Friday, 7 June 2019

Risk factors for Parkinsonism

Risk factors for Parkinsonism

The following are some risk factors for Parkinson's disease. 
  1. Pesticide exposure
  2. Head injury
  3. Drinking well water
  4. Agricultural occupation
  5. Use of beta-blockers.

Development in the first year of life summarised

Development in the first year of life summarised
  1. Smiling starts at 3 weeks. 
  2. Selective smiling starts at 6 months. 
  3. Fear of strangers starts at 8 months, while separation anxiety starts later to that. 
  4. At the end of the first year, children also learn a few simple words like mama, dada, etc. 
  5. Weaning starts at around 6 months and should have completed by the end of the year. 
  6. An ordered sleep-wake cycle has also got established, Children learn to point at objects in the first year of life.

Types of Personality Disorder

It is classified into three clusters as:


which include





Emotional and impulsive:







Obsessive compulsive

Another way to classify them is Mad, Bad and Sad respectively for the suspicious, impulsive and anxious clusters. Remember there are no clusters in ICD11 anymore, The individual personality disorders have been eliminated from ICD11.

Saturday, 1 June 2019

What is Neuroleptic malignant syndrome (NMS) ?

How do we define NMS?

It is an acute disorder of thermoregulation and neuromotor control that occurs because of exposure to dopaminergic drugs.

What drugs or medications can cause NMS?

Antipsychotics, especially the ones with high anti-dopaminergic potency. But also dopaminergic agonist withdrawal e.g. withdrawal from levodopa.

The Gene associated with antisocial behaviour

Criminal behavior, lack of guilt, and irritability are typical features of antisocial personality disorder. Evidence suggests that a low-activity variant of the MAO-A gene predisposes to adult antisocial behavior in men, especially in those who faced early adversity1–4. Catechol-O-methyltransferase enzyme metabolizes dopamine and other monoamines. Its gene, the COMT-gene, occurs in two forms: a high-activity form and a low-activity form. They associate these variants with differential abilities of the prefrontal cortex, especially working memory. People with low-activity form may have a more efficient prefrontal cortex, likely because of the greater dopamine level in the synaptic space5,6. We have associated serotonin transporter gene variants with neuroticism and a predisposition to depression. The variants may also influence individual response to SSRIs8. APOE4 gene is a risk factor for Alzheimer’s disease (compared to APOE2 and APOE3).

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ICD-11 Criteria for Gambling Disorder (6C50)

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