Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 84-year-old man presented with dysphagia two years after the onset of symptoms. Repeated assessments at both ENT and neurology clinics had not recorded any of the more classical signs of Parkinson's disease and these did not become apparent until intercurrent illness had been treated. Once diagnosed, treatment was started and dramatic improvement was seen.
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PMID:Dysphagia, a reversible cause not to be forgotten. 772 42

The sense of smell significantly contributes to quality of life. In recent years much progress has been made in understanding the biochemistry, physiology and pathology of the human olfactory system. Olfactory disorders may arise not only from upper airway phlogosis but also from neurodegenerative disease. Hyposmia may precede motor signs in Parkinson's disease and cognitive deficit in Alzheimer's disease. These findings suggest the complementary role of olfactory tests in the diagnosis and management of neurodegenerative diseases. In this report we present a review of modern olfactory tests and their clinical applications. Although rarely employed in routine clinical practice, the olfactory test evaluates the ability of odour identification and is a useful diagnostic tool for olfaction evaluation. Olfactory screening tests are also available. In this work we strongly recommend the importance of an ENT evaluation before the test administration and dissuade from a self-administration of an olfactory test.
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PMID:Modern psychophysical tests to assess olfactory function. 1608 27

Swallowing disturbances (SDs), anxiety and depression are commonly present in Parkinson's disease (PD) patients. We hypothesized that there is an association between the presence of SDs and the PD affective state. Sixty-nine PD patients were assessed for the presence of SDs by undergoing cognitive screening with the Mini Mental State Examination (MMSE), completing three inventories: a swallowing disturbance questionnaire (SDQ), the Spielberger manual for the trait anxiety and Beck depression inventories. All patients underwent clinical swallowing evaluations by a speech and language pathologist (SLP). Patients diagnosed with SDs were also assessed by fiberoptic endoscopic evaluation of swallowing (FEES) performed by an ENT and SLP. Thirty-eight patients experienced SDs, the other 31 did not. The clinical characteristics of the two groups were matched. Patients with SDs experienced increased anxiety and depression compared to patients without SDs. Comparisons between patients who scored in the two opposite ends of the anxiety and depression ranges demonstrated that the most anxious and depressed patients reported more swallowing difficulties (SDQ scores) compared with the least anxious and depressed ones. In addition, the most anxious patients had significantly increased disease severity and decreased MMSE scores compared with the least anxious patients. Disease severity was also increased in the most depressed patients compared with the least depressed ones. Advanced disease emerged as being associated with high anxiety levels and greater numbers of SDs. The contribution of anxiety or depression to the development or worsening of SDs and their role in treatment strategy warrant further investigation.
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PMID:Anxiety, depression and swallowing disorders in patients with Parkinson's disease. 1907 Oct 54

Cerebral imaging and olfactory disorders: a review. Olfactory disorders are often misjudged and rarely given due clinical consideration. Nevertheless, they occur in a wide range of neurological disorders, and their evaluation can help in diagnosis. Whereas psychophysical tests have been used to evaluate olfactory dysfunction in numerous diseases, functional brain imaging using olfactory stimuli is an emergent technique and few studies have been published to date. After a reminder of cerebral imaging and analysis techniques and a rapid description of our actual knowledge of olfactory processes in healthy subjects, the current review focuses on cerebral imaging studies performed on patients with neurological disorders and presenting olfactory dysfunction. Neurological disorders such as Alzheimer's disease, Parkinson's disease, epilepsy, migraine, multiple chemical sensitivity and schizophrenia are examined.
B-ENT 2009
PMID:Cerebral imaging and olfactory disorders: a review. 2008 6

