Parkinsonism

Parkinsonism

[pahr-kin-suh-niz-uhm]
Parkinsonism: see Parkinson's disease.

Neurological disorder causing progressive loss of control of movement. It was first described in 1817 by British physician James Parkinson (1755–1824). The cause of primary parkinsonism, or Parkinson disease, is unknown. The mean age of onset is about 57, but juvenile parkinsonism is also known. Neurons in the brain that normally produce dopamine deteriorate. When 60–80percnt are destroyed, signals suppressing unintended movement are disrupted and symptoms appear, including tremor at rest, muscle rigidity, trouble in starting movements, and loss of balance. Known causes include sleeping sickness; certain poisons; repeated blows to the head, as in boxing; and the drug MPTP. Environmental toxins or genetic susceptibility may account for some cases. Drug therapy requires careful scheduling and combinations to delay development of tolerance and side effects. Surgical pallidotomy (destruction of the globus pallidus, a brain structure involved in motor control) and transplantation of fetal dopamine-producing tissue remain experimental.

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Parkinsonism (also known as Parkinson's syndrome, atypical Parkinson's, or secondary Parkinson's) is a neurological syndrome characterized by tremor, hypokinesia, rigidity, and postural instability. The underlying causes of parkinsonism are numerous, and diagnosis can be complex. While the neurodegenerative condition Parkinson's disease (PD) is the most common cause of parkinsonism, a wide-range of other etiologies can lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of non-PD neurological conditions. Its most common cause is as a side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones (such as haloperidol (Haldol)), piperazines (such as ziprasidone), and rarely, antidepressants.

Etiology

If PD has been excluded, the differential diagnosis or list of potential causes for this syndrome includes:

References

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