Parkinson's Disease: An update on Pathophysiology, Epidemiology, Diagnosis and Management. Part 2 : Etiology and Pathophysiology

Parkinson's disease is a common neurodegenerative disorder which involves the loss of nigral dopaminergic neurons in particular. The attributes of the cardinal motor are rigidity, bradykinesis, tremor in rest and postural instability. Nonmotor symptoms are normal in the course of the disease both early and late, and include autonomic, neuropsychiatric and cognitive disorders. Parkinson's disease has symptoms beyond the nigrostriatal system so it is not shocking that some motor characteristics (such as postural instability) and many non-motor characteristics have a restricted response to dopaminergic medications. The cause is uncertain but there is growing evidence that this could be due to a combination of ecological and hereditary factors. Treatment intends to control the patient's manifestations by renewing the dopaminergic framework with levodopa or dopamine agonists. Treatment during the early stage of Parkinson's disease has developed, and studies recommend that dopamine agonist monotherapy may forestall the response fluctuations that are associated with progression of the disease. However, L-dopa therapy remains the most effective treatment available. In the advanced stage, therapy focuses on improving the management of a variety of different health conditions. Successful control of motor activity variability (e.g. wearing off, on-off variations, deterioration at night, early morning deterioration and dyskinesias) and psychological issues is frequently conceivable with explicit treatment approaches. Surgical treatment is a possibility for a well-defined patient category. The latest update of Parkinson's disease will be reviewed fully in eight review papers.