Glossary

Palate:

The bony and muscular structure that forms the roof of the mouth and separates the oral and nasal cavities.

Palilalia:

A symptom of Parkinsonism, especially the postencephalitic form, in which a word or syllable is repeated and the flow of speech is interrupted.

Pallidectomy:

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

Pallidotomy:

A surgical procedure in which a part of the brain, called the globus pallidus, is lesioned in order to improve symptoms of tremor, rigidity, and bradykinesia.

Palsy:

Paralysis of a muscle or group of muscles.

Palsy - Progressive Supranuclear:

Alternative name for Progressive Supranuclear Palsy

Paraesthesia:

(1) 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). (2) An abnormal sensation, such as prickling, tingling, or burning that is frequently subjective and experienced without environmental stimulation.

Paranoia:

Elaborate and overly suspicious thoughts and feelings of persecution

Parasympathetic nervous system:

Part of the nervous system that, together with the sympathetic nervous system, forms the autonomic nervous system (ANS). The ANS controls the functioning of involuntary structures, including the heart, glands, and smooth muscle. The parasympathetic nervous system regulates nerve transmissions to certain effector organs under normal conditions, as opposed to times of stress. It serves to "steady" involuntary activities and conserve or restore energy. Parasympathetic responses may include slowing of the heart and breathing rates, contraction of the pupils, an increase in glandular activity, and an acceleration in the rate of peristalsis.

Parathyroid glands:

Two pairs of endocrine glands located in the neck at the back of the thyroid gland. The parathyroid glands produce parathyroid hormone, which increases blood calcium levels by causing bones to release calcium into the blood, the kidneys to conserve calcium, and the intestines to increase calcium absorption from food. When blood calcium levels are high, the parathyroid glands reduce their production of parathyroid hormone, essentially reversing the process.

Paresthesias:

Abnormal sensations occurring spontaneously or in response to stimulation. Paresthesias may include prickling, tingling, burning, or tickling feelings; numbness; "pins and needles"; or cramp-like sensations. Various neurologic movement disorders may be characterized by paresthesias, including restless legs syndrome (RLS), paroxysmal kinesigenic dyskinesia (PKD), and paroxysmal non-kinesigenic dyskinesia (PNKD).

Parkinsonism:

A constellation of the following symptoms: tremor, rigidity, bradykinesia (slow movements), and loss of postural reflexes. Although classically seen in Parkinson's disease, parkinsonism may have other causes. In the elderly, parkinsonism may be caused by dopamine-blocking drugs, multiple system atrophy, striatonigral degeneration, Shy-Drager syndrome, cortico basal degeneration, diffuse Lewy body disease, and Alzheimer's disease with parkinsonism. In younger people, parkinsonism may be caused by juvenile-onset dystonia/parkinsonism, Westphal variant of Huntington's disease, Wilson's disease, L-dopa-responsive dystonia, Hallervorden-Spatz disease, and progressive pallidal degeneration.

Parkinson's disease (PD):

The most common form of parkinsonism, originally described by James Parkinson as a chronic, slowly progressive disease of the central nervous system. It is characterized by slowness or poverty of movement (bradykinesia), rigidity, postural instability, and tremor primarily while at rest. Additional characteristic findings include a shuffling, unbalanced manner of walking; forward bending or flexion of the trunk; a fixed or "mask-like" facial expression; weakness of the voice; abnormally small, cramped handwriting (micrographia); depression; or other symptoms and findings. Such abnormalities are thought to result from progressive loss of nerve cells within a certain region of the substantia nigra of the brain and the associated depletion of the neurotransmitter dopamine.

