Parkinsonism- early onset with mental retardation
Overview
An early onset form of Parkinson's disease as well as mental retardation
Symptoms
* Large head * Protruding forehead * Parkinson seizures * Reduced muscle tone * Muscle contractures * Spasticity * Dandy-Walker malformation
Causes
* Parkinson's disease –“Pill-rolling” appearance –Associated cog-wheel rigidity, shuffling gait, akinesis, and/or depression * Benign familial or essential tremor –Especially common with head tremor (e.g., actress Katherine Hepburn) –Positive family history –No other neurologic findings * Drug or toxin-induced tremors (e.g., MPTP) * Postural tremors: Elicited when a limb is held up against gravity; caused by metabolic conditions (e.g., thyrotoxicosis) * Voluntary movement (hyperkinetic) tremors * Wilson's disease * Stroke * Cerebellar disease Movement tremors * Intentional tremor: Occurs with movement toward a target; associated with a cerebellar deficit which would inhibit (e.g., multiple sclerosis, midbrain injury or stroke)
Prognosis
The 'prognosis' of Parkinsonism, early onset with mental retardation usually refers to the likely outcome of Parkinsonism, early onset with mental retardation. The prognosis of Parkinsonism, early onset with mental retardation may include the duration of Parkinsonism, early onset with mental retardation, chances of complications of Parkinsonism, early onset with mental retardation, probable outcomes, prospects for recovery, recovery period for Parkinsonism, early onset with mental retardation, survival rates, death rates, and other outcome possibilities in the overall prognosis of Parkinsonism, early onset with mental retardation. Naturally, such forecast issues are by their nature unpredictable.
Treatment
* Parkinson's disease –Anticholinergic medications (e.g., benztropine) –Amantidine –Levodopa-carbidopa –Dopamine agonists (e.g., bromocriptine) –Selegiline treats symptoms, but may also have a neuroprotective effect that slows disease progression –Surgical intervention had been the used in the past –Transplantation of fetal nigral cells into the putamen is under investigation * Essential or familial tremor responds well to propranolol (10–80 mg BID), primidone, mysoline, or low-dose valium; however, treatment is only symptomatic * Thyrotoxicosis is treated by surgery or nuclear ablation, propranolol, and/or antithyroid medications (tapazole or propylthiouracil) * Drug and alcohol withdrawal is treated with detoxification * Wilson's disease is treated with chelation