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Parkinson's Disease

period 4 jarocki
by

Jade Lee

on 18 May 2016

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Transcript of Parkinson's Disease

Muscle Rigidity
Overview
Stages of Parkinson's Disease
There are 2 kinds of stages:
Parkinson's Disease
(PD) is a progressive disorder of the central nervous system.

It is one of the movement disorders, and frequently causes stiffness and slowing of the movement.
What is it?
Vannessa Ocampo, Paige Ordonez, and Cynthia Nunez
Parkinson's Disease
Causes
Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons
. Parkinson's primarily affects neurons in an area of the brain called the
substantia nigra
. Some of these dying neurons produce
dopamine
, a chemical that sends messages to the part of the brain that controls movement and coordination.
As PD progresses, the amount of dopamine produced in the brain decreases
, leaving a person unable to control movement normally.
Signs and Symptoms
Symptoms Usually begin on one side of the body.

Four Main Symptoms Include:

~Tremors
~Bradykinesia
~Rigidity
~Postural instability


Tremors
- Usually begins in a limb.
- "Pill rolling" tremors (very common-rolling the forefinger and thumb together like your rolling a pill).
- Tremors in the hand is usually one of the first symptoms.
- The tremor usually is more pronounced when the person is under stress.
- Tremors usually disappear during sleep and improves with intentional movements.
Bradykinesia
- It means slowness of movement.

(Brady- means slow, kin- means movement, & ia- means condition)

- It causes steps to be come shorter, or to drag your feet while ambulating causing you to walk with short, shuffling steps.

- Makes repetitive actions difficult, such as tapping of the fingers

- Makes doing activities of daily living, such as dressing, more difficult
It's the inability for muscles to relax normally, causing muscle tone to always be tight. Also can cause muscle aches for someone with Parkinson's.

This can be seen when you try to move the arm on a Patient with Parkinson's, there arm will only move in short, jerky like movements.
Impaired Posture
Parkinson's causes people to become stooped

They have difficulty balancing, especially when getting up from a chair.
Other Symptoms
- Depression and emotional changes
- Trouble swallowing
- Changes in speech
- Skin problems
(can be either oily or dry)
- Sleeping problems
- Dementia
- Orthostatic hypertension
- Muscle Cramps
Hoehn and Yahr scale
Stages 1-5
Focuses on movement symptoms:
- The
Unified Parkinson's Disease Rating Scale (UPDRS)
is used to follow the longitudinal course of Parkinson's disease. The UPDRS rating scale is the most commonly used scale in the clinical study of Parkinson's disease.

The UPDRS is made up of these sections:
Part I
: evaluation of mentation, behavior, and mood
Part II
: self-evaluation of the activities of daily life (ADLs) including speech, swallowing, handwriting, dressing, hygiene, falling, salivating, turning in bed, walking, and cutting food
Part III
: clinician-scored monitored motor evaluation
Part IV
: complications of therapy
Part V
: Hoehn and Yahr staging of severity of Parkinson's disease
Part VI
: Schwab and England ADL scale
Unified Parkinson's Disease Rating Scale
Risk Factors
Age
: over 60
Significant Family History

Gender
: Male
Toxic Exposure
Complications

Many of these can be treated.
- Constipation
- Trouble identifying smells
- Problems urinating and controlling bladder

Complications in later stages:
- Dementia
- Trouble swallowing
- Increase risk of falls
- No longer responding to medication
Test and Diagnosis
- No specific test exists to diagnose Parkinson's disease.
- Diagnosis is based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.

- Your doctor may order tests
such as blood tests, MRI, ultrasound of the brain, SPECT and PET scans
, to rule out other conditions that may be causing your symptoms.

- In addition to your examination, your doctor may give you carbidopa-levodopa, a Parkinson's disease medication. You must be given a sufficient dose to show the benefit, as low doses for a day or two aren't reliable. Significant improvement with this medication will often confirm your diagnosis of Parkinson's disease.

- Sometimes it takes time to diagnose Parkinson's disease. Doctors may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate your condition and symptoms over time and diagnose Parkinson's disease

Treatment
There is no cure, but treatment can help treat symptoms:

- Medication
- Brain Surgery
- Alternative Therapies
Medications
Medications may help you manage problems with walking, movement and tremor. These medications increase or substitute for dopamine

Carbidopa-levodopa
: natural chemical that passes into your brain and is converted to dopamine

Dopamine agonists
: Unlike levodopa, dopamine agonists don't change into dopamine. Instead, they mimic dopamine effects in your brain

MAO-B inhibitors
: help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO-B)

Amantadine
: provides short-term relief of symptoms of mild, early-stage Parkinson's disease.
Brain Surgery
In
Deep Brain Stimulation
(DBS), surgeons implant electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest near your collarbone that sends electrical pulses to your brain and may reduce your Parkinson's disease symptoms
Alternative Therapies
- Massages
- Yoga
- Acupuncture
- Music or Art Therapy
- Physical and OCCUPATIONAL therapy.
Parkinson and Occupational Therapy
For Parkinson's disease, occupational therapy generally provides assessment, treatment, and recommendations in the following areas:

- Arm and hand therapy
- Handwriting aids
- Home modification information
- Cooking and homemaking adaptations
- Eating and dinnerware adaptations
- Ways to make the most of your energy
- Workplace or work equipment modifications
- Leisure skill development
- Manual or electric wheelchair use
- Bathtub and toilet equipment use
- Dressing and grooming aids
Big and Loud Program
Big Program
Works to improve limb movement. Uses repetitive core movements used in daily living.


Loud Program
Stimulates the muscles of the larynx. Goal is to improve speech ability and voice level.
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