Parkinson's facies:

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

Parkinsonism:

The name given to a group of disorders with similar features - four primary symptoms (tremor, rigidity, postural instability, and bradykinesia) that are the result of the loss of dopamine-producing brain cells. Although classically seen in Parkinson's disease, parkinsonism may have other causes. In the elderly, parkinsonism may be caused by dopamine-blocking drugs, multiple system atrophy, striatonigral degeneration, Shy-Drager syndrome, cortico basal degeneration, diffuse Lewy body disease, and Alzheimer's disease with parkinsonism. In younger people, parkinsonism may be caused by juvenile-onset dystonia/parkinsonism, Westphal variant of Huntington's disease, Wilson's disease, L-dopa-responsive dystonia, Hallervorden-Spatz disease, and progressive pallidal degeneration.

Paralysis agitans:

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

Paraneoplastic syndromes:

These are instances in which patients with cancer suddenly begin to show signs of neurological disease such as difficulty speaking or loss of coordination—due not to the spread of the cancer, but to an autoimmune attack on the brain.

Paresthesias:

An abnormal sensation, such as prickling, tingling, or burning that is frequently subjective and experienced without environmental stimulation. In MS, it sometimes feels like abdominal tightness.

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.

Paroxysmal:

Pertaining to or occurring in paroxysms or sudden, recurrent episodes. The term paroxysms often describes transient episodes of abnormal involuntary movements (e.g., chorea, athetosis, dystonia, and/or ballismus) or ataxia, which is characterized by an impaired ability to coordinate voluntary movements.

Paroxysmal movement disorders:

Certain neurologic movement disorders characterized by abrupt, transient episodes of abnormal involuntary movement, such as chorea, athetosis, dystonia, and/or ballismus (i.e., the paroxysmal dyskinesias) or impaired coordination of voluntary actions and other associated findings (i.e., paroxysmal ataxias). Depending upon the specific disorder present, episodes may be precipitated or worsened by different factors. As examples, in those with paroxysmal kinesigenic dyskinesia (PKD), episodes may be triggered by sudden voluntary movements. In non-kinesigenic dyskinesia (PNKD), episodes occur spontaneously and may be worsened by caffeine or alcohol consumption, stress, fatigue, or other factors. In patients with paroxysmal kinesigenic ataxias, episodes may be triggered by sudden voluntary movements or postural changes. These disorders may be familial, appear to occur randomly for unknown reasons (sporadically), or occur secondary to other underlying conditions or disorders (symptomatic).

Pathogens:

Anything that can cause disease. Common pathogens include bacteria, viruses, and parasites.

Pathogenesis:

The origination and development of a disease.

Pathophysiology:

The effects of disease on body functions; the physiology of altered function seen in disease. ("Patho-" is a combining form denoting any disease state, and "physiology" refers to the study of the processes and functioning of the human body.)

PDV (Percent Daily Value):

A nutritional guideline on the appropriate doses of vitamins and minerals required for good health. The values are similar to, but generally toward the upper range of the RDA.

Penetrance:

The regularity or frequency with which a specific gene yields its effect or "is expressed." For example, if a specific gene produces a disease in all individuals who carry the gene, it is termed 100% penetrant. If a gene produces the disease less than 100% of the time, it is not fully penetrant.

Peptide:

A compound made from two or more amino acids. Peptides are short chains of amino acids. Very long chains of amino acids are called proteins.

Pericardium:

The pericardium is the two-layered sac that surrounds and protect the heart. If the pericardium becomes fibrotic or filled with fluid, it limits the motion of the heart and, therefore, the ability of the heart to pump efficiently.

Perinatal:

Occuring before, during, or after birth.

Periodic apnea:

Episodes of the temporary cessation of spontaneous breathing. Periodic apnea may be characterized by absence of airflow, absence of chest wall movements, or airway obstruction that may result from poor control of tongue movements, impaired coordination of upper airway muscles, or other abnormalities.

Periodic limb movements in sleep (PLMS):

Periodic limb movements of sleep are regular rhythmic twitches of the limbs that occur during sleep. The twitches usually affect the legs but they also sometimes affect the arms. The twitches usually last between half a second and five seconds and usually occur every five to 90 seconds. The diagnosis of periodic limb movement disorder is based on the results of an overnight sleep study. If the person has five or more series of limb movements per hour of sleep, a diagnosis of periodic limb movement disorder is made.

