UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS

(Universidad del Perú, Decana de América)

“Año del Fortalecimiento de la Soberanía Nacional”

CURSO:
Inglés Aplicado en las Ciencias de la Salud II

DOCENTE:
Daniel Robles Cossio

GRUPO:
2

INTEGRANTES:
➔ Valeria Ximena Medina Palermo
➔ Eladio Caleb Vellón Gonzales
➔ Lisha Diana Tulich Ortiz
➔ Leonardo Michele Flores Vargas

AÑO ACADÉMICO:

2022-II
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

PARKINSON'S DISEASE

1. What is Parkinson’s disease?

Parkinson's is a multisystemic neurodegenerative disease that affects the nervous system,

causing the appearance of motor and non-motor symptoms. It is characterized by the loss of
neurons in the black substance, causing a lack of dopamine. (1)

2. Origin

In Parkinson's disease, some nerve cells (neurons) in the brain progressively break down or
die. Many of the symptoms are due to a loss of neurons that produce dopamine, a type of
neurotransmitter in the brain. When dopamine levels drop, this causes abnormal brain
activity, leading to movement disorders and other symptoms of Parkinson's disease.
The exact origin of Parkinson's disease is unknown, but several factors appear to play a role,
including:
● Genes:
Researchers have identified specific gene changes that can cause Parkinson's disease.
However, these are rare, except in some cases where many family members have
Parkinson's disease. (2)
● Environmental triggers:
Exposure to certain toxins or environmental factors may increase the risk of developing
Parkinson's disease in the future, but the risk is small. (2)
● The presence of Lewy bodies:
Masses of specific substances within brain neurons are microscopic markers of Parkinson's
disease. These masses are called Lewy bodies, and researchers believe these Lewy bodies
hold an important clue to the cause of Parkinson's disease.(2)
● Alpha-synuclein found within Lewy bodies:
While many substances are found in Lewy bodies, scientists believe that one important
substance is the natural and widespread protein called alpha-synuclein (a-synuclein). It is
found in all Lewy bodies as a mass that cells cannot break down. Currently, this substance is
a major focus among Parkinson's disease researchers.(2)

3. History

➢ The first description of the black substance is attributed to the German scientist
Samuel Thomas von Soemmering, in his treatises of 1778 and 1792. Since the 19th
century and, especially, from the beginning of the 20th century onwards, it has been
called the black substance or locus niger. from Soemmering.
➢ Half a century later, the Italian neuroanatomists Giovanni Mingazzini and Domenico
Mirto and the Berlin-based Japanese morphologist Torata Sano added additional
information regarding neurons in the black substance. Thus, for example, if it was
stratified into a dorsal and a ventral layer, the great similarity between nigritic neurons
and those of the globus pallidus was established, and it was shown that most nigritic
neurons were of the Golgi I type, that is, projection neurons.
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

➢ At that time, at the end of the 19th century, the great English clinicians postulated
that the lesion that caused Parkinson's disease would be found, according to
Hughlings Jackson, in the cerebellum or, according to William Gowers, in the
cerebral hemispheres, without pathological evidence of their postulates.
➢ In 1893, the pathologist Paul Oscar Blocq and the Romanian neurologist Georges
Marinesco, doctors working for Pierre Marie at the Hospital de la Salpêtrière,
described the case of a 38-year-old man with hemiparkinsonism, characterized by
tremor and rigidity and caused by a tuberculoma in contralateral black substance.

4. Types

● Primary Parkinson’s:
It is one that is not caused by another pathology or medication. Its origin can be idiopathic,
sporadic or genetic, such as degenerative processes.
It is not always possible to know the cause of the disease. When there are genetic
alterations that are not identified, it is called idiopathic Parkinson's. Almost 90% of people
with Parkinson's are of this type.
● Secondary Parkinson's:
In this case it is caused by another pathology, medications or chemical exposure. In this
category we find more types of Parkinson's than in the primary class, but they are rare and
the probability of suffering from them is lower.

