neurologic disorders
Parkinson Disease
Introduction
Parkinson disease is a slowly progressive, degenerative disorder characterized by resting tremor, stiffness (rigidity), slow and decreased movement (bradykinesia), and eventually gait and/or postural instability. Diagnosis is clinical. Treatment aims to restore dopaminergic function in the brain withlevodopapluscarbidopaand/or other drugs (eg,dopamineagonists, monoamine oxidase type B [MAO-B] inhibitors,amantadine). For refractory, disabling symptoms in patients without dementia, stereotactic deep brain stimulation or lesional surgery andlevodopaand anapomorphinepump may help. (See also Overview of Movement and Cerebellar Disorders .) Parkinson disease affects about 0.4% of people > 40 years 1% of people ≥ 65 years 10% of people ≥ 80 years The mean age at onset is about 57 years. Parkinson disease is usually idiopathic. Juvenile parkinsonism,which is rare, begins during childhood or adolescence up to 20 years. Onset between ages 21 and 40 years is sometimes called young or early-onset Parkinson disease. Genetic causes are more likely in juvenile and early-onset Parkinson disease; these forms may differ from later-onset Parkinson disease because They progress more slowly. They are very sensitive to dopaminergic treatments. Most disability results from nonmotor symptoms such as depression, anxiety, and pain. Secondary and Atypical Parkinsonism None Secondary and Atypical Parkinsonism None 