INSTITUTO

POLITECNICO NACIONAL

PARKINSO
N

Jos Manuel Ramrez Antonio

PARKINSON
Enfermedad
degenerativa del
sistema nervioso
central, la ms
frecuente de las
enfermedades
que se
manifiestan por
movimientos
anormales

reas rurales:
Pesticidas
Agua de pozo

EPIDEMIOLOGA
4% - 7%
juvenil.

60 a 69
aos de
edad.

4/2

4q 21-q23

Factores Biolgicos

Factores Biolgicos

 Protenas de
complemento
Interfern
Inducidos por
INFLUENZA A

AMBIENTAL
ES

1920-1924: Epidemia
encefalitis letrgica

Envejecimiento
Disminucin de receptores de D1 y D2

Disminucin dopamina:
Ganglios basales
Putamen
Cuerpo estriado
Tirosina hidroxilasa
Glutation Peroxidasa

Categoras de la
EP
DE INICIOS
ASIMETRICOS
Rigidez
Bradicinesia
Temblor
Inestabilidad
postural

Posible: TEMBLOR,
RIGIDEZ O
BRADICINECIA
Probable: TEMBLOR
DE REPOSO,
RIGIDEZ,
BRADICINECIA O
INESTABILIDAD
POSTURAL
Definitvo: 3 de los 4
signos cardinales

THE HOEHN AND

YAHR
Stage 0 - no signs of disease
Stage 1 - symptoms on one side only (unilateral)
Stage 1.5 symptoms unilateral and also involving the neck and spine
Stage 2 symptoms on both sides (bilateral) but no impairment of balance
Stage 2.5 - mild bilateral symptoms with recovery when the pull test is given
(the doctor stands behind the person and asks them to maintain their balance
when pulled backwards)
Stage 3 - balance impairment. Mild to moderate disease. Physically independent
Stage 4 - severe disability, but still able to walk or stand unassisted
Stage 5 - needing a wheelchair or bedridden unless assisted

ANATOMIA
PATOLGICA

Exploracin fsica

Exploracin fsica

Exploracin fsica

Exploracin fsica

Exploracin fsica

Caracterstica
primordial

TRATAMIENTO
FARMACOLGICO
Los agonistas
dopaminrgicos
ergotamnicos
Bromocriptina
Pergolide
Cabergolina
Lisurida

Los agonistas no
ergticos
Pramipexol
Rotigotina
Apomorfina
Ropinirol

Inhibidores de la
catecolometiltransfer
asa (iCOMT) y los
inhibidores de la
monoaminooxidasa
(iMAO).

THE HOEHN AND

YAHR
Stage 0 - no signs of disease
Stage 1 - symptoms on one side only (unilateral)
Stage 1.5 symptoms unilateral and also involving the neck and spine
Stage 2 symptoms on both sides (bilateral) but no impairment of balance
Stage 2.5 - mild bilateral symptoms with recovery when the pull test is given
(the doctor stands behind the person and asks them to maintain their balance
when pulled backwards)
Stage 3 - balance impairment. Mild to moderate disease. Physically independent
Stage 4 - severe disability, but still able to walk or stand unassisted
Stage 5 - needing a wheelchair or bedridden unless assisted

TRATAMIENT
O
Menores de 65 aos estadios
I y II de Hoehn y Yahr
Agonistasdopaminrgicos.

Mayores de 65 aos y
aquellos que se desee
conseguir la mejora
sintomtica en un tiempo
breve, podr comenzarse el
tratamiento con levodopa

Tratamiento de las fluctuaciones motoras

inhibidores de la COMT pueden conseguir una reduccin
efectiva y duradera (6 meses) de la cantidad diaria de
levodopa que recibe un paciente con un aumento
simultneo del tiempo on

QUIRURGI
CO

CIRUG
A