A 54 year old male patient presents to the Neurology O.P with complaints of slowness of movements, tremors, postural instability, rigidity and memory loss. The features in this patient are suggestive of?
Correct Answer: Parkinson's disease
Description: The features described in this patient are typical of parkinson's disease. Parkinson's disease (PD) is the second commonest neurodegenerative disease. Clinically, PD is characterized by rest tremor, rigidity, bradykinesia, and gait impairment, known as the "cardinal features" of the disease. Additional features include freezing of gait, postural instability, speech difficulty, autonomic disturbances, sensory alterations, mood disorders, sleep dysfunction, cognitive impairment and dementia. Pathologically, the hallmark features of PD are degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc), reduced striatal dopamine, and intracytoplasmic proteinaceous inclusions known as Lewy bodies. Levodopa is routinely administered in combination with a peripheral decarboxylase inhibitor to prevent its peripheral metabolism to dopamine and the development of nausea and vomiting due to activation of dopamine receptors in the area postrema that are not protected by the BBB. Dopamine Agonists, MAO-B Inhibitors and COMT Inhibitors are also used in treatment of PD. Ref: Harrison's Internal Medicine, 18th Edition, Pages 3317-3326, 3309, 3305, 3330
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