Download - Text Book Reading Parkinson Disease
-
7/25/2019 Text Book Reading Parkinson Disease
1/15
Text Book ReadingPARKINSON DISEASE : Management in on-of
phase
Pembimbing:
dr . Untng! Sp.S
Dissn o"eh:
A"i# $di%ani A
&'&())&&')
*AKU+,AS KEDOK,ERAN UPN E,ERAN/AKAR,A
KEPANI,ERAAN K+INIK DEPAR,EMEN SARA*
DA+AM RUMA0 SAKI, MAR1ONO SEOKAR/O
PERIODE
-
7/25/2019 Text Book Reading Parkinson Disease
2/15
Defnition
Parkinsons Disease is a progressiveneurodegenerative disordercharacterized by bradykinesia,tremor at rest, and rigidity
-
7/25/2019 Text Book Reading Parkinson Disease
3/15
Cassifcation
Duus Topica Diagnosis !euroogy,"#$$
-
7/25/2019 Text Book Reading Parkinson Disease
4/15
%ign and %ymptomThey a&ect the
cranio'aciamuscuature to produce amas2"i2e #a3ies4hypomimia),
de'ective mouthcosure, reduced
binking,dysphagia,saivation
4droo"ing5,(mpairment o' fne
motor contro impairsactivities o' daiy iving
such as 'asteningbuttons, 6riting4micrographia),
eating )ith kni'e and
+evated musce toneis 'et by the patient as
musce tension orspasm and by theexaminer as increasedresistance to passive
movement across the
-
7/25/2019 Text Book Reading Parkinson Disease
5/15
Postural changes incude stooped posture, a midy-exed and adducted posture o' the arms, and postura
instabiity or "oss o# ba"an3e. Reated phenomena
incude invountary acceeration o' the gait .festination),di73"t in sto in 6a"2in ! ait instabi"it ! and
-
7/25/2019 Text Book Reading Parkinson Disease
6/15
Depression.The range o'depressive mani'estationsincudes )orry, anxiety,avoidance o' socia contact,
genera unhappiness,istessnessAn9iet%.Tension, )orry,menta agitation, ack o'concentration, and dizziness
are reativey commoncompaints/,he dee"opment o#dementia in PD iscorreated )ith an increase
in the number o' 0e)ybodies$"ood pressre 3hanges side e&ect o'antiparkinsonian medications
;onstipation as a mani'estation o' the
disease, or asa side e&ect o' medication .antichoiner ic
-
7/25/2019 Text Book Reading Parkinson Disease
7/15
-
7/25/2019 Text Book Reading Parkinson Disease
8/15
Patofsioogi
0oss o' pigment in thesubstantia nigra can be seenma3ros3opi3a""%/ The mostprominentneurochemicalabnormality is a defciencyo dopamine in thestriatum,
0e)y bodies is an eosinophiicintracytopasmic incusions inneurons
-
7/25/2019 Text Book Reading Parkinson Disease
9/15
patophysioogy
-
7/25/2019 Text Book Reading Parkinson Disease
10/15
diagnostic
+ncycopedia o'
2erantoogy,"#$3
-
7/25/2019 Text Book Reading Parkinson Disease
11/15
The higher the score the greater thedisease severity and disabiity
+ary iness $* $#, 4oderate $$* "#%evere "$ * 5#
-
7/25/2019 Text Book Reading Parkinson Disease
12/15
the Scientic Advisory Board'or the Michael J. Fox Foundation for Parkinsons esearch .6ankovic, "#$71/
S3reening
-
7/25/2019 Text Book Reading Parkinson Disease
13/15
Treatment
S%mptomati3 ,reatment
,ransp"ant Srger%
Stereota3ti3 Nerosrgi3a"Pro3edres! Deep $rainStim"ation
1eneti3s o# PD
-
7/25/2019 Text Book Reading Parkinson Disease
14/15
Drug +&ect in ParkinsonDiseases
=! T(4+
=>> T(4+
?+@R(!2 =>> D+0@A+D =!
ON-O** P0ENOMENON
>R++(!2 +P(%=D+%
-
7/25/2019 Text Book Reading Parkinson Disease
15/15
*"3tations in drg efe3t 4=on>ofphases! end-o#dose akinesia1 can o'tenbe improved by the use o' sustained*
reease 0*D=P@ preparations, division o'the daiy dose into smaer individuadoses at more 'reuent intervas.perhaps )ith the use o' iuid
preparations1, and:or the addition o'dopamine agonists or C=4T inhibitors/