➔ Parkinson's disease due to head trauma: the cases presented are of boxers who
have received blows repeatedly.
➔ Parkinson's due to encephalitis: there are cases where Parkinson's can be caused
by infectious diseases, the one that predominates is due to infection in the brain.
➔ Drug-induced Parkinson's: Medications such as chlorpromazine, haloperidol,
metoclopramide, reserpine, or valproate can cause tremor and bradykinesia. It is
reversible by stopping treatment with these drugs.

5. Early signs
For doctors, it is still difficult to diagnose Parkinson's disease. People who suffer from it only
improve their symptoms with medication, since it is a progressive disease, however an early
consultation can give adequate treatment and improve quality of life.

There are some early signs and symptoms that can help diagnose this disease. These signs
are sometimes called biomarkers, none of these signs separately should be cause for
concern, however, if you have more than one, you should consult your doctor for a ruling out
diagnosis.
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

➔ Tremor
Tremors or twitching in the extremities
are early and common symptoms of
Parkinson's disease.
The pains can be normal after a
demanding physical activity, a focused
injury or taking a medication that has this
effect.

➔ Small handwriting
A sudden change in the size of the type that one
writes can be an early symptom of Parkinson's
disease.
The size of the letter can vary as we get older, or
due to room temperature our fingers feel more
rigid, but it is over a long period of time and not
suddenly.

➔ Loss of smell
Having trouble smelling certain foods like bananas,
pickles or cinnamon, you might see your doctor but
not necessarily because of Parkinson's disease.
The sense of smell may be lost or diminished for a
brief period with the presence of a cold or flu, also
if the nose is stuffy.

➔ Trouble sleeping
Movements in bed that are mostly perceived
by another person, if sudden during deep
sleep, can also be an early sign.
Bad nights are also normal of course,
however they are not so continuous.
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

➔ Trouble moving or walking

Muscle stiffness usually disappears with
movement and locomotion, but if not, it may also
be an early sign. If you feel that your feet stick to
the floor or that your arms do not move at the
rhythm of walking, in addition to the opportunities
that make you know of some rigid
appearance.Once again, injuries in a certain local
area may be normal and prevent the correct
movement of a limb, or even arthritis may produce
similar symptoms.

➔ Constipation
Making a lot of effort to defecate in some
cases has also been a sign, however, this is
also normal if there is a lack of water or fiber
in the diet that can cause constipation
problems. It can also be caused by any
medication, if there is no medication involved
and you have a healthy diet, you should
consult your doctor.

➔ A soft or low voice

Changes in the volume of the voice without
intention or inflammation may also be an early
sign. Perhaps to the perception of the individual,
the people around them are becoming deaf, but
it is really the voice that is going down in
volume.
If this isn’t caused by the flu, cold, or any virus
that is also detected, you can consult your
doctor, especially when the voice volume does
not return to normal.

➔ Masked face
Having a rigid or expressionless appearance
without any reason for emotion is also a sign to
consider, having a mask appearance includes
the absence of blinking.
Medications or a local anesthetic can cause this,
however if there is no recovery after this, a
doctor should be consulted.
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

➔ Dizziness or fainting
Fainting may be symptoms of low blood
pressure, which may be related to
Parkinson's disease.
Sudden moments of movement, such as;
when we first get out of bed, it can cause
dizziness, but if it occurs frequently, it is
reason enough to see your doctor.

➔ Stooping or hunching over

Stooping of your posture when standing, if
not caused by injury or old age, has also
been considered a sign that may be related
to Parkinson's disease. Also bone disease
can cause this problem.

Each symptom by itself does not imply a close relationship with the disease, however,
having a preventive position in our health is always better, especially when we do not know
the cause of these signs.

6. Treatment and medicines:

Although there is no cure for Parkinson’s disease, medications, surgical treatment, and
therapies can often offer quality of life to the patient.

