (A-9), directly implicating this tract vis-a-vis the neuroleptic-induced pseudoparkinsonian side effects. The assumption that psychosis is related to the A-10 system is made by exclusion. Evidence also indicates that clozapine may differentially block DA pathways. Specifically, it seems to act on the mesolimbic dopaminergic system (A-10), while being relatively inactive in the striatal system (A-9) however, this remains controversial. Chronic administration of clozapine decreases the firing rate of A-10 mesocortical tract dopamine neurons... 

The discovery of toxin-induced parkinsonism in drug addicts led to the idea that idiopathic Parkinson disease may occur when susceptible individuals are exposed to some environmental toxin.14 Exposure to such a toxin through industrial waste or certain herbicides may begin the neuronal changes that ultimately result in Parkinson disease. A specific environmental factor, however, has not been identified yet. 

Parkinsonism is the collective name for a group of disorders that share similar clinical characteristics, including tremor, rigidity of the limbs or trunk, bradyki-nesia, and postural instability. The most well known of these disorders is Parkinson s disease, which was first described in 1817 by James Parkinson in Essay on the Shaking Palsy (70). Parkinson s disease is also known as primary or idiopathic Parkinson s disease. 

Idiopathic Parkinson s, or Parkinson s, is a chronic and progressive disorder of the central nervous system, especially the motor control regions of the central nervous system. It is characterized by difficulty in initiating voluntary movements, decreased spontaneous movements, slowness of movements, muscular rigidity of the limbs and trunk, postural instability (especially an inability to... 

Most of these disorders are related to degenerative processes that are confined to the neuromelanin-pigmented nuclei of the basal ganglia (the substantia nigra), the locus coeruleus and parts of the dorsal vagal nucleus and reticular formation. While the cause of idiopathic Parkinsonism is unknown, neuroleptics, viral infections and metals such as manganese are... 

Idiopathic Parkinsonism is distinguished from the other syndromes by the presence of Lewy bodies in the substantia nigra and locus coeruleus, and to a lesser extent in the substantia innominata, hypothalamus, dorsal medulla and sympathetic ganglia (Figure 13.2). 

IDIOPATHIC PARKINSONISM MULTIPLE SYSTEM ATROPHY NEUROFIBRILLARY TANGLE TYPE e.g. INDUCED BY NEUROLEPTICS... 

The enkephalins, somatostatin and substance P all appear to be depleted in idiopathic Parkinsonism, which may be a consequence of neuronal degeneration rather than a cause of any of the symptoms of the disease. Thus these changes do not correlate with the severity of the motor symptoms, although there is some indication that the loss of somatostatin may be associated with intellectual impairment. 

Hornykiewicz O, Pifl C (1994) The validity of the MPTP primate model for the neurochemical pathology of idiopathic Parkinson s disease. In Briley M, Marien M (Eds), Noradrenergic Mechanisms in Parkinson s Disease, pp. 11-23. VRV Press, Boca Raton. 

---