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2011, Número 1

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Gac Med Mex 2011; 147 (1)


Diagnóstico premotor de la enfermedad de Parkinson

Morales-Briceño H, Cervantes-Arriaga A, Rodríguez-Violante M

Idioma: Español
Referencias bibliográficas: 82
Paginas: 22-32
Archivo PDF: 123.95 Kb.


RESUMEN

Introducción: La enfermedad de Parkinson (EP) es una trastorno neurodegenerativo caracterizado por bradicinesia, temblor en reposo y rigidez. Patológicamente, la EP se ha definido por la presencia de cuerpos de Lewy, que son resultado de la agregación de a-sinucleína (α-SN). Braak ha propuesto que la enfermedad por agregación de α-SN en la EP comienza en la médula oblongada y progresa predeciblemente alcanzando la sustancia nigra en el mesencéfalo después de afectar el tallo cerebral. Aparte de la sintomatología motora de la enfermedad, los síntomas no motores (SNM) pueden anteceder a la EP, estos incluyen trastornos neuropsiquiátricos, trastornos del sueño y disfunción autonómica. Objetivo: Describir y discutir los SNM y las pruebas diagnósticas con utilidad potencial en el diagnóstico premotor de la EP. Conclusiones: Los síntomas no motores son ahora aceptados como parte integral del espectro de la EP, y existe evidencia que sugiere que la disfunción olfatoria y trastornos del sueño pueden anteceder a los signos motores. La presencia de diversos SNM en conjunto con estudios de imagen tienen el potencial para detectar a pacientes con EP en la fase premotora. Se requieren un número mayor de estudios y en particular diseños de cohorte de sujetos en riesgo.


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