Olfactory and gustatory disorders increase with advancing age. Moreover, olfactory disorders are common in neurodegenerative disorders, especially in idiopathic Parkinson's disease (IPD) and Alzheimer's Disease (AD). Since the decrease in olfactory function is usually gradual, it often remains undetected. Given the poor self-assessment of olfactory function, olfactory testing is mandatory in suspected cases to establish the diagnosis of hyposmia or anosmia. The high rate of anosmia over the age of 70 is suspected to be due to several factors such as changes in the olfactory epithelium (reduced mucus secretion, hormonal changes, changes in epithelial thickness, for example), and the reduced neuroregeneration rate in olfactory receptor cells themselves. There is no known adequate treatment for stopping or reversing this age-related decline in olfaction. In IPD, olfactory impairment precedes motor symptoms by years and is independent of dopaminergic loss. Using fMRI, altered neuronal activity in the amygdaloid complex and hippocampal formation during olfactory stimulation have been demonstrated, as has a link between the expression of olfactory event-related potentials and olfactory-induced brain activity. In AD--by contrast with IPD--the severity of the disease and the olfactory disorder correlate. The olfactory disorders alone, however, cannot distinguish between AD and IPD. A complete loss of gustatory function is rare, while dysgeusia is common, especially with increasing age. There are multiple possible explanations, including concomitant disease and the side-effects of medication. These need to be established on the basis of exact history and examination. Treatment remains difficult.
B-ENT 2009
PMID:Ageing, neurodegeneration, and olfactory and gustatory loss. 2008 14

Bilateral vocal cord paralysis in patients with Parkinson's disease is a life-threatening complication. The need for surgical treatment such as a tracheotomy or laser arytenoidectomy is determined by the severity of the patient's symptoms. A case of bilateral vocal cord paralysis in a patient with Parkinson's disease treated with an urgent tracheotomy is reported.
B-ENT 2012
PMID:Bilateral vocal cord paralysis in a patient with Parkinson's disease. 2289 35

Swallowing disorders (dysphagia) comprise a common cause of medical consultation and are defined as a subjective sensation of difficulty or abnormality of swallowing. In the initial step, a clear differentiation of dysphagia from odynophagia and globus sensation for further diagnostic procedures is mandatory. The careful questioning of patients symptoms and complaints is often helpful for the differentiation of oropharyngeal and esophageal dysphagia. Oropharyngeal dysphagia is mainly caused by neurological disorders (cerebral ischemia, Parkinson's disease, dementia) or local compression of malignancies, thyroid gland or lymph nodes. In contrast, stenosis of the tubular esophagus (peptic stricture, rings and webs, diverticula, malignancies, infections) can lead to esophageal dysphagia, mostly only after ingestion of solids. Esophageal dysphagia after ingestion of solids and liquids is often caused by motility disorders of the esophagus (achalasia, hypertensive or hypercontractile esophagus). Important diagnostic procedures comprise endoscopy, barium swallow and high-resolution manometry. Overlap syndromes are frequent and need to be supervised interdisciplinary. The diagnostic algorithm and interpretation of exam results is complex. If the results are ambiguous, a reevaluation and, when appropriate, repetition of diagnostics are recommended. Whereas oropharyngeal dysphagia is treated by neurologists or ENT physicians, diagnostic and treatment of esophageal dysphagia is a challenging role for gastroenterologists.
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PMID:[Dysphagia from a gastroenterologist's perspective]. 3032 71

In ophthalmology, there have been few reports of botulinum toxin type-A (BTX-A) injection into the lacrimal gland to treat epiphora. In ENT, adductor and abductor (ABSD) spasmodic dysphonia are often treated with BTX-A injections into the respective overacting vocal cord muscles. We describe a 53-year old male with Parkinson's disease who did not respond to BTX-A injections to either the lacrimal gland, for epiphora secondary to Parkinsonian-related blink lagophthalmos, or posterior cricoarytenoid (PCA) muscles for ABSD. Subsequent BTX type-B (BTX-B) injections into the lacrimal gland remarkably improved his epiphora. BTX-B injections into the PCA muscle also greatly improved his dysphonia. We describe the first reported case of (1) BTX-B injection into the lacrimal gland for epiphora, (2) use of Botox in treating epiphora due to blink lagophthalmos/reduced blink frequency secondary to Parkinson's disease, (3) BTX-B use in treating ABSD, and (4) association between ABSD and Parkinson's disease.
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PMID:Botulinum toxin-B injection into the lacrimal gland and posterior cricoarytenoid muscle for the treatment of epiphora and abductor spasmodic dysphonia secondary to Parkinson's disease. 2993 26