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History

Early sources, including an Egyptian papyrus, an ayurvedic medical treatise, the Bible, and Galen 's writings, describe symptoms resembling those of PD. After Galen, no references unambiguously related to PD appear until the 17th century. In the 17th and 18th centuries, Franciscus Sylvius, Hieronymus David Gaubius, John Hunter and Auguste François Chomel wrote about elements of the disease.

Although the first systematic description of the disease is attributed to James Parkinson, the disease itself with all four cardinal signs (tremor, bradykinesia, rigor and postural instability) was described in 1690 by Ferenc Pápai Páriz, in a Hungarian medical text over 120 years before the classical description of James Parkinson. However, as it was published in Hungarian, his book was ignored in the western medical literature.

In 1817, James Parkinson published his essay reporting six people with paralysis agitans. An Essay on the Shaking Palsy described the characteristic resting tremor, abnormal posture and gait, paralysis and diminished muscle strength, and the way that the disease progresses over time. Early neurologists who made further additions to the knowledge of the disease include Trousseau, Gowers, Kinnier Wilson and Erb, and Jean-Martin Charcot, whose studies between 1868 and 1881 increased the understanding of the disease. Among other advances, Charcot made the distinction between rigidity, weakness and bradykinesia. He championed the renaming of the disease in honor of James Parkinson.

In 1912, Frederic Lewy described microscopic particles in affected brains, later named Lewy bodies. In 1919, Konstantin Tretiakoff reported that the substantia nigra was the main cerebral structure affected, but this finding was rejected until it was confirmed by further studies published by Rolf Hassler in 1938. The underlying biochemical changes in the brain were identified in the 1950s, due largely to the work of Arvid Carlsson on the neurotransmitter dopamine and Oleh Hornykiewicz on its role on PD. In 1997, alpha-synuclein was found to be the main component of Lewy bodies by Spillantini, Trojanowski, Goedert, and others.

Anticholinergics and surgery (lesioning of the corticospinal pathway or some of the basal ganglia structures) were the only treatments until the arrival of levodopa, which reduced their use dramatically. Levodopa was first synthesized in 1911 by Casimir Funk, but it received little attention until the mid 20th century. It entered clinical practice in 1967 and brought about a revolution in the management of PD. By the late 1980s deep brain stimulation introduced by Alim Louis Benabid and colleagues at Grenoble, France, emerged as a possible treatment.

An illustration of advanced Parkinson's disease by William Richard Gowers was published in 1886 in A Manual of Diseases of the Nervous System, based on 1879 photographs attributed to Albert Londe. A new image was created in 2020 to represent diversity in levels of severity.