Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about Parkinson's disease. And you can find written notes on this topic at zero to finals.com slash Parkinson's or in the neurology section of the second edition of the zero to finals medicine book.

And you can find flashcards and questions to train your knowledge on this content

and help you remember the information for longer at members.0 to finals.com.

So let's get straight into it.

Parkinson's disease is a condition where there is a progressive reduction in dopamine in the basal ganglia in the brain, leading to disorders of movement.

The symptoms are characteristically asymmetrical, with one side of the body affected more than the other.

The typical patient is an older man, for example around 70 years old, with a gradual onset of symptoms.

There is a classic triad of features in Parkinson's disease, a resting tremor, which is a tremor that's worse at rest,

rigidity, which is resistance to passive movement of the joints, so the joints become stiff,

and bradykinesia, which is slowness of movement. Let's talk about the pathophysiology.

The basal ganglia are a group of structures situated near the center of the brain.

They're responsible for coordinating habitual movements such as walking,

controlling voluntary movements, and learning specific movement patterns.

Dopamine plays an essential role in the function of the basal ganglia.

Patients with Parkinson's disease have a slow but progressive drop in the production of dopamine.

This affects the function of the basal ganglia

causing movement disorders.

Let's go through the features.

The tremor in Parkinson's is worse on one side

and it has a 4 to 6 hertz frequency,

many cycles at 4 to 6 times per second.

It's described as a pill rolling tremor due to the appearance of rolling a pill

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