Glossary

Acetylcholine: A chemical messenger released by cholinergic nerves.
Normally in many parts of the body, including the brain, and necessary to
normal body functioning. There appears to be a reciprocal seesaw
relationship between acetylcholine and dopamine and their respective
nerve cell systems.

Action Tremor: Rhythmic, involuntary movement of a limb when movement is
initiated, e.g., when writing or lifting a cup. Not usually seen in the
earlier stages of Parkinson's.

Adrenaline (epinephrine): The neurotransmitter of the adrenal gland which
is secreted in moments of crisis. It stimulates the heart to beat faster
and work harder, increases the flow of blood to the muscles, causes an
increased alertness of mind, and produces other changes to prepare the
body to meet an emergency.

Agonist: A chemical or drug that mimics neurotransmitter activity.

Akinesia: Absence of body movements.

Alpha-Tocopherol: Chemical name for biologically active form of Vitamin E.

Amantadine: A drug which stimulates the release of available dopamine in
the brain.

Anticholinergic: Adjective applied to a substance (medication) that
reduces the action of acetylcholine.

Anticholinergic Drugs (Artane, Cogentin): The group of drugs which
decreases the action of acetylcholine. The specified drugs may help
reduce rigidity, tremor, and drooling in Parkinson's.

Antihistamines: Drugs opposing the actions of histamine; commonly used to
treat allergies. Used in the past for Parkinson's as they sometimes had
beneficial effects on symptoms due to their anticholinergic properties.

Apomorphine: A derivative of morphine and a dopamine agonist. Currently
experimentally used as injectable treatment for severe Parkinsons.

Ataxia: Loss of balance

Athetosis: Dyskinesias in which there are slow, repetitive, sinuous
involuntary movements.

Autonomic Nervous System: The branch of the nervous system that controls
internal organs in the body, i.e., heart, lungs.

Basal Ganglia or Nuclei: Deeper structures in the brain, concerned with
normal movement and walking. The caudate nucleus, putamen and Substantia
Nigra are basal ganglia affected in Parkinson's.

Benign Essential Tremor: A condition characterised by tremor of the
hands, head, voice, and sometimes other parts of the body. Essential
tremor often runs in families and is sometimes called familial tremor. It
is sometimes mistaken for a symptom of Parkinson's . However, this is an
action tremor and there is no rigidity or bradykinesia.

Beta-Blockers: Drugs which block the action of epinephrine at certain
sites. Usually used to treat hypertension and heart disease, they may be
effective in the treatment of benign essential tremor.

Bilateral: Occurring on both sides of the body.

Blepharospasm: Spasmodic blinking or involuntary closing of the eye lids;
a type of dystonia.

Bradykinesia: Slowing down of a movement. Bradykinesia involves slowness
of initiating and executing movements and fine motor movements and
difficulty in performing repetitive movements. It is a major symptom of
Parkinson's.

Carbidopa: The ingredient in Sinemet which prevents the breakdown of the
levodopa in the body before it can reach the brain.

Central Nervous System (CNS): Consists of the brain and spinal cord.

Cerebellum:  Part of the brain that is involved in coordination.

Cerebral Cortex: The largest part of the brain; responsible for thought,
reasoning, memory, sensation, voluntary movement.

Choline: A naturally occurring substance which is a precursor of
acetylcholine.

Chorea: A type of dyskinesia (abnormal movement), characterised by
continuing, rapid, dance-like movements. May result from high doses of
levodopa and/or long term levodopa therapy.

Choreoathetosis: A dyskinesia characterised by choreic and athetoid
movements.

Cogwheel Rigidity: Stiffness in the muscles, with a jerky quality when
arm and leg joints are repeatedly moved.

Constipation: Diminished ability of intestinal muscles to move feces
(stool), often resulting in very hard stool. A common problem in Parkinson's.

Deprenyl: (Eldepryl, Selegiline, Jumex) A drug that slows the breakdown
of chemicals like dopamine by inhibiting the action of certain enzymes.
It increases effects of dopamine in the brain.

Dopa Decarboxylase Inhibitors: Drugs that block the conversion of
levodopa to dopamine outside the brain.  These include carbidopa and
benserazide.

Dopamine: A chemical produced by the brain; it assists in the effective
transmission of electrochemical messages from one nerve cell to the next.
It is deficient in the basal ganglia and Substantia Nigra of a person
with Parkinson's. It governs actions of movement, balance and walking.

Dopamine Agonist: Drugs that mimic the effects of dopamine and stimulate
the dopamine receptors.

Dopaminergic: An adjective used to describe a chemical, a drug, or a drug
effect related to dopamine.

Drug Holiday: A 3 to 14 day withdrawal of a drug  after long term treatment.

Drug Induced Parkinsonism: Parkinson's symptoms which have been caused by
drugs used to treat other conditions, e.g., neuroleptic drugs, and
reserpine, used to be used to treat hypertension

Dysarthria: Speech difficulties caused when the muscles associated with
speech are affected.

Dyskinesia: Abnormal movement of voluntary muscles. Dystonia, athetosis,
and chorea are types of dyskinesia.

