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Parkinson's disease is a major neurodegenerative disease mainly affecting the elders. In autopsy studies, the diagnosis of Parkinson's disease before death is found to be incorrect in a number of cases. In contrast, Parkinson's disease may be misdiagnosed as depression, or in the very elderly, “normal” aging. Other neurodegenerative disorders, like progressive nuclear palsy or multiple system atrophy, may not be distinguished easily from Parkinson's disease early in the course of the disease. This chapter also discusses the classic triad of symptoms of Parkinson's disease, which consists of tremor, rigidity, and hypokinesia. In the early stages of the disease, the signs and symptoms may be vague and nonspecific in such a way that a trustworthy diagnosis cannot yet be made. Symptoms can be gravitated by contralateral activation, or concentration on mental and physical tasks. The chapter also stresses on the fact that gait is impaired in the patients with Parkinson's disease. Although the most important lesion in Parkinson's disease is located in the substantia nigra and its dopaminergic projections, lesions of the presynaptic nigrostriatal dopamine system lead to widespread abnormalities in regional brain metabolism. |
