![]() ![]() ![]() To control tremor and rigidity, pharmacologic management is the treatment of choice.Degeneration of substantia nigra in the basal ganglia of midbrain leads to depletion of dopamine Positron emission tomography (PET) and single photon emission computed tomography (SPECT) shows decrease dopamine uptake in the basal ganglia.The key to diagnosis is the patient’s response to levodopa (see Pharmacologic Highlights). The diagnosis of Parkinson’s disease is usually made through clinical findings rather than diagnostic tests.Self-care deficit related to rigidity and tremors.Shuffling steps, stooped position, and propulsive gait.Blank facial expression-mask –like facies.Rigidity with jerky interrupted movements.Tremors increasing when fatigued and decreasing with purposeful activity or sleep.Tremors in hands and fingers at rest (pill rolling).Handwriting that becomes progressively smaller.Bradykinesia, abnormal slowness of movement, and sluggishness of physical and mental responses. ![]() Dopamine-depleting drugs such as reserpine, phenothiazine, metoclopramide, tetrabenazine, and the butyrophenones (droperidol and haloperidol) can lead to secondary Parkinson’s disease. ![]() Secondary, or iatrogenic, Parkinson’s disease is drug- or chemical-related. The cause is unknown a few cases suggest a hereditary pattern. The majority of all cases of classic Parkinson’s disease are primary, or idiopathic, Parkinson’s disease (IPD).
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