Perioperative setting:

The perioperative setting is the time before, during, and after an operation.

Peripheral edema:

unusual fluid accumulation, resulting in swelling of the arms or legs.

Peripheral nervous system:

The peripheral nervous system is that portion of the nervious system outside of the brain and spinal cord (central nervous system)

Peripheral neuropathy:

Inflammation, degeneration, or damage of nerves of the peripheral nervous system (PNS). The PNS includes nerves that extend from the brain and spinal cord (central nervous system) to various parts of the body. Peripheral neuropathy may involve motor nerves, causing muscle weakness, and/or sensory nerves, resulting in pain, abnormal sensations, such as numbness or tingling, or other findings.

Peristalsis:

Rhythmic, wave-like contractions of smooth or involuntary muscle fibers that propel food through the digestive tract.

Permax (Pergolide):

A drug similar in action to Parlodel but more potent.

Peroxidation:

The process by which fatty acids get oxidized.

Phenomenology:

classification based on a scientific explanation.

Phenylalanine:

An essential amino acid that is converted in the body to tyrosine.

Phenylketonuria:

An inherited disorder that, if untreated, causes profound mental retardation as well as other medical problems.

Phonation:

The production of speech; utterance of sounds through use of the vocal cords.

Phosphatidyl choline:

The most significant component of lecithin. it emulsifies and breaks down fat deposits in the body, which make it helpful in the prevention of arteriosclerosis, heart disease, gallstones and liver problems. Medical studies have also shown that Phosphatidtl Choline is beneficial in neurological disorders, memory loss and depression. Phosphatidyl Choline is 3 times more potent than lecithin.

Phospholipids:

Fatty acids combined with the mineral phosphorus and other molecules that make up the lining of a cell membrane.

Physiatrist:

A physician specializing in physical medicine and rehabilitation.

Physiologic tremor:

A form of rapid tremor that may occasionally occur in any individual. Physiologic tremor is typically the result of fear, anxiety, or excitement. Physiologic tremor may affect the arms, legs, and, in some patients, the face or neck.

Pittsburgh sleep quality index:

This 24-item self-administered questionnaire is designed to provide a brief clinically useful assessment of a variety of sleep disturbances that might affect sleep quality.

Placebo:

(1)A dummy pill that contains no active ingredient. (2)A substance that appears to be identical to the treatment under study but that has no effects on the test subject. The placebo is given to members of the control group during experimental trials that test the effects of a drug or other substance.

Placebo-controlled trial:

A clinical experiment in which patients have been randomly assigned to receive either the treatment under study or placebo, an alternative that has no effects.

Plaques:

In Alzheimer’s disease, patches of built-up material in the brain that cause cognition problems.

Platelet:

A small, round, or oval cell found in the blood, which is involved in blood-clotting.

Pleura:

The pleura are the two-layer membranes that cover the outside of the lungs and line the chest cavity.

Polymerase chain reaction (PCR):

A highly sophisticated technique during which a known sequence of DNA is copied rapidly over a short period, such as millions of copies over a few hours. PCR testing assists in diagnosing certain genetic disorders, helps identify individuals through analysis of a single cell or so-called "DNA fingerprinting," or characterizes certain strains of infectious microorganisms.

Polypharmacy:

The prescribing of multiple drugs for an individual patient. polypharmacy is most common in older adults, who tend to have more illnesses for which medications are prescribed. Adults aged 65 years and older represent 12% of the population but consume 30% of all prescription medications. Among persons older than age 65 years, the rate of nonprescription (over-the-counter) drug use is seven times that of the general population. The incidence of adverse drug reactions increases with advancing age and the number of drugs taken. Deteriorating vision and cognitive function cause older adults to make many mistakes when taking medications, often with serious consequences. Up to 10% of all hospital admissions for patients over 65 years of age involve medication toxicity.

