By Perkin G David
Any dialogue of the scientific features of Parkinson's affliction needs to take into consideration the inaccuracies of scientific prognosis. In a successive sequence of a hundred sufferers with a scientific prognosis of Parkinson's disorder, purely seventy six fulfilled the factors for prognosis at autopsy exam. makes an attempt to tighten the diagnostic standards result in elevated specificity yet with diminished sensitivity.In An Atlas of Parkinson's sickness and comparable problems Dr. David Perkin has compiled a sequence of pictures highlighting a number of features of Parkinson's disorder and similar motor issues. The publication offers an invaluable pattern of scientific, investigative (CT, MRI, and puppy) and pathological photos with succinct descriptive textual content of the issues featured. nearly one-third of the cloth during this ebook is pathological, incorporating either macroscopic and microscopic sections. one other zone of the cloth is represented by means of imaging, largely magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning. the world of move issues has been fairly fruitful for puppy scanning, which can provide, with the improvement of particular ligands for many of the receptor websites, to extra extend knowing of the pathophysiological mechanisms of the move issues. Reflecting the top criteria scientific images and imaging in addition to the prestigious author's specialist wisdom of the topic, Dr. Perkin's An Atlas of Parkinson's illness and comparable issues is the definitive and crucial scientific reference in its box.
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Additional info for An Atlas of Parkinson's Disease and Related Disorders (Encyclopedia of Visual Medicine Series)
The patient had presented with a Parkinsonian state with, eventually, predominant axial features Figure 26 Coronal brain section (same patient as in Figure 25) showing numerous small lacunes in the heads of both caudate nuclei and in the anterior part of the putamen ©2004 CRC Press LLC Figure 27 Histological sections from Parkinson's disease with dementia showing cortical Lewy bodies stained with ubiquitin (immunochemistry preparation, left; silver impregnation, right) Figure 28 Histology showing a subthalamic neuron containing a globose neurofibrillary tangle in progressive supranuclear palsy (Bielschowsky silver impregnation) ©2004 CRC Press LLC A B C D Figure 29 In this patient with progressive supranuclear palsy, upward (A) and lateral gaze (B and C) are preserved whereas down gaze (D) is impaired ©2004 CRC Press LLC Figure 30 Attempted down gaze (left) shows improvement with the doll's-head maneuver (right) in this patient with progressive supranuclear palsy Figure 31 Sagittal T1-weighted MRI showing midbrain atrophy (arrowed) in progressive supranuclear palsy ©2004 CRC Press LLC Figure 32 11C-raclopride binding in a normal subject (left) compared with that in Parkinson's disease (middle) and in progressive supranuclear palsy (right).
The main tremor peak is at approximately 5 Hz with a harmonic at 10 Hz ©2004 CRC Press LLC Figure 14 Positive glabellar tap. Persistent blinking is a feature of Parkinson’s disease, but is also seen in Alzheimer’s disease Figure 15 6-[18F]-fluorodopa–PET scan appearance in a normal subject (upper) compared with a Parkinsonian patient (lower) ©2004 CRC Press LLC Nerve terminal + Levodopa 3,4-Dihydroxyphenylacetic acid Selegiline Levodopa dopa decarboxylase – monoamine oxidase-B Dopamine Amantadine + Glial cell Homovanillic acid reuptake Dopamine 3-Methoxytyramine COMT – Tolcapone + Bromocriptine Lysuride Pergolide Ropinirole Cabergoline Terminal expressing either D1 or D2 receptor Postsynaptic neuron Figure 16 Synthesis and metabolism of dopamine within the central nervous system.
COMT, catechol O-methyltransferase; +, by stimulation; –, by inhibition ©2004 CRC Press LLC Figure 17 Dystonic posturing secondary to dopa therapy. There is hyperextension of the left big toe Figure 18 Dystonic posturing of the right thumb and little finger (on the left) secondary to dopa therapy ©2004 CRC Press LLC Figure 19 CT of a patient with previous bilateral thalamotomies (arrowed) performed for control of a Parkinsonian tremor Figure 20 Fluorodopa-uptake studies in a patient following dopaminergic grafting ©2004 CRC Press LLC Figure 21 Coronal brain section showing abnormal white matter (white arrow) above the ventricular roof with relative preservation of subcortical white matter (U fibers; black arrow) Figure 22 Histology showing parietal white matter at the bottom of the cortex, a relatively preserved (but not quite normal) arcuate zone (white arrow), and rarefied pale-staining deep white matter, containing thick-walled arteriosclerotic blood vessels lying in dilated and fibrotic perivascular spaces (black arrow)(Luxol fast blue–H & E) ©2004 CRC Press LLC Figure 23 Histology showing a lacunar infarct (pale area) with an irregular cavity lined by reactive cells (astrocytes and macrophages).
An Atlas of Parkinson's Disease and Related Disorders (Encyclopedia of Visual Medicine Series) by Perkin G David