By G. David Perkin
An authoritative creation to Parkinson's ailment and its similar problems and syndromes, this ebook presents a concise assessment of the sickness and its analysis and administration. the writer provides samples of scientific, investigative (CT, MRI, and PET), and pathological photographs with succinct descriptive textual content of the problems featured. He describes the stipulations relating to Parkinson's disorder, and the photographs offer pathological macroscopic and microscopic sections, a variety of imaging stories, and information of circulate problems in most cases. The publication will function an invaluable instructing software that demonstrates the imaging and pathology of the illness.
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Extra resources for An Illustrated Pocketbook of Parkinson’s Disease and Related Disorders
Drug-induced movements in these patients usually take the form of dystonia rather than chorea. Certain other clinical features are suggestive of the disease and are notoriously difficult to manage. These include postural instability with falls, excessive snoring associated with vocal cord abductor palsy, and anterocollis. Management of the postural hypotension includes the use of elastic Table 3 Multiple system atrophy: proposed clinical diagnostic criteria Definite Probable PLUS Severe symptomatic autonomic failure Striatonigral type (predominantly parkinsonism) Olivopontocerebellar type (predominantly cerebellar) Postmortem confirmation Sporadic adult-onset Non—or poorly levadopa-responsive Postmortem confirmation Sporadic adult-onset Cerebellar syndrome (with or without parkinsonism or pyramidal signs) 32 AN ILLUSTRATED POCKETBOOK OF PARKINSON’S DISEASE Figure 32 Striatonigral degeneration: histology of putamen Striatonigral type (predominantly parkinsonism) OR Cerebellar signs OR Pyramidal signs OR Olivopontocerebellar type (predominantly cerebellar) PLUS Severe symptomatic autonomic failure OR Pathological sphincter electromyogram pathological sphincter electromyogram Possible Sporadic, adult-onset, non- or poorly Sporadic adult-onset cerebellar levadopa-responsive parkinsonism syndrome with parkinsonism Adult onset, 30 years of age; sporadic, no multiple system atrophy in first—or second-degree relatives; autonomic failure, postural syncope and/or urinary incontinence or retention due to other causes; levadopa-responsive, moderate or good levadopa response accepted if waning and multiple atypical features present; parkinsonism, no dementia, areflexia, or supranuclear down-gaze palsy stockings, raising the head of the bed by 10°, fludrocortisone or a sympathomimetic agent.
Segmental myoclonus originates from a brain stem or spinal level. The movements are more or less continuous, usually at around 1–3 Hz, and explicable by discharges from contiguous anatomical levels (Figure 70). Palatal myoclonus is a rhythmic contraction of the soft palate, frequently accompanied by contraction of other muscles of the pharynx and larynx, sometimes to the face and even the diaphragm. Typically, it follows pontine infarction, often after a latent period of several weeks or months.
PET using [18F] fluorodeoxyglucose has been used to measure local cerebral metabolic rates for glucose in both multiple system atrophy and in sporadic and familial forms of OPCA. In the former two, reduced metabolic activity, albeit to differing degrees, is found in the brain stem, cerebellum, putamen, thalamus, and cerebral cortex. In familial OPCA, changes are confined to the brain stem and cerebellum (Figure 41). AN ILLUSTRATED POCKETBOOK OF PARKINSON’S DISEASE 35 Figure 37 Histology of multiple system atrophy with olivopontocerebellar atrophy (OPCA).