Positron emission tomography (PET) Scan:

(1) A noninvasive, diagnostic procedure used to record the uptake and distribution of certain substances in the tissues and organs of the body. Thus, PET assists in evaluating various metabolic and physiological activities in the body. During this procedure, three-dimensional, color-coded images are created based upon the detection of positively charged particles (positrons). The positrons are produced by certain biochemicals (e.g., glucose) carrying radioactive substances that have been introduced into the body (via intravenous injection). PET scanning may help to detect abnormal biochemical patterns associated with certain neurologic conditions, such as Parkinson’s disease, brain tumors, seizure disorders, and psychiatric abnormalities. (2) An advanced, computerized imaging technique that uses radioactively-labels substances (e.g., glucose) to demonstrate chemical and metabolic activities in the brain as well as track other brain functions. Brain structures are also visualized on PET scans. (3) A computer-based imaging technique that provides a picture of the brain's activity rather than its structure by measuring levels of injected glucose which are labeled with a radioactive tracer.

Postpartum:

The period after childbirth.

Postural deformity:

Stooped posture.

Postural instability:

unsteadiness of balance, gait or standing.

Postural tremor:

(1) Tremor that increases when hands are stretched out in front. (2) Any tremor that is present while an individual voluntarily maintains a position against gravity, such as holding the arms outstretched.

Power of attorney:

Legal document that lets you appoint another person (your “agent” or “attorney in fact”) to make property, financial and other legal decisions on your behalf. Allows agent to make health decisions related to insurance and spending on care.

Precursor:

(1)Something that precedes, e.g., a sign or symptom that forewarns of another, such as muscle aching may be the precursor of a tremor. (2)Literally a "forerunner," such as a substance that precedes another in a biochemical reaction. (3) A substance that precedes, and is the source, of another substance; for instance, 5-HTP is the precursor to serotonin.

Prenatally:

Before birth.

Prevalence:

Refers to the number of people in a given group or population who have a disease.

Prion:

An abnormally shaped protein in the central nervous system that causes a family of infectious diseases that affect the brain.

Prion diseases:

A related group of illnesses (eg, bovine spongiform encephalopathy—“mad cow disease,” Creutzfeld-Jakob disease) of the central nervous system, caused by a prion, which causes changes in the brain’s tissue.

Primary fatigue:

A type of fatigue that is directly relatable to multiple sclerosis and that is not related to gender, age, level of physical disability, or the presence of a sleep disturbance.

Primary-progressive multiple sclerosis (PPMS):

A type of multiple sclerosis characterized by progressive worsening of disease, with no relapses or periods of recovery.

Probe:

A genetic probe is a single strand of DNA or RNA with a specific base sequence used to detect the corresponding base sequence by hybridization—which is the process of joining two complementary strands of DNA or one each of DNA and RNA to form a double-stranded molecule. The single strand is either radioactively or immunologically labeled.

Progressive-relapsing multiple sclerosis (PRMS):

A type of multiple sclerosis that is characterized by both progressive worsening of disease and acute relapses that may or may not be followed by periods of recovery. The disease continues to progress between relapses.

Progressive Supranuclear Palsy (PSP):

A degenerative progressive neurological disorder characterized by neurodegenerative changes of certain brain regions, including particular areas of the basal ganglia and the brainstem. PSP is sometimes difficult to distinguish from Parkinson's especially in the early stages. Symptom onset most often occurs in the sixth decade of life. Associated findings may include balance difficulties, sudden falls, stiffness (rigidity), slowness of movement (bradykinesia), difficulty in voluntarily looking up and down. Affected individuals may also develop slurred speech; balance problems; swallowing difficulties; personality changes; dystonia; sudden, involuntary, "shock-like" muscle contractions (myoclonus); or other abnormalities. The disorder usually appears to occur randomly for unknown reasons (sporadically); however, there are some reports of families with multiple affected members, suggesting a possible hereditary component to the disease. Those with PSP often have poor response to antiparkinson medications. Alternate names for this condition include dementia-nuchal dystonia; Richardson-Steele-Olszewski syndrome; palsy - progressivesupranuclear.

