Mortalidad por enfermedad de Parkinson en Chile / Parkinson disease mortality rates in Chile

Background: Parkinson disease (PD) is the second more common neurodegene-rative disorder and determines a loss in quality oflife, caregiver burden and increased mortality in those affected. Aim: To determine the rates of mortality due to Parkinson disease in Chile. Material andMethods: Data were collected from death certificates between 1997 and 2008. Mortality rates were calculated and the mortality trend was established along the study period, and analyzed by age, sex and geographic región of Chile. Results: There was a steady increase in mortality over the years, particularly since2001 (r²= 0.85, p < 0.01). The increase in mortality rates was 0.25per 100.000 habitants/year (r²: 0.89, p < 0.01). Mortality was always higher in men and in those older than 80years. The highest rate (per 100,000 habitants) in Chile was observed in the región of Valparaíso (2.4) while the lowest was in Antofagasta (0.8) (t = 3.72, p < 0.05). Conclusions: Mortality associated with PD has increased progressively, consistent with the expected increase in prevalence ofthe disease in the population.

Temblor ortostático como causa de inestabilidad postural en enfermedad de Parkinson: Caso clínico / Orthostatic tremor causing postural instability in Parkinson disease: Report of one case

Parkinson disease (PD) is a movement disorder characterized clinically by the variable combination of rigidity, bradykinesia, rest tremor and postural instability. Usually postural instability is a late-onset manifestation and is frequently associated with axial manifestations and with a poor prognosis. We report a 67-year-old female with orthostatic tremor as the etiology of her postural instability. The patient was treated with increasing doses of clonazepam, reaching 2 mg/day, and levodopa. There was an improvement of postural instability with a good response of parkinsonian symptoms.

Features associated with the development of non-motor manifestations in Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disorder, predominantly characterized by the presence of motor symptoms. However, the non motor manifestations (NMM) are a frequent complaint in the PD patients. There is a lack of information about the risk factors associated with the NMM in these patients. The aim of this study is to evaluate the prevalence of the more common NMM in a population of PD patients and to determine the features associated with its development. We studied 124 ambulatory PD patients. NMM were defined by the presence of neuropsychiatric manifestations, cognitive disorder, autonomic dysfunction or sleep related problems. In a multivariate analysis we found that the years of evolution of the PD and the presence of cognitive dysfunction are the risk factors for the neuropsychiatric and autonomic manifestations, whereas axial impairment is a risk factor for cognitive disorders and dyskinesias is for sleep related problems. In conclusion, this study shows that the features related to the PD progression appear as the main risk factors associated with NMM.

La enfermedad de Parkinson (EP) es un trastorno neurodegenerativo, caracterizado predominan-temente por la presencia de síntomas motores. No obstante, la presencia de manifestaciones no motoras (MNN) son frecuentes en los pacientes con EP. Existe escasa información sobre los factores de riesgo asociados con la aparición de MNN en dichos pacientes. El objetivo de este estudio fue evaluar la prevalencia de las MNN más comunes en una población de pacientes portadores de EP y determinar los factores de riesgo asociados con su aparición. Estudiamos 124 pacientes portadores de EP atendidos en forma ambulatoria. La presencia de MNN fue definida por la aparición de manifestaciones neuropsiquiátricas, trastorno cognitivo, disfunción autonómica o alteraciones del sueño. En el análisis multivariado encontramos que los años de evolución de la EP y la presencia de disfunción cognitiva son los principales factores de riesgo para las manifestaciones neuropsiquiátricas y autonómicas, mientras que el compromiso axial es el mayor factor de riesgo para la aparición de manifestaciones cognitivas y la presencia de discinesias es el principal factor asociado con la aparición de trastornos del sueño. En conclusión, este estudio muestra que los factores asociados a la progresión de la EP son los principales factores de riesgo para la aparición de las MNN en nuestra población.

Déficit de la olfacción en la enfermedad de Parkinson: un síntoma a considerar en la práctica clínica: [revisión] / Olfaction deficit in parkinson disease: a symptom to considerate in clinical practice: [review]

Se estima que entre el 0,8 y 1,42% de la población general presenta algún grado de disfunción olfativa. En estudios epidemiológicos de población general han demostrado que esto aumenta con la edad, llegando a afectar al 29% de las personas entre 70 y 79 años. Las causas más comunes del déficit de olfacción en el adulto mayor son trauma de cráneo, inflamación del tracto respiratorio alto de etiología tanto infecciosa como alérgica y las enfermedades degenerativas del sistema nervioso central como la enfermedad de Alzheimer y de Parkinson. El 60 al 90% de los pacientes con Enfermedad de Párkinson tiene déficit olfativo, siendo uno de los síntomas más frecuentes de la enfermedad. Se presenta en forma precoz y bilateral, el déficit en general no es a todos los olores, permaneciendo la habilidad de reconocer algunos. En esta revisión, se caracteriza la forma de presentación de este trastorno y su impacto como un marcador biológico en la enfermedad de Parkinson...

Between 0,8 to 1,42% of the population presents some grade of smell dysfunction. Several epidemiological studies have demonstrated that this increases with the age, affecting to 29% of subjects between 70 and 79 years. The more common causes of this dysfunction are skull trauma, inflammation of upper respiratory tract of infectious or allergic etiologies and the degenerative diseases of the central nervous system, mainly Alzheimer and Parkinson disease. Between 60 to 90% of the patients with Parkinson Disease have smell deficit, being one of the more common symptoms in this disease. Usually this smell dysfunction is presented bilaterally and it appears early in the course of the disease. In this review is characterized the clinical presentation of this dysfunction and its impact as a biological marker in the PD...