Paralysis agitans

Paralysis Agitans is a term historically used to refer to Parkinson's disease, a long-term degenerative disorder of the nervous system that primarily affects the motor system. The symptoms generally come on slowly over time, and early in the disease, the most obvious symptoms are shaking, rigidity, slowness of movement, and difficulty with walking. Cognitive and behavioral problems may also occur, with dementia commonly occurring in the advanced stages of the disease. Other symptoms include sensory, sleep, and emotional problems. The disease is named after the English doctor James Parkinson, who first described it in detail in 1817.

Symptoms and Signs

The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit. The cause of this cell death is poorly understood, but involves the build-up of proteins into Lewy bodies in the neurons. Early in the course of the disease, the most obvious symptoms are movement-related. These include shaking, rigidity, slowness of movement, and difficulty with walking and gait. Later, cognitive and behavioral problems may arise, with dementia commonly occurring in the advanced stages of the disease. Other symptoms include sensory, sleep, and emotional problems.

Causes

The cause of Parkinson's disease is generally unknown, but believed to involve both genetic and environmental factors. Those with a family member affected are more likely to get the disease themselves. There is also an increased risk in people exposed to certain pesticides and among those who have had prior head injuries.

Diagnosis

Parkinson's disease is typically diagnosed based on the presenting symptoms, physical examination, and, in some cases, specialized movement tests. Since there are no medical tests to confirm the disease, the diagnosis is often complicated and might require multiple consultations.

Treatment

While there is no cure for Parkinson's disease, medications, surgery, and multidisciplinary management can provide relief from the symptoms. The main families of drugs useful for treating motor symptoms are levodopa, dopamine agonists, and MAO-B inhibitors.

Prognosis

The progression of symptoms in Parkinson's disease is often a bit different from one person to another due to the diversity of the disease. People with Parkinson's disease can maintain a high quality of life with appropriate treatment and support.

Epidemiology

Parkinson's disease affects about 1% of people aged 60 years and over, making it the second most common aging-related disorder after Alzheimer's disease.

History

The disease is named after the English doctor James Parkinson, who first described "the shaking palsy" in 1817.

See Also

• Parkinson's disease clinical research
• Management of Parkinson's disease
• History of Parkinson's disease

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