Dysphagia: Difficulty in swallowing.

Dystonia: Involuntary spasms of muscle contraction that cause abnormal
movements and postures. May appear as a side effect of long term drug
treatment in Parkinson's and may worsen in response to stress.

Encephalitis: Inflammation of the brain usually caused by a virus infection.

Encephalitis Lethargica: (Sleeping Sickness) A specific kind of
encephalitis which occurred in scattered epidemics throughout the world
during the period 1916 to 1926; it usually caused sleepiness, double
vision, trouble swallowing, and drooling. Many of those affected
developed advanced Parkinsonism as depicted in the movie Awakenings'.

Ethopropazine: (Parsidol/Parsitan) A drug sometimes used in the past for
Parkinson's due to its anticholinergic effects.

Extrapyramidal Nervous System: Refers to the caudate, putamen, and
Substantia Nigra. It is affected in Parkinson's.

Festination: Walking in rapid, short, shuffling steps.

Flexion: A bent, curved posture.

Freezing: Temporary, involuntary inability to move.

Glaucoma: A sustained increase of pressure within the eyeball which can
injure the optic nerve and cause impaired vision or blindness. Treatment
with anticholinergics may exacerbate glaucoma.

Globus pallidus: The inner part of the lenticular nucleus. The lenticular
nucleus and the caudate nucleus form the Striatum.

Heimlich Manoeuvre: A form of first aid for people who are choking.

Hypokinesia: Abnormally diminished motor activity.

Idiopathic: An adjective meaning of unknown cause'. The usual form of
Parkinson's is idiopathic Parkinson's.

Intention Tremor: One occurring when the person attempts voluntary movement.

Lenticular nucleus: This group of cells along with the caudate nucleus
form the Striatum or Corpus Striatum.

Levodopa: The international generic name for the medicinal formulation of
L-Dopa. It is contained in Sinemet and Prolopa.

Levodopa-Induced Dyskinesias: A side effect of medication which may occur
with prolonged use. These abnormal, involuntary movements may be
alleviated by reducing the amount of medication.

Lewy Body: Pink, staining spheres on damaged brain cells: markers for
Parkinson's.

Livido Reticularis: A purplish or bluish mottling of the skin seen
usually below the knee and sometimes on the forearm in persons under
treatment with the drug amantadine (Symmetrel).

Micrographia: The tendency to have very small handwriting due to
difficulty with fine motor movements in Parkinson's.

MPTP: A toxic chemical, exposure to which can lead to Parkinson's.

Myoclonus: Jerking, involuntary movement of arms and legs, usually
occurring during sleep.

Neostriatum: Vital part of the brain comprised of two basal ganglia
(caudate and putamen).

Neuroleptic Drugs: (Also called major tranquilizers) A class of drugs
which act as dopamine antagonists (by blocking some dopamine receptors).
They can aggravate symptoms of Parkinson's. This class includes
Haloperidol (Haldol), and the phenothiazines, e.g., Compazine, Stelazine,
Chlorpromazine, etc.

Neuron: A nerve cell.

Neurotransmitter: A specialised chemical produced in nerve cells that
permits the transmission of information between nerve cells .

Nigrostriatal Degeneration: Degeneration of the nerve pathways from
Substantia Nigra to the striatum. These pathways are normally rich in
dopamine and are those affected in PS.

Norepinephrine (Noradrenalin): Chemical transmitter found mainly in two
areas of the brain involved in governing the involuntary autonomic
nervous system.

On-Off Fluctuations: Fluctuations that occur in response to levodopa
therapy in which the person's mobility changes suddenly and unpredictably
from a good response (on) to a poor response (off).

Orthostatic Hypotension: A drop in blood pressure during rapid changes in
body position (e.g., from sitting to standing).

Palilalia: A symptom of Parkinsonism, especially the post-encephalitic
form, in which a word or syllable is repeated and the flow of speech is
interrupted.

Pallidotomy: Excision or destruction of the Globus Pallidus, which is
part of the Lenticular Nucleus, which is part of the Striatum.

Paraesthesia: Sensations, usually unpleasant, arising spontaneously in a
limb or other part of the body, variously experienced as pins and
needles' or a feeling of warmth or coldness (thermal paresthesias).

Parkinson's Disease: That form of Parkinsonism originally described by
James Parkinson as a chronic, slowly progressive disease of the nervous
system characterised clinically by the combination of tremor, rigidity,
bradykinesia, and stooped posture, and pathologically by loss of the
pigmented nerve cells of the Substantia Nigra in the brain.

Parkinson's Facies: A stolid masklike expression of the face, with
infrequent blinking; it is characteristic of Parkinson's.

Parkinsonism: A clinical state characterised by tremor, rigidity,
bradykinesia, stooped posture, and shuffling gait. The more common causes
of Parkinsonism are Parkinson's Disease, striatonigral degeneration, and
a reversible syndrome induced by major tranquillising drugs.

Paralysis agitans: The Latin form of the older, popular term shaking
palsy', which was used to designate Parkinson's in James Parkinson's time.

