Parkinson’s disease: Blind groupthink in a closed box
Aesop’s fable of the blind men and the elephant is always useful. The usual image is of three elderly gents wearing dark glasses, with a white cane over one arm, and lascivious grimaces, clutching some part of the elephant and expounding on what they are holding. The point being that we mostly have a tendency to claim absolute truth based on limited and subjective experience. This is unfortunately likely to be the case for the diagnosis of and understanding of Parkinson’s disease (PD)
The management of advanced phases of Parkinson’s disease
Parkinson’s disease (PD) is a slowly progressive neurodegenerative condition with an increasing incidence worldwide.1 PD is characterized by its unique involvement of the motor system, but prominent neuropsychiatric symptoms, autonomic nervous system features and disorders of sleep are increasingly recognized as important factors in causing disability. Accumulation and spread of insoluble alpha-synuclein deposits through the brainstem, basal ganglia and cerebral cortex are thought to be the most likely cause for the clinical features and progression.
Eye oscillations: Unravelling their significance
The outdated view that eye movement oscillations are isolated phenomena and not usually of localizing or aetiological value is changing. David Zee, the doyen of neuro-ophthalmology and neuro-otology makes a strong case for eye movement research. He views eye movements and eye oscillations as windows to the brain, mind and more; biomarkers whose value are yet untapped. The type, direction, associated symptoms and management of ocular oscillations can be vexing. But by adopting a considered approach to eye oscillations, unravelling their value can be immensely helpful in general neurology practice.
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