A degeneration of the brain marked by shaking of limbs and a generalised stiffness of movement. Parkinson’s disease is a progressive brain disorder causing shaking and issues with motion. It results from a deficiency of dopamine, the neurotransmitter that smoothes muscle motions, and is most common in guys over the age of 60.
Parkinson’s disease results from degeneration of cells in a specific part of the brain called the basal ganglia, which control the smoothness of muscle moves. Cells in the basal ganglia generate a neurotransmitter (a substance that carries nerve impulses) called dopamine, which acts with acetylcholine, another neurotransmitter, to fine tune muscle moves. In Parkinson’s disease, the amount of dopamine relative to acetylcholine is reduced, and muscle control is lost.
Although the cause of Parkinson’s disease isn’t understood, genetic factors are likely called for. About 3 in 10 individuals with the illness have an affected relative. About 1 in 100 individuals over the age of 60 in the West have Parkinson’s disease.
Parkinsonism is the term given to the symptoms of Parkinson’s disease when they’re due to another underlying disorder. Specific drugs, including some antipsychotic drugs used to treat acute psychiatric illness as well as affliction and antivertigo drugs, may cause parkinsonism, as may recurrent head injuries.
Causes of Parkinson’s Disease
For reasons not understood, there is an abnormally rapid loss of certain specialised cells within the brain in individuals with Parkinson’s disease. These cells produce a chemical called dopamine, which is involved in the fine control of muscle activity. Dopamine is one of a number of neurotransmitters in the body, which are the chemicals through which one nerve cell communicates with another.
Parkinson’s disease is mainly a disease of ageing, affecting about 2% of those over 80, but it is not unknown in younger age groups. A few cases are caused by dings that have reversible Parkinsonian side effects, for example sedatives such as chlorpromazine. There are a number of other rare neurological diseases that mimic Parkinson’s disease but are differentiated on investigation. In this case the condition is called Parkinsonism.
Symptoms of Parkinson’s Disease
The early symptoms are easily mistaken for the general effects of ageing: lack of mobility, dizziness, slow speech and a mild tremor of the hands. The diagnosis becomes more obvious once the more typical symptoms appear, for example a tremor of the hands in a pattern where the thumb keeps rubbing against the index and middle fingers – a so-called pill-rolling movement. There is a general rigidity of the limbs. For example, walking is with a stiff gait with the arms held rigidly at the sides and the whole body bent over. As the condition worsens patients have an immobile, expressionless face. They have difficulty in starting to walk, making a few shuffling paces before getting into their stride. In addition, there is frequently depression and constipation.
The primary symptoms of Parkinson’s disease start slowly over a period of months or even years. Symptoms include:
- greasiness of the face and excessive salivation
- expressionless or mask-like face
- tremor of one hand, arm or leg, generally when resting and after happening on both sides
- muscle rigidity, making it hard to begin going
- handwriting that gets smaller and smaller
- slowness of motion
- shuffling walk
- stooped position.
Afterwards, rigidity, immobility and a continuous trembling of both hands can make day-to-day tasks hard to perform. Language may become slow and uncertain, and swallowing may be challenging. Many individuals with Parkinson’s disease grow depression. About 3 out of 10 individuals with the illness eventually develop dementia.
Interestingly, handwriting becomes small and cramped and the diagnosis can be suspected on this evidence alone.
Diagnosis of Parkinson’s Disease
Since Parkinson’s disease starts slowly, it’s frequently not possible to diagnose instantly.
- Your physician will arrange for you to see a neurologist. Tests including CT scan or magnetic resonance imaging (MRI) may be done to exclude other possible causes.
- Occasionally it’s just a favorable reaction to antiparkinsonism drugs that supports the identification.
- If a particular inherent illness is found to be causing your symptoms, you may be diagnosed as having parkinsonism rather than Parkinson’s disease.
