PARKINSON'S DISEASE: CONCEPTS, DIAGNOSIS AND TREATMENT

ELEXANDRA APARECIDA SIMÕES, IGOR YOSHIMITSU BAMBIL UJIIE, EMERSON HENKLAIN FERRUZZI

Resumo


Introduction: Parkinson's disease (PD) is the second most common neurodegenerative disease1,4,5. It is
estimated about 5 million people worldwide affected by this disorder. It affects men and women of all
ethnicities, occupations and countries1. Understanding this pathology allows healthcare professionals
suspect previously of its appearance, thus allowing early referral for medical evaluation, culminating,
possibly, with diagnosis and appropriate treatments. Diagnosis of this condition is clinical. Objective:
Present the concepts on DP, diagnosis and treatment, allowing for better dissemination of knowledge
about this condition among health professionals. Materials and Methods: This research consists of a
literature review guided by theoretical frameworks, including books and articles published in English and
Portuguese. The databases consulted included "Medline" and "PubMed". Results: The keywords were
used "Parkinson" associated with the word "disease" in the last 10 years with 17.764 results in PubMed
and 623 Medline. The research has been done in recent publications and considered relevant to the topic
under discussion. Discussion and Conclusion: PD is the most common form of parkinsonism (general term
for bradykinesia with rigidity and / or tremor)1.4. Starts on average at 60 years, reaching patients aged 20
or less1.The cases are sporadic (85-90% of cases, against 10 to 15% of family origin) of unknown cause,
believing it to be a combination of gene mutation, which induces susceptibility, and toxic environmental
factors1.4. Pathologically, the DP consisting mainly of degeneration of dopaminergic neurons of the
substantia nigra, reduced striatal dopamine and proteinaceous intracytoplasmic inclusions (Lewy
bodies)1,2,4. The "essential" clinical manifestations include resting tremor, rigidity, bradykinesia, and gait
impairment, associated with other motor features like facies in mask hypophonia and freezing of gait; and
not including the motor characteristics autonomic disturbances (orthostatic hypotension, gastrointestinal
and genitourinary disorders, and sexual dysfunction), sensory, sleep, psychosis, depression, dementia and
anosmia1,2.4,5,6,7,8. The diagnosis is clinical and currently considers resting tremor, asymmetry and good
response to levodopa1. Images tests are rarely needed in clinical practice. Currently, the management of
treatment is individualized and there is no standardized approach, but should take into account the
functional, cognitive and emotional commitments, beyond the point of introduction of neuroprotective
drugs. The main drug is levodopa, dopamine precursor. This drug is commonly associated with a
peripheral decarboxylase inhibitor1,3,5. Besides this, other work in the extension of dopamine action as
dopamine agonists, inhibitors of monoamine oxidase type B (MAO-B) and inhibitors of catechol-O-methyltransferase (COMT)1. Another feature is the surgical treatment such as deep brain stimulation that
simulates the effects of a brain injury, the more secure techniques of brain parenchyma such as
pallidotomy1.3. Knowledge of this condition during the clinical examination is essential to suspicion and
clinical diagnosis as well as pharmacological and non pharmacological and surgical (if necessary) in order
to ensure the well-being, quality of life and survival of patients.




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Referências


Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Medicina Interna de Harrison. 18ª

ed. Porto Alegre: AMGH, 2013.

Kumar V, Abbas AK, Aster JC. Robbins & Cotran Patologia: Bases patológicas das doenças. 8ª ed. Rio de

Janeiro: Elsevier. 2012.

Rieder CRM, Borges V, Neto CY, Tosta ED. Recomendações para o tratamento da doença de Parkinson.

São Paulo: Omnifarma, 2010. Disponível em: [http://neurologiahu.ufsc.br/files/2012/08/Manual-derecomenda%C3%A7%C3%B5es-da-ABN-em-Parkinson-2010.pdf]. Acesso em 12-09-2015

Kalia LV, Lang EA. Parkinson´s disease. Lancet. 2015; 386: 895-912.

Ximenes JCM, Neves KRT, Leal LKAM, Carmo MRS, Brito GAC, Naffah-Mazzacoratti MG, Cavalheiro EA,

Viana GSB. Valproic Acid Neuroprotection in the 6-OHDA Model of Parkinson´s Disease Is Possibly Related

to Its Anti-Inflammatory and HDAC inhibitory Properties. Journal of Neurodegenerative Diseases. 2015,

Article ID 313702, 14 pages

Calderón-Fajardo H, et al. Electroconvulsive therapy in Parkinson’s disease. Arq Neuropsiquiatr. 2015:

-5.

Zahodne LB, Fernandez HH. A review of the pathophisiology and treatment of psychosis in Parkinson’s

disease. Drugs Aging. 2008; 25(8): 665 - 682.

Nishioka K, et al. Quantitative evaluation of electroconvulsive therapy for Parkinson’s disease with

refractory psychiatric symptoms. J Neural Transm. 2014.


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