J Parkinson’s disease
Definition
Parkinsonism is a clinical syndrome that consists of four cardinal signs: tremor, rigidity, akinesia, and postural disturbances (TRAP). Parkinson’s disease is a common cause of TRAP syndrome, but there are numerous other causes.
Incidence and prevalence
Parkinson’s disease, which is the second most common neurodegenerative disorder after Alzheimer’s disease, occurs in approximately one in 1000 persons in the general population and in 1% of persons older than 65 years. Men are affected slightly more than women (3:2).
Pathophysiology
The cause of Parkinson’s disease is believed to be a variable combination of poorly understood genetic and environmental factors. Both autosomal dominant and autosomal recessive genes can cause classic Parkinson’s disease. Many of the features of Parkinson’s disease are attributable to loss of dopamine in the neostriatum (especially the putamen) secondary to loss of the pigmented dopaminergic neurons in the substantia nigra pars compacta of the midbrain. Approximately 60% of these dopaminergic neurons will have degenerated before clinical features of the disease develop.
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