In: Nursing
Mr. N, age 66 years, has noticed excessive fatigue, muscle aches, and weakness in his legs for some time. His hands were shaking slightly, although his wife reported that the shaking appeared to stop when he fell asleep. Some unintentional head movements were also apparent. He remembers that his grandfather died in his mid-60s after suffering for years from a condition with similar symptoms. After several tests and the elimination of some other neuromuscular conditions, a diagnosis of Parkinson's disease was made for Mr. N.
1. Discuss the pathophysiology of Parkinson’s disease and how it differs from other neuromuscular conditions affecting older adults. (See Parkinson’s Disease.)
2. Discuss the usual progression of the disease as the pathophysiology develops further. Indicate additional manifestations that will be noticeable. (See Parkinson’s Disease—Signs and Symptoms.)
3. Describe the complications that frequently develop, including the rationale for each and the early indications of each problem.
4. Discuss the treatments available to this patient. (See Parkinson’s Disease—Treatment.)
parkison's disease is second most common neurodegnerative disorder after Alzheimer's disease
parkinson's disease is a disorder of neuromuscular affect motor neurons ,the main pathophysiology is cell death in brain's basal ganglia and presence of lewy bodies (alfa protein) in many of remaining neurons
there is disturbance in all five pathways of brain (motor,oculomotor,associative,limbiv and orbitofrontal) connecting other brain area wuth basal ganglia
the basic sign and symptoms are- Bradykinesia ;-slowness of voluntary movement
-rest tremor
-rigidity - increase muscles tone during examination
-postural instability
cognitive and memory disturbane
management of parkinson's -
prevent from injury - prevent the patient from fall down because of motor disturbance
keep the wash room dry,have bright light and near from bed room
physiotherapy -physiotherapy prevent the patient from rigidityof muscles and increase muscles power
speech therapy - increase quality of speech,mouth exercise prevent secretions and prevent swallowing problems
basic medication used in PD is -levodopa -
- COMT- inhitors
- dopamine agonist
MAO-B inhibitors- increase amount of dopamine dopamine in basal ganglia by inhibit MAO-B