Parkinson disease :
Parkinsons disease is a long term neurodegenerative disease that effects mainly the central nervous system affecting the movement , balance and coordination. The symptoms emerge slowly and can be both motor and non motor as the disease progresses. Parkinsons disease is usually sporadic ie., occurs haphazardly from time to time but can have genetic, environmental factors , medications as some risk factors and causes nerve cell death and decrease in the dopamine. Patients usually present with tremors, rigidity, postural instability,micrographia (small handwriting which progress to become smaller), bradykinesia also known as slow movements, disturbance in mood, behaviour, sleep pattern, cognition ,mask like face , soft muffled speech, small cramped handwriting and non motor symptoms like constipation, inability to smell, dementia, psychosis, swallowing difficulties, malnutrition, weight loss, aspiration pneumonia etc. Patients usually have a typical gait with short steps and forward flexed posture. Management of PD is by medications like DRT (Dopamine replacement therapy), dopamine agonists, COMT inhibitors, MAO-B inhibitors, deep brain stimulation, speech therapy, occupational therapy and other supportive care.