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Glossary of Terms
Acetylcholine
A chemical messenger released by cholinergic nerves. Normally in many
parts of the body, including the brain, and necessary to normal body
functioning. There appears to be a reciprocal seesaw relationship
between acetylcholine and do pamine and their respective nerve cell
systems.
Action Tremor
Rhythmic, involuntary movement of a limb when movement is initiated,
e.g., when writing or lifting a cup. Not usually seen in the earlier
stages of Parkinson's.
Adrenaline (epinephrine) The neurotransmitter of the adrenal
gland which is secreted in moments of crisis. It stimulates the heart to
beat faster and work harder, increases the flow of blood to the muscles,
causes an increased alertness of mind, a nd produces other changes to
prepare the body to meet an emergency.
Agonist
A chemical or drug that mimics neurotransmitter activity.
Akinesia
Absence of body movements.
Alpha-Tocopherol
Chemical name for biologically active form of Vitamin E.
Amantadine
A drug which stimulates the release of available dopamine in the brain.
Anticholinergic
Adjective applied to a substance (medication) that reduces the action of
acetylcholine.
Anticholinergic Parkinson's Drugs (Artane, Cogentin)
The group of drugs which decreases the action of acetylcholine. The
specified drugs may help reduce rigidity, tremor, and drooling in
Parkinson's.
Antihistamines
Drugs opposing the actions of histamine; commonly used to treat
allergies. Used in the past for Parkinson's as they sometimes had
beneficial effects on symptoms due to their anticholinergic properties.
Apomorphine
A derivative of morphine and a dopamine agonist. Currently
experimentally used as injectable treatment for severe Parkinson's.
Ataxia
Loss of balance
Athetosis
Dyskinesias in which there are slow, repetitive, sinuous involuntary
movements.
Autonomic Nervous System
The branch of the nervous system that controls internal organs in the
body, i.e., heart, lungs.
Basal Ganglia or Nuclei
Deeper structures in the brain, concerned with normal movement and
walking. The caudate nucleus, putamen and Substantia Nigra are basal
ganglia affected in Parkinson's.
Benign Essential Tremor
A condition characterised by tremor of the hands, head, voice, and
sometimes other parts of the body. Essential tremor often runs in
families and is sometimes called familial tremor. It is sometimes
mistaken for a symptom o f Parkinson's . However, this is an action
tremor and there is no rigidity or bradykinesia.
Beta-Blockers (§-Blockers)
Drugs which block the action of epinephrine at certain sites. Usually
used to treat hypertension and heart disease, they may be effective in
the treatment of benign essential tremor.
Bilateral
Occurring on both sides of the body.
Blepharospasm
Spasmodic blinking or involuntary closing of the eye lids; a type of
dystonia.
Bradykinesia
Slowing down of a movement. Bradykinesia involves slowness of initiating
and executing movements and fine motor movements and difficulty in
performing repetitive movements. It is a major symptom of Parkinson's.
Carbidopa
The ingredient in Sinemet which prevents the breakdown of the levodopa
in the body before it can reach the brain.
Central Nervous System (CNS)
Consists of the brain and spinal cord.
Cerebellum
Part of the brain that is involved in coordination.
Cerebral Cortex
The largest part of the brain; responsible for thought, reasoning,
memory, sensation, voluntary movement.
Choline
A naturally occurring substance which is a precursor of acetylcholine.
Chorea
A type of dyskinesia (abnormal movement), characterised by continuing,
rapid, dance-like movements. May result from high doses of levodopa
and/or long term levodopa therapy.
Choreoathetosis
A dyskinesia characterised by choreic and athetoid movements.
Cogwheel Rigidity
Stiffness in the muscles, with a jerky quality when arm and leg joints
are repeatedly moved.
Constipation
Diminished ability of intestinal muscles to move feces (stool), often
resulting in very hard stool. A common problem in Parkinson's.
Deprenyl
(Eldepryl, Selegiline, Jumex) A drug that slows the breakdown of
chemicals like dopamine by inhibiting the action of certain enzymes. It
increase effects of dopamine in the brain.
Dopa Decarboxylase Inhibitors
Drugs that block the conversion of levodopa to dopamine outside the
brain.These include carbidopa and benserazide.
Dopamine
A chemical produced by the brain; it assists in the effective
transmission of electrochemical messages from one nerve cell to the
next. It is deficient in the basal ganglia and Substantia Nigra of a
person with Parkinson's. It governs act ions of movement, balance and
walking.
Dopamine Agonist
Drugs that mimic the effects of dopamine and stimulate the dopamine
receptors.
Dopaminergic
An adjective used to describe a chemical, a drug, or a drug effect
related to dopamine.
Drug Holiday
A 3 to 14 day withdrawal of a drug after long term treatment.
Drug Induced Parkinsonism
Parkinson's symptoms which have been caused by drugs used to treat other
conditions, e.g., neuroleptic drugs, and reserpine, used to be used to
treat hypertension
Dysarthria
Speech difficulties caused when the muscles associated with speech are
affected.