Parlodel (Bromocriptine): A dopamine agonist useful in treating all of
the primary symptoms of Parkinson's. It may be used alone or with other
antiparkinson medications.

Permax (Pergolide): A drug similar in action to Parlodel but more potent.

Postural Deformity: Stooped posture.

Postural Instability: Difficulty with balance.

Postural Tremor: Tremor that increases when hands are stretched out in front.

Precursor: Something that precedes, e.g., a sign or symptom that
forewarns of another, such as muscle aching may be the precursor of a tremor.

Progressive Supranuclear Palsy (PSP): A degenerative brain disorder
sometimes difficult to distinguish from Parkinson's especially in the
early stages. PSP symptoms are rigidity and akinesia, difficulty looking
up and down, speech and balance problems. Those with PSP often have poor
response to antiparkinson medications.

Prolopa: Trade name for the antiparkinson drug composed of levodopa and
benserazide. This drug combination contains a ratio of 4 mg. of levodopa
to 1 mg. of benserazide (Prolopa 50-12.5, 100-25, 200-50).

Propulsive Gait: Disturbance of gait typical of Parkinsonism in which,
during walking, steps become faster and faster with progressively shorter
steps that pass from a walking to a running pace and may precipitate
falling forward.

Range of Motion: The extent that a joint will move from being fully
straightened to completely bent.

Receptor: A sensory nerve ending that responds to a stimulus.

Resting Tremor: Shaking that occurs in a relaxed and supported limb.

Retropulsive Gait: Walking that is propelled backwards.

Rigidity: Refers in medical usage to a type of muscular stiffness
encountered when examining people with Parkinson's. It is characterised
by a constant, even resistance to passive manipulation of the limbs.

Seborrhoea: Increased discharge of the oily secretion sebum from the
sebaceous glands of the skin.

Seborrhoeic Dermatitis: Inflammation of the skin sometimes associated
with seborrhoea.

Shaking Palsy: Old popular term which James Parkinson employed to
designate the specific disorder we now call Parkinson's.

Shy-Drager Syndrome: This is a condition in which the symptoms are the
result of abnormalities in motor function and problems in the autonomic
nervous system. A person with Shy-Drager Syndrome has Parkinsonism,
extremely low blood pressure which worsens upon standing, bladder
problems, severe constipation, and decreased sweating. This condition is
quite rare.

Sialorrhea: Drooling of saliva.

Side Effect: A drug's effect that is different from the beneficial effect
for which the drug is being taken.

Sinemet: Trade name for the antiparkinson drug that is a mixture of
levodopa and carbidopa. This drug combination contains a ratio of
levodopa 4 mg. or 10 mg. to carbidopa 1 mg. (Sinemet 100/25, Sinemet 250/25).

Sinemet CR: Controlled-release Sinemet. 200 mg. Levodopa with 50 mg.
Carbidopa in a capsule contained in a matrix (outer layer) releasing the
drug more slowly in the body. These capsules are not to be taken all at
once, but rather in separate doses over the course of a day.

Stereotactic Surgery: Surgical technique that involves placing a small
electrode in an area of the brain to destroy a tiny amount of brain tissue.

Striatonigral Degeneration: This is a degeneration of the nerve pathways
traveling from the striatum to the Substantia Nigra. People with this
degeneration also appear to have Parkinsonism. However, they respond
differently to drug therapy than people with Parkinson's.

Striatum: Area of brain controlling movement, balance, and walking.
Connects to and receives impulses from Substantia Nigra.

Substantia Nigra: Black pigmented area of the midbrain where cells
manufacture the neurotransmitter dopamine.

Sustention or Postural Tremor: Tremor that increases when hands are
stretched out in front.

Symmetrel (Amantadine): A drug that releases dopamine and is useful in PS.

Tardive Dyskinesia: This is a movement disorder associated with long-term
use of neuroleptic drugs such as Chlorpromazine, Haloperidol, Loxapine,
etc. Movements of a person with tardive dyskinesia are similar in
appearance to those of a person with levodopa induced dyskinesias, but
the causes of the two conditions are different.

Thalamotomy: Operation in which a small region of the thalamus is
destroyed, achieved by stereotactic techniques. Tremor and rigidity in
Parkinsonism and other conditions may be relieved by thalamotomy.

Thalamus: Anatomical term designating a mass of grey matter centrally
placed deep in the brain near its base and serving as a major relay
station for impulses traveling from the spinal cord and cerebellum to the
cerebral cortex.

Toxin: A poisonous substance.

Tremor: Rhythmic shaking and involuntary movement of part(s) of the body
as a result of sequential muscle contractions.

Unilateral: Occurring on one side of the body. Parkinson's symptoms
usually begin unilaterally.

Vomiting Center: Term referring to an area of the brain where the nausea
and vomiting reflex may be triggered by some medications.

Wearing Off' Phenomenon: Waning of the effect of the last dose of
levodopa, associated with abrupt reduction or loss of mobility.



Modified from the glossary published by The Parkinson's Society of
Southern Alberta

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Barbara Patterson                               [log in to unmask]
HSC 2J22                                        905-525-9140, ext. 22403
                        School of Nursing
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