ABSTRACT
During the last decades, atypical parkinsonian disorders such as multiple system atrophy, dementia with Lewy bodies, progressive supranuclear palsy, and corticobasal degeneration along with secondary parkinsonian disorders have been increasingly recognized as important causes of parkinsonism. Although treatment options are largely limited to date, remarkable progress has occurred through advances in the fields of molecular biology and diagnostic neuroimaging, resulting in intense preclinical drug discovery programs. Early-investigation-assisted clinical diagnosis has become more crucial than ever because disease-modifying therapies will hopefully become available within this decade.
Subject(s)
Parkinson Disease, Secondary/diagnosis , Parkinson Disease, Secondary/history , Parkinson Disease, Secondary/physiopathology , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Lewy Body Disease/diagnosis , Lewy Body Disease/epidemiology , Lewy Body Disease/genetics , Multiple System Atrophy/diagnosis , Multiple System Atrophy/epidemiology , Multiple System Atrophy/genetics , Neurodegenerative Diseases/diagnosis , Neurodegenerative Diseases/epidemiology , Neurodegenerative Diseases/genetics , Parkinson Disease, Secondary/epidemiology , Supranuclear Palsy, Progressive/diagnosis , Supranuclear Palsy, Progressive/epidemiology , Supranuclear Palsy, Progressive/geneticsABSTRACT
Manganese plays an important role as a cofactor in many enzymatic reactions in humans but in excess amounts can cause irreversible nervous system damage. Although manganism is a rare condition, it can be the cause of complex nervous system symptoms, especially in the setting of environmental exposure. Specifically, manganese is a well-known cause of dystonic parkinsonism. This article highlights several historical descriptions of the clinical manifestations, pathological changes, and attempted therapeutic intervention in manganese intoxication.
Subject(s)
Manganese Poisoning/history , Animals , History, 19th Century , History, 20th Century , Humans , Male , Manganese Poisoning/complications , Manganese Poisoning/diagnosis , Manganese Poisoning/therapy , Occupational Exposure/adverse effects , Occupational Exposure/history , Parkinson Disease, Secondary/etiology , Parkinson Disease, Secondary/historyABSTRACT
A historical review of the adverse reactions to neuroleptic agents--extrapyramidal side effects--is presented. Soon after its introduction in 1952, chlorpromazine was noted to induce symptoms resembling Parkinson's disease. At first, these symptoms were thought to be related to the drug's antipsychotic effect. Later, more careful research showed that they are not directly associated with the antipsychotic activity of neuroleptic agents. More recently, extrapyramidal side effects have gained importance because they are significant factors in both the patient's acceptance of the particular drug and his or her social adjustment.