Dyskinesia
Abnormal movement of voluntary muscles. Dystonia, athetosis, and chorea
are types of dyskinesia.
Dysphagia
Difficulty in swallowing.
Dystonia
Involuntary spasms of muscle contraction that cause abnormal movements
and postures. May appear as a side effect of long term drug treatment in
Parkinson's and may worsen in response to stress.
Encephalitis
Inflammation of the brain usually caused by a virus infection.
Encephalitis Lethargica
(Sleeping Sickness) A specific kind of encephalitis which occurred in
scattered epidemics throughout the world during the period 1916 to 1926;
it usually caused sleepiness, double vision, trouble swallowing, and
drooling. M any of those affected developed advanced Parkinsonism as
depicted in the movie Awakenings.
Ethopropazine
(Parsidol/Parsitan) A drug sometimes used in the past for Parkinson's
due to its anticholinergic effects.
Extrapyramidal Nervous System
Refers to the caudate, putamen, and Substantia Nigra. It is affected in
Parkinson's.
Festination
Walking in rapid, short, shuffling steps.
Flexion
A bent, curved posture.
Freezing
Temporary, involuntary inability to move.
Glaucoma
A sustained increase of pressure within the eyeball which can injure the
optic nerve and cause impaired vision or blindness. Treatment with
anticholinergics may exacerbate glaucoma.
Globus pallidus
The inner part of the lenticular nucleus. The lenticular nucleus and the
caudate nucleus form the Striatum.
Heimlich Manoeuvre
A form of first aid for people who are choking.
Hypokinesia
Abnormally diminished motor activity.
Idiopathic
An adjective meaning "of unknown cause". The usual form of Parkinson's
is idiopathic Parkinson's.
Intention Tremor
One occurring when the person's attempts voluntary movement.
Lenticular nucleus
This group of cells along with the caudate nucleus form the Striatum or
Corpus Striatum.
Levodopa
The international generic name for the medicinal formulation of L-Dopa.
It is contained in Sinemet and Prolopa.
Levodopa-Induced Dyskinesias
A side effect of medication which may occur with prolonged use. These
abnormal, involuntary movements may be alleviated by reducing the amount
of medication.
Lewy Body
Pink, staining spheres on damaged brain cells; markers for Parkinson's.
Livido Reticularis
A purplish or bluish mottling of the skin seen usually below the knee
and sometimes on the forearm in persons under treatment with the drug
amantadine (Symmetrel).
Micrographia
The tendency to have very small handwriting due to difficulty with fine
motor movements in Parkinson's.
MPTP
A toxic chemical, exposure to which can lead to Parkinson's.
Myoclonus
Jerking, involuntary movement of arms and legs, usually occurring during
sleep.
Neostriatum
Vital part of the brain comprised of two basal ganglia (caudate and
putamen).
Neuroleptic Drugs
(Also called major tranquilizers) A class of drugs which act as dopamine
antagonists (by blocking some dopamine receptors). They can aggravate
symptoms of Parkinson's. This class includes Haloperidol (Haldol), and
the phenothiazi nes, e.g., Compazine, Stelazine, Chlorpromazine, etc.
Neuron
A nerve cell.
Neurotransmitter
A specialised chemical produced in nerve cells that permits the
transmission of information between nerve cells .
Nigrostriatal Degeneration
Degeneration of the nerve pathways from Substantia Nigra to the
striatum. These pathways are normally rich in dopamine and are those
affected in PS.
Norepinephrine (Noradrenalin)
Chemical transmitter found mainly in two areas of the brain involved in
governing the involuntary autonomic nervous system.
On-Off Fluctuations
Fluctuations that occur in response to levodopa therapy in which the
person's mobility changes suddenly and unpredictably from a good
response (on) to a poor response (off).
Orthostatic Hypotension
A drop in blood pressure during rapid changes in body position (e.g.,
from sitting to standing).
Palilalia
A symptom of Parkinsonism, especially the postencephalitic form, in
which a word or syllable is repeated and the flow of speech is
interrupted.
Pallidectomy
Excision or destruction of the Globus Pallidus, which is part of the
Lenticular Nucleus, which is part of the Striatum.
Paraesthesia
Sensations, usually unpleasant, arising spontaneously in a limb or other
part of the body, variously experienced as Òpins and needlesÓ or a
feeling of warmth or coldness (thermal paresthesias).
Parkinson's Disease
That form of Parkinsonism originally described by James Parkinson' as a
chronic, slowly progressive disease of the nervous system characterised
clinically by the combination of tremor, rigidity, bradykinesia, and
stooped postur e, and pathologically by loss of the pigmented nerve
cells of the Substantia Nigra in the brain.
Parkinson's Facies
A stolid masklike expression of the face, with infrequent blinking; it
is characteristic of Parkinson's.
Parkinsonism
A clinical state characterised by tremor, rigidity, bradykinesia,
stooped posture, and shuffling gait. The more common causes of
Parkinsonism are Parkinson's Disease, striatonigral degeneration, and a
reversible syndrome induced by ma jor tranquillising drugs.
Paralysis agitans
The Latin form of the older, popular term shaking palsy, which was used
to designate Parkinson's in James Parkinson's time.
