Parkinson disease idiopathic

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... 

Parkinson disease (PD) For the treatment of the signs and symptoms of idiopathic PD. 

Parkinson disease To treat patients with idiopathic Parkinson disease to substitute (with equivalent strength of each of the 3 components) for immediate release carbidopa/levodopa and entacapone previously administered as individual products to replace immediate release carbidopa/levodopa therapy (without entacapone) when patients experience the signs and symptoms of end-of-dose wearing-off (only for patients taking a total daily dose of levodopa of 600 mg or less and not experiencing dyskinesias). 

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. 

Rajapakse S, Abeynaike L, Wickramarathne T. Venlafaxine-associated serotonin syndrome causing severe rhabdo-myolysis and acute renal failure in a patient with idiopathic Parkinson disease. J Clin Psychopharmacol 2010 30(5) 620-2. 

Zhang F, Dryhurst G. Effects of I-cysteine on the oxidation chemistry of dopamine—new reaction pathways of potential relevance to idiopathic parkinsons disease. J Med Chem 1994 37 1084—1098. 

It s sometimes hard to distinguish parkinsonism from idiopathic Parkinson s Disease (PD). Look for clues tTahle 36.5L but if unsure, refer to neurology for single photon emission computed tomography (SPECT) imaging. If Tom has PD and EPSE, he ll need joint management with neurology. 

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. 

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 Treatment of idiopathic or postencephalitic Parkinson s disease. 

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. 

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... 

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. 

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. 

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