Treatment of Parkinson’s Disease
Although there isn’t any specific treatment for Parkinson’s disease, drugs, surgery and physical treatments may alleviate symptoms. If you’ve got parkinsonism as a result of drug your physician may alter your drugs. Symptoms may subsequently vanish in about eight weeks.
If symptoms don’t work out, treatment with antiparkinsonism drugs may be desired. The drugs available work by boosting the levels of dopamine in the brain. Probably the best known is L-Dopa. given alone or in combination with other drugs, such as carbidopa, which improve the brain uptake of L-Dopa. Side effects such as nausea, low blood pressure and confusion are common. Unfortunately, most patients develop resistance to these drugs
after a few years. There are a few alternative drugs, such as selegiline, which can relieve symptoms and put off the need to go on to L-Dopa. Newer drugs such as cabergoline or entacapone enhance the effect of L-Dopa.
Levodopa is generally successful for several years. In the beginning, its side effects are primarily nausea and vomiting, although in some situations involuntary motions and hallucinations may occur. Long term use of levodopa occasionally leads to sudden changes of symptoms known as the “on-off occurrence.
Moves are slow-moving and hard as the drug wears off during the “off’ intervals. During the “on” intervals, freedom is impaired by involuntary movements for example tics, spasms and writhing.Levodopa is usually prescribed in combination with another drug called carbidopa. which reduces the side effects. Carbidopa prevents the breakdown of levodopa, so smaller doses of levodopa supply the exact same effect. Anticholinergic drugs can be successful for sevefal years. Nevertheless, side effects may include vision problems, difficulty urinating and a dry mouth.
The physician may organize physiotherapy to help with mobility difficulties, or speech therapy for language and swallowing difficulties. In case you are finding it hard to manage at home, occupational therapy may be useful. The therapist may suggest changes, for example installing grab-rails in your house, to allow it to be simpler that you move around.
Physiotherapists and occupational therapists are useful to many sufferers, helping people with Parkinson’s to make their home environment as safe and convenient as possible.
Surgery is occasionally performed, cutting certain nerve pathways in the brain to relieve disturbances of movement. There is also the possibility of implanting brain cells taken from a foetus to replace the dopamine-producing cells in the brain. This is still an experimental and controversial method of treatment with unpredictable results but may lead to an eventual cure of this common and distressing condition.
Commonly Asked Questions
Is there anything other than drug treatment?
Physical aids are important, such as something as simple as slip-on shoes that don’t need lacing tip. Enthusiastic physiotherapy encourages people to make the best use of their remaining mobility.
Does it affect the mind?
Parkinsonism does not cause dementia; it can be difficult to accept this when faced with a severely disabled individual, but the mind does remain intact. Having a normal mind in a diseased body is one reason why people with Parkinson’s frequently get depressed.
What is the long-term outlook?
Many people have mild symptoms with little progression even over several years. A few people deteriorate rapidly. For the majority there is a gradual decline over 10-20 years; life expectancy is little affected.
Complementary Treatment Parkinson’s Disease
Warning: Vitamin Bg should only be administered by a doctor to Parkinson’s patients. Biodynamics can help in the early stages of the disease. Regular exercise via tai chi/chi kung can help delay the progress of the disease in its earliest stages, as can the Alexander Technique. Diel – nutritional therapy can be helpful. Ask your therapist about a low-protein diet. Various vitamin and mineral supplements could help, for example vitamins B, C and E – but note the warning above with regard to vitamin B6.
Self Help – Keeping Active
It is necessary to continue to work out and take good care of your general well-being.
Try and take a walk daily. Stretching exercises can allow you to keep your strength and freedom. Nevertheless, it’s also wise to rest during the day to prevent becoming tired. Support and psychological support from family, friends and support groups is, in addition, significant.
The course of the disorder is variable, but drugs may be effective in treating the symptoms and enhancing quality of life. Individuals can lead active lives for a long time after being diagnosed with Parkinson’s disease. Yet, most people eventually want daily help, and their symptoms may become increasingly difficult to control with drugs.