Parlodel (Bromocriptine)
A dopamine agonist useful in treating all of the primary symptoms of
Parkinson's. It may be used alone or with other antiparkinson
medications.
Permax (Pergolide)
A drug similar in action to Parlodel but more potent.
Postural Deformity
Stooped posture.
Postural Instability
Difficulty with balance.
Postural Tremor
Tremor that increases when hands are stretched out in front.
Precursor
Something that precedes, e.g., a sign or symptom that forewarns of
another, such as muscle aching may be the precursor of a tremor.
Progressive Supranuclear Palsy (PSP)
A degenerative brain disorder sometimes difficult to distinguish from
Parkinson's especially in the early stages. PSP symptoms are rigidity
and akinesia, difficulty looking up and down, speech and balance probl
ems. Those with PSP often have poor response to antiparkinson
medications.
Prolopa
Trade name for the antiparkinson drug composed of levodopa and
benserazide. This drug combination contains a ratio of 4 mg. of levodopa
to 1 mg. of benserazide (Prolopa 50-12.5, 100-25, 200-50).
Propulsive Gait
Disturbance of gait typical of Parkinsonism in which, during walking,
steps become faster and faster with progressively shorter steps that
pass from a walking to a running pace and may precipitate falling
forward.
Range of Motion
The extent that a joint will move from being fully straightened to
completely bent.
Receptor
A sensory nerve ending that responds to a stimulus.
Resting Tremor
Shaking that occurs in a relaxed and supported limb.
Retropulsive Gait
Walking that is propelled backwards.
Rigidity
Refers in medical usage to a type of muscular stiffness encountered when
examining people with Parkinson's. It is characterised by a constant,
even resistance to passive manipulation of the limbs.
Seborrhoea
Increased discharge of the oily secretion sebum from the sebaceous
glands of the skin.
Seborrhoeic Dermatitis
Inflammation of the skin sometimes associated with seborrhoea.
Shaking Palsy
Old popular term which James Parkinson employed to designate the
specific disorder we now call Parkinson's.
Shy-Drager Syndrome
This is a condition in which the symptoms are the result of
abnormalities in motor function and problems in the autonomic nervous
system. A person with Shy-Drager Syndrome has Parkinsonism, extremely
low blood pressure which wo rsens upon standing, bladder problems,
severe constipation, and decreased sweating. This condition is quite
rare.
Sialorrhea
Drooling of saliva.
Side Effect
A drug's effect that is different from the beneficial effect for which
the drug is being taken.
Sinemet
Trade name for the antiparkinson drug that is a mixture of levodopa and
carbidopa. This drug combination contains a ratio of levodopa 4 mg. or
10 mg. to carbidopa 1 mg. (Sinemet 100/25, Sinemet 250/25).
Sinemet CR
Controlled-release Sinemet. 200 mg. Levodopa with 50 mg. Carbidopa in a
capsule contained in a matrix (outer layer) releasing the drug more
slowly in the body. These capsules are not to be taken all at once, but
rather in separate doses over the course of a day.
Stereotactic Surgery
Surgical technique that involves placing a small electrode in an area of
the brain to destroy a tiny amount of brain tissue.
Striatonigral Degeneration
This is a degeneration of the nerve pathways travelling from the
striatum to the Substantia Nigra. People with this degeneration also
appear to have Parkinsonism. However, they respond differently to drug
therapy than pe ople with Parkinson's.
Striatum
Area of brain controlling movement, balance, and walking. Connects to
and receives impulses from Substantia Nigra.
Substantia Nigra
Black pigmented area of the midbrain where cells manufacture the
neurotransmitter dopamine.
Sustention or Postural Tremor
Tremor that increases when hands are stretched out in front.
Symmetrel (Amantadine)
A drug that releases dopamine and is useful in PS.
Tardive Dyskinesia
This is a movement disorder associated with long-term use of neuroleptic
drugs such as Chlorpromazine, Haloperidol, Loxapine, etc. Movements of a
person with tardive dyskinesia are similar in appearance to those of a
person with levodopa induced dyskinesias, but the causes of the two
conditions are different.
Thalamotomy
Operation in which a small region of the thalamus is destroyed, achieved
by stereotactic techniques. Tremor and rigidity in Parkinsonism and
other conditions may be relieved by thalamotomy.
Thalamus
Anatomical term designating a mass of grey matter centrally placed deep
in the brain near its base and serving as a major relay station for
impulses travelling from the spinal cord and cerebellum to the cerebral
cortex.
Toxin
A poisonous substance.
Tremor
Rhythmic shaking and involuntary movement of part(s) of the body as a
result of sequential muscle contractions.
Unilateral
Occurring on one side of the body. Parkinson's symptoms usually begin
unilaterally.
Vomiting Center
Term referring to an area of the brain where the nausea and vomiting
reflex may be triggered by some medications.
"Wearing Off" Phenomenon
Waning of the effect of the last dose of levodopa, associated with
abrupt reduction or loss of mobility.
*PD Glossary provided by The National Parkinson Foundation. |
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