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).

Pro-oxidant:

A substance that causes oxidation and damage to cells and surrounding molecules. Some antioxidants in very high doses can turn into pro-oxidants.

Prophylactic:

Referring to preventive treatment (i.e., prophylaxis); a medication, procedure, or device that serves as a preventive against disease.

Prophylaxis:

Protection from or the prevention of disease; preventive (i.e., prophylactic) therapy; often refers to the use of a drug, mechanical agent, or procedure to prevent infection with certain microorganisms (e.g. bacteria).

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.

Prostaglandin:

One of a number of substances derived from fatty acids and involved in a number of important functions in tissues and cells.

Proteasome inhibitor:

A proteasome inhibitor is a chemical that interferes with, or inhibits, the action of proteasomes—the recyclers of proteins in the cells.

Protein:

(1)Proteins are large complex molecules made up of amino acids. Each protein starts out as a chain of amino acids. Determined by the sequence of the base pairs in the gene that encodes it, the protein then folds itself into its unique shape. Proteins serve many different roles within the body, including providing structure (collagen), allowing movement (actin and myosin), increasing the rate of a chemical reaction (enzymes), transporting substances (hemoglobin); regulating processes within the cells (insulin); and responding to the stimuli (receptor proteins on surface of all cells). (2) The second most common component of the body, besides water. Protein is crucial for the body's tissue development and growth. The body builds protein from amino acids. Common food sources include eggs, fish, chicken, red meat, milk and cheese, and brown rice.

Proteopathy:

Proteopathy is the abnormal accumulation and toxicity of proteins in certain disease states. The proteopathies (sometimes referred to as "proteinopathies") comprise more than 30 diseases that affect a variety of organs and tissues, including Alzheimer's disease, Parkinson's disease, type 2 diabetes, amyloidosis, selective hyperproteolytic diseases (e.g. critical illness myopathies or tumor cachexia), and a wide range of other disorders.

Proxy:

A proxy is someone who is authorized to act on behalf of another person. This person may be a relative or friend, for example.

Pseudoexacerbation:

A temporary aggravation of MS symptoms that may result from factors such as infection or hot weather. Unlike true exacerbations (relapses), pseudoexacerbations are unrelated to new disease activity, and they disappear once the cause is removed.

Pseudorelapse:

A relapse in patients with multiple sclerosis that occurs in association with infection or fever. It is a transient effect that is caused by disturbed conduction of electrical impulses and that disappears when the infection or fever is controlled.

Psychogenic:

Of mental or emotional origin; referring to a symptom, condition, or disorder that is caused by mental, psychological, or emotional factors rather than physical illness.

Psychosis:

A thought disorder characterized by impaired ability to distinguish reality from unreality, personality changes, and deterioration of normal social functioning. People with psychosis may experience hallucinations, illusions, or delusions, or they may be paranoid or have distorted thinking.

Pulmonary:

Referring to the lungs.

Pulmonary fibrosis:

A condition in which excessive scar tissue forms in the lungs, making them stiff, decreasing the amount of surface area that is available to provide gas exchange, and interfering with their function.

Putamen:

One of the 3 major brain regions that, together with the caudate nuclei and the globus pallidus, comprise the basal ganglia. Relatively similar in function and structure, the putamen and the caudate nuclei are collectively referred to as the striatum. Specialized groups of nerve cells within the putamen receive input from various regions of the cerebral cortex. The messages are processed and relayed by way of the thalamus to the motor cortex, influencing voluntary movement.

Pyramidal pathway:

A collection of nerve tracts that travel from the cerebral cortex through the pyramid of the medulla oblongata in the brainstem to the spinal cord. Within the pyramid of the medulla, fibers cross from one side of the brain to the opposite side of the spinal cord; the pyramidal pathway is intact in Parkinson's disease.

beginning of glossary

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