Parkinson’s disease is a chronic, progressive neurodegenerative disorder characterized by tremors, rigidity, bradykinesia, and postural instability, caused by the loss of dopamine-producing neurons in the substantia nigra.
Mnemonic: "P.A.R.K. = Progressive Akinesia, Rigidity, Kinetic
Tremor"
CAUSES & RISK FACTORS
- Idiopathic (Unknown Cause – Most Common).
- Genetic (HLA-DR2, HLA-DR3 – Rare, Except in Early-Onset Cases).
- Environmental Toxins (Pesticides, MPTP – Drug-Induced Parkinsonism).
- Head Trauma (Repeated Concussions – Seen in Boxers).
- Age > 60 Years (Strongest Risk Factor).
- Less Common in Smokers & Coffee Drinkers.
Mnemonic: "I.G.E.H.A. = Idiopathic, Genetic, Environmental,
Head Trauma, Age"
PATHOLOGY OF PARKINSON’S DISEASE
- Loss of Dopaminergic Neurons in Substantia Nigra.
- Presence of Lewy Bodies (Abnormal Protein Aggregates in Neurons).
- Decreased Dopamine Levels in Basal Ganglia.
- Increased Activity of Subthalamic Nucleus (Leads to Bradykinesia).
Mnemonic: "L.L.D.S. = Lewy Bodies, Loss of Dopamine,
Subthalamic Hyperactivity"
SYMPTOMS OF PARKINSON’S DISEASE
(TRAP)
- Tremor (Resting Tremor – "Pill-Rolling")
- Rigidity (Lead-Pipe & Cogwheel Stiffness)
- Akinesia/Bradykinesia (Slow Movements, Masked Face, Micrographia – Small Handwriting)
- Postural Instability (Frequent Falls, Stooped Posture, Shuffling Gait)
Mnemonic: "T.R.A.P. = Tremor, Rigidity, Akinesia, Postural
Instability"
OTHER CLINICAL FEATURES
- Facial Symptoms → Masked Face (Hypomimia), Reduced Blinking.
- Speech Issues → Soft, Monotonous Speech (Dysarthria).
- Autonomic Dysfunction → Constipation, Orthostatic Hypotension, Sweating.
- Neuropsychiatric Symptoms → Depression, Dementia (Late-Stage).
- Glabellar Tap Sign → Persistent Blinking with Forehead Tapping.
Mnemonic: "F.S.A.N.G. = Face, Speech, Autonomic, Neuro,
Glabellar Tap"
DIAGNOSIS OF PARKINSON’S DISEASE
- Clinical Diagnosis (No Specific Test).
- MRI/CT Brain (To Exclude Other Causes – Stroke, Tumors).
- Dopamine Transporter Scan (DaTSCAN) – Confirms Dopamine Deficiency.
- Response to Levodopa (Good Response Suggests PD).
Mnemonic: "C.M.D.R. = Clinical, MRI, DaTSCAN, Response to
Levodopa"
TREATMENT OF PARKINSON’S DISEASE
1. MEDICAL MANAGEMENT
- Levodopa + Carbidopa (Most Effective – Converts to Dopamine in Brain).
- Dopamine Agonists (Bromocriptine, Pramipexole – Mimics Dopamine Action).
- MAO-B Inhibitors (Selegiline, Rasagiline – Prevents Dopamine Breakdown).
- COMT Inhibitors (Entacapone – Prolongs Levodopa’s Effect).
- Anticholinergics (Trihexyphenidyl – Controls Tremors in Young Patients).
- Amantadine (For Mild Symptoms, Reduces Dyskinesia).
Mnemonic: "L.D.M.C.A.A. = Levodopa, Dopamine Agonists, MAO-B
Inhibitors, COMT Inhibitors, Anticholinergics, Amantadine"
2. SURGICAL MANAGEMENT
- Deep Brain Stimulation (DBS) – For Advanced PD, Stimulates Subthalamic Nucleus.
- Pallidotomy/Thalamotomy – Rarely Done, Used for Severe Tremors.
Mnemonic: "D.P.T. = Deep Brain Stimulation, Pallidotomy,
Thalamotomy"
3. SUPPORTIVE MANAGEMENT
- Physiotherapy – Improves Balance, Prevents Falls.
- Speech Therapy – Helps with Soft Speech.
- Occupational Therapy – Improves Daily Activities.
Mnemonic: "P.S.O. = Physiotherapy, Speech Therapy,
Occupational Therapy"
HOMOEOPATHIC MANAGEMENT OF
PARKINSON’S DISEASE
For Tremors & Rigidity:
Rhus Tox, Agaricus, Causticum, Zincum Met.
For Bradykinesia & Gait Problems:
Gelsemium, Plumbum Met, Conium.
For Neuropsychiatric Symptoms:
Hyoscyamus, Belladonna, Nux Vomica.
Mnemonic: "R.A.C.Z. = Rhus Tox, Agaricus, Causticum, Zincum
for Tremors"
FINAL REVISION WITH MNEMONICS
- Definition = "P.A.R.K. = Progressive Akinesia, Rigidity, Kinetic Tremor"
- Causes = "I.G.E.H.A." (Idiopathic, Genetic, Environmental, Head Trauma, Age)
- Pathology = "L.L.D.S." (Lewy Bodies, Loss of Dopamine, Subthalamic Hyperactivity)
- Symptoms = "T.R.A.P." (Tremor, Rigidity, Akinesia, Postural Instability)
- Other Features = "F.S.A.N.G." (Face, Speech, Autonomic, Neuro, Glabellar Tap)
- Diagnosis = "C.M.D.R." (Clinical, MRI, DaTSCAN, Response to Levodopa)
- Medical = "L.D.M.C.A.A." (Levodopa, Dopamine Agonists, MAO-B Inhibitors, COMT Inhibitors, Anticholinergics, Amantadine)
- Surgery = "D.P.T." (Deep Brain Stimulation, Pallidotomy, Thalamotomy)
- Supportive = "P.S.O." (Physiotherapy, Speech Therapy, Occupational Therapy)
- Homeopathy = "R.A.C.Z." (Rhus Tox, Agaricus, Causticum, Zincum for Tremors)