By Anthony Schapira, Andreas Hartmann, Yves Agid
This booklet offers the reader an updated, transparent and logical suggestion of what taking care of parkinsonian sufferers includes - a problem that clinicians will face for a few years to return. it truly is break up into 3 sections:
Section 1: A compilation of the key mind lesions usually obvious in PD
Section 2: therapies in PD
Section three: 25 circumstances designed to check the reader and the sensible program of the data provided within the different sections.
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Additional info for Parkinsonian Disorders in Clinical Practice
What is Parkinson’s disease? 21 does not degenerate abruptly (although the exact kinetics in humans remain unknown), but crosses several intermediate stages, possibly over the course of years. This means that a proportion of neurons may be suffering and dysfunctional, but morphologically intact. Early rescue of diseased neurons may clinically result in an improvement in symptoms or, with the prospect of future preclinical identification of PD, delay the symptomatic phase of the disease and halt its progression.
10) although dementia and visual hallucinations are seen early during the course of the disease in patients with Lewy body disease. In sum, most patients with PD remain intellectually intact. If present, cognitive impairment evolves in two steps during the course of the disease. 9 Neuropsychological pattern in patients with movement disorders Dementia Global impairment Fluctuations Memory Storage disorders Recall disorders Instrumental disorders Linguistic Praxic Executive disorders Planning Behavior Psychosis PD MSA CBD PSP PDD HD DLBD AD+EP – – – – – – + – + – + – + + ++ – – + – + – + – ++ – ++ – ++ + + ++ + – – – – + ++ ± ± ± ± ± ± + + ++ + + ± – + ± – + + – ++ ++ – ++ + ± + ± + + ± ++ + ± + Abbreviations: PD, Parkinson’s disease; MSA, multiple system atrophy; CBD, corticobasal degeneration; PSP, progressive supranuclear palsy; PDD, Parkinson’s disease with dementia; HD, Huntington’s disease; DLBD, diffuse Lewy body disease; AD+EP, Alzheimer’s disease plus extrapyramidal signs.
23 stages, the majority of neurons in the central nervous system remain undamaged. • PD is not an accelerated form of aging: Although neuronal death probably occurs slowly (both at the systemic and at the cellular level), the decline is still much sharper than during normal aging (Fig. 13). Thus, it is estimated that nigral neuronal loss is 1% per year in PD patients, while neuronal loss with aging may be minimal, although connectivity and cellular function do decline. Furthermore, the type and localization of neurons most affected by PD or by aging differ.