★ Medicines:
Medicines can help treat the symptoms of Parkinson’s by: (4)

● Increasing the level of dopamine in the brain

● Having an effect on neurotransmitters, which transfer information between brain cells
● Helping control non-movement symptoms

The main therapy for Parkinson’s is levodopa and Carbidopa to prevents or reduces some of
the side effects of levodopa therapy — such as nausea, vomiting, low blood pressure, and
restlessness
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

Patients use levodopa to make dopamine to replenish the brain’s supply.

Suddenly stopping the drug may have serious side effects, like being unable to move or
having difficulty breathing.

The doctor may prescribe other medicines to treat Parkinson’s symptoms, including: (4)

● Dopamine agonists to stimulate the production of dopamine in the brain

● Enzyme inhibitors to increase the amount of dopamine by slowing down the
enzymes that break down dopamine in the brain
● Amantadine to help reduce involuntary movements
● Anticholinergic drugs to reduce tremors and muscle rigidity

★ Deep brain stimulation

Parkinson’s disease's patients who do not respond well to medications, the doctor may
recommend deep brain stimulation. During a surgical procedure, a doctor implants
electrodes into part of the brain and connects them to a small electrical device implanted in
the chest. The device and electrodes painlessly stimulate specific areas in the brain that
control movement and it helps stop many of the movement-related symptoms of Parkinson’s,
such as tremor, slowness of movement, and rigidity.

★ Other therapies
Other therapies that may help manage Parkinson’s symptoms include:

● Physical, and speech therapies, which may help with gait and voice disorders,
tremors and rigidity, and decreased in mental functions
● A healthy diet
● Exercises to strengthen muscles and improve balance and coordination
● Massage therapy to reduce tension
● Others: Yoga and tai chi

Support for people living with Parkinson’s disease (4)

As we know the progression of Parkinson’s is usually very slow, eventually a person’s daily
routines may be affected.
Activities such as working, taking care of a home and day to day activities may become
challenging. Experiencing these changes can be hard, but some groups can help people
cope. These groups can provide information, advice and support for those living with
Parkinson’s disease' patients, their families, and caregivers.
 UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS
(Universidad del Perú, Decana de América)
“Año del Fortalecimiento de la Soberanía Nacional”

Conclusion:
As a group, we developed a reflection on the importance of preventing Parkinson's disease,
spreading of its treatment to offer quality of life to the patient and promotion of information on
patient’s care. Parkinson's currently affects more than 30,000 people across the country and
more than 7 million worldwide. Therefore, we urgently note the activism for its prevention
and early detection.

Bibliography:

1. Causes of Parkinson's. researching this disease. Meet Parkinson's. 2019.

Available in:
https://conoceelparkinson.org/investigacion/origen-causas-parkinson/
2. Parkinson’s disease. Mayoclinic.org. 2022. Available in:
https://www.mayoclinic.org/es-es/diseases-conditions/parkinsons-disease/sym
ptoms-causes/syc-20376055
3. Types of Parkinson’s disease and causes. CUIDANIA - Cuidado de Ancianos,
Personas Mayores y Servicio Doméstico Madrid | Empleadas de Hogar.
CUIDANIA - Cuidado de Ancianos y Servicio Doméstico Madrid | Empleadas
de Hogar; 2019. Available from: https://www.cuidania.com/tipos-de-parkinson/
4. Parkinson’s disease: Causes, symptoms, and treatments. National Institute on
Aging. From: https://www.nia.nih.gov/health/parkinsons-disease
5. 10 Early Signs. Parkinson’s Foundation. 2022.Recovered from:
https://www.parkinson.org/understanding-parkinsons/10-early-signs
6. Carlos C. ENFERMEDAD DE PARKINSON - Una historia de doscientos años.
2022; Available from: http://repositorio.cmp.org.pe/handle/20.500.12971/76