229 Update on Parkinson’s Disease Copyright@ Jorge Garza-Ulloa --------------------------------------------------------------------------------------------------------------------------------- This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.000614 Review Article Jorge Garza-Ulloa* Research Consulting Services garzaulloa.org, University of Texas El Paso, USA *Corresponding author: Jorge Garza-Ulloa, Research Consulting Services garzaulloa.org, University of Texas El Paso, USA. To Cite This Article: : Jorge Garza-Ulloa. Update on Parkinson’s Disease. Am J Biomed Sci & Res. 2019 - 2(6). AJBSR.MS.ID.000614. DOI: 10.34297/AJBSR.2019.02.000614 Received: April 16, 2019 | Published: May 03, 2019 American Journal of Biomedical Science & Research ISSN: 2642-1747 www.biomedgrid.com Introduction Parkinson’s Disease (PD) is a progressive neurodegenerative disease producing neuronal cell death, presenting loss of dopamine- production in the brain area known as substancia nigra [1], altering the central nervous system CNS (brain and spinal cord), and affecting the regulation of the human movements and emotions. the exact cause of this damage is still unknown, and currently there is no cure for Parkinson’s disease. PD is a form of extrapyramidal disorder that affects movements disorder caused by damage to the extrapyramidal tract, a network of nerves that controls movements. PD is a typical movement disorder [2] and the 2nd most common neurodegenerative condition after Alzheimer’s disease. PD is a continuous neurological disorder where the symptoms continue to worsen gradually [3]. PD is a highly variable disease, meaning that different patients have different combinations of symptoms, and those symptoms can be at varying severity levels. Symptoms of PD The main symptoms of PD are of three kinds: primary motors, secondary motors and non-motors [4]. Where Motors (Directly Related to Movement) a. Tremors (shaking) in the limbs, b. Rigidity (muscle stiffness), c. Bradykinesia (slowness of movements), d. Postural instability (impaired balance or difficulty standing or walking, Secondary Motor (Consequence of Movement Disorders) a. Hypomimia - loss of facial expressions known also as Parkinson mask. b. Freezing of gait or shuffling gait – the gait, or way of walking, may be affected by a temporary hesitation (freezing) or dragging of the feet (shuffling). c. Unwanted accelerations – movements which are too quick, which may appear in movement or in speech. d. Speech difficulty or changes in speech – including slurred speech or softness of voice Abstract Parkinson’s disease (PD) is a progressive nervous system disorder that affect movement and present other symptoms, that can be different for everyone and the exact cause of this damage is still unknown. Parkinson’s disease can’t be cured, medications and surgeries might significantly improve their symptoms, these must be prescribed by the neurologist, but it is important to understand how the medication works, what do we expect from them and what other options are available today. In this review the goal is introduce and explain to PD patients and their caregivers the PD: symptoms, stages, treatments, causes and types. Keywords: Parkinson’s disease; Tremors; Movement disorders; Postural instability; Levodopa; Parkinsonism; Idiopathic Parkinson’s; Atypical parkinsonism Abbrevations: PD: Parkinson’s Disease; CNS: Central Nervous System; MRI: Magnetic Resonance Imaging; STN: Subthalamic Nucleus; GPI: Globus Pallidus Internal; DBS: Deep Brain Stimulation; IPG: Implanted Pulse Generator; UPDRS: Unified Parkinson’s Disease Rating Scale; L-DOPA: Levodopa; LRRK2: Leucine-Rich Repeat Kinase 2; PARK7: Parkinsonism Associated Deglycase; PRKN: Parkin Rbr E3 Ubiquitin Protein Ligase; TMS: Transcranial Magnetic Stimulation; THC: Tetrahydrocannabinol; CBD: Cannabidiol; TCE: Trichloroethylene; CSE: Chronic Solvent Encephalopathy; MSA: Multiple System Atrophy; PSP: Progressive Supranuclear Palsy; CBS: Corticobasal Syndrome; DLB: Dementia with Lewy Bodies; VP: Vascular Parkinsonism; PBA: Pseudobulbar Affect.