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PARKINSON( Pendahuluan)

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• PARKINSONISMSindroma : tremor waktu istirahat, rigiditas, bradikinesia, dan

hilangnya refleks ostural !!!!! "RAP

 Sindroma Parkinson 

• P#N$AKI" PARKINSON

Penyakit

% k l i n i s  : tremor waktu istirahat, rigiditas, bradikinesia,dan hilangnya refleks ostural

% patologis : degenerasi neuron%neuron bergigmen  neuromelanin, terutama di ars komakta substansia nigra,

yang disertai adanya inklusi sitolasmik eosinofilik

(Lewy bodies)

  Parkinsonisme idiopatik atau primer 

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Klasifkasi Parkinsonism

& Primer (idiopatik) : Penyakit Parkinson

& Sekunder (simptomatik)

& Drug induced& Ineksi (postensealitis, siflis)

& eta!olik

& Struktural (tumor otak, hydrosealus,

trauma)

& "oksin ( #O, #S$, #N, an%an, P"P)

& &askular (multiinark)

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Klasifkasi Parkinsonism

& Sindroma Parkinsonism'plus ' e%enerasi kortio'!asal %an%lioni

 ' *emiparkinsonism'hemioatrof

 ' Syndroma dementia: Penyakit Al+heimer,iuse -e.y !ody disease

 ' Atrof multipel'system

 ' Parkinsonism'dementia'A-S omple/ o 0uam

(-ytio'!odi%) ' Pro%ressi1e supranulear palsy

 ' Penyakit herediter de%enerati  

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Penyakit Parkinson (P)

& Salah satu 2enis parkinsonism yan%

penye!a!nya idiopatik

& seara patolo%is ditandai den%ande%enerasi neuron !erpi%men

neuromelamin di pars kompakta

su!stansia Ni%ra yan% disertai adanya-e.i !odies

& ise!ut 2u%a Parkinson Primer

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P

&  3ames Parkinson 4546 memakai

istilah 7shakin% palsy8

& Penyakit Parkinson (P): tremor,

ri%iditas, !radikinesia,

ketidaksta!ilan postur dan %ait

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P

Insiden

& 9,'$4; 4

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ParkinsonDs isease RiskEators

&  Defnite: Old a%e

&  Probable: Positi1e amily history

&  Possible: *er!iides, pestiides, hea1y

metals, pro/imity to industry, ruralresidene, .ell .ater, repeated headtrauma, et=

&  Possible protective eect: Smokin%

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Prelinial ParkinsonDsisease

& No speif linial markers kno.n

& 9'4@ o autopsies in elderly sho.in%inidental -e.y !odies are re%arded as

prelinial ases& Inreased risk o neurolepti parkinsonism

& uration o prelinial phase unkno.n

(se1eral years to se1eral deadesF)& PG" studies may identiy prelinial ases

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Garly Si%ns and Symptoms

#ardinal#harateristis

& Restin% tremor

H radykinesia& Ri%idity

& Postural insta!ility

Other& iro%raphia

& asked ae

& Slo.in% o A-S& Stooped, shuJin%%ait

& ereased arm

s.in% .hen.alkin%

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#riteria or ia%nosis

& At least t.o o three: rest tremor,!radykinesia, ri%idity

& A!sene o a seondary ause'dru%s,

meta!oli, et=& efniti1e dia%nosis an only !e made !y

autopsy

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 "reatment Options

& Pre1enti1e treatment ' No defniti1e treatment a1aila!le

& Symptomati treatment

 ' Pharmaolo%ial ' Sur%ial

& Non'motor mana%ement

& Restorati1e'e/perimental only

 ' "ransplantation ' Neurotrophi ators