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Parkinsonism


Parkinsonism is a condition relating to a series of symptoms that mimic the movement disorders in Parkinson's disease. This includes impaired speech, stiffness of the muscles, slow movement, and visible tremors. These symptoms are caused by a dwindling supply of neurons or nerve cells that contain the substance dopamine. While Parkinson’s disease commonly causes Parkinsonism, not all people diagnosed with Parkinsonism are afflicted with Parkinson's disease.

Parkinsonism rarely affects each afflicted person in the same way. In some patients, the condition progresses fairly quickly, while in orders, the onset is slow and gradual. Some people who acquire Parkinsonism end up severely and permanently debilitated, while others find the disease to be mere disruptions of their fine motor skills.

While Parkinsonism may be a minor complaint for some, and a severe disability for others, the disease carries many common symptoms. One of the most common is a tremor. Parkinsonism tremors are unique in that sufferers exhibit a rhythmic forward and backward motion of their thumbs and forefingers measured at three beats every second. These tremors, commonly known as “pill rolling”, starts in one hand, although there are cases where either one foot or a person's jaw exhibits this symptom first.

PARKINSONISM SYMPTOMS

The tremors are most apparent when the patient is under any form of stress, and in a majority of sufferers, the tremors are concentrated on only one side of the body, particularly when the disease is at its early stages. Later on, as it progresses, the tremors become generalized. Parkinsonism tremors are rarely debilitating and they disappear on their own when the patient is asleep, or during voluntary and intentional motion.

Another symptom of Parkinsonism, rigidity causes the muscles to resist movement. Due to the dysfunctional signals sent to the brain, the opposing muscles that are supposed to relax during movement start to contract and tense with the affected person's every motion. This leads to the sufferer feeling weak and stiff, while movements become jerky and abrupt.
Parkinsonism
Image: Parkinsonism


A person with Parkinsonism will experience a slowing down and a gradual loss of any movement that is spontaneous or automatic. This symptom, known as Bradykinesia, is unpredictable at best, and patients will find themselves unable to perform ordinary motions that they were able to do several moments beforehand. Because of this symptom, normal activities such as bathing or dressing take several hours to complete.

PARKINSONISM CAUSES

Parkinsonism also causes Postural instability. This symptom is characterized by a balance impairment where a sufferer develops a posture that leans to far forward or too far back. Patients with a marked Postural instability have perpetually drooping shoulders and a bowed head; they are also prone to falls. To compensate for this, they continually halt in mid-walk, or take small and rapid steps to keep their balance.

There are various ailments and diseases that lead to the onset of Parkinsonism. One such disease is a virus called encephalitis lethargica, which afflicted nearly 5 million people just after World War 1. It was widely known as the sleeping sickness, and abruptly disappeared around the 1920's. Nearly one-third of all people afflicted died, and most of the survivors were left with a movement disorder known as Postencephalitic Parkinsonism.

In some cases Parkinsonism can be caused by the use of psychiatric medications, such as chlorpromazine or haloperidol. Some drugs for stomach disorders, like metoclopramide, or high-blood pressure medication, like reserpine, may also cause Parkinsonian symptoms. These symptoms are temporary, however, and once the patient goes off medication or lowers their usual dosage, the symptoms eventually disappear.

One other cause of Parkinsonism is a condition known as Striatonigral degeneration. With this disease, the brain's substantia nigra becomes afflicted, and the brain exhibits a degree of damage characteristic of patients diagnosed with Parkinson's disease. With Striatonigral degeneration, symptoms of rigidity are more pronounced, and Parkinsonism progresses at a faster rate.

Arteriosclerotic Parkinsonism may also cause Parkinsonism. This disorder leads to a patient experiencing a number of small strokes that results in damage to several brain vessels. While this disorder rarely exhibits the symptoms of tremors, patients are likely to lose their mental skills and abilities.

There are some toxins and poisons that can cause Parkinsonism, as well. Manganese dust, for instance, or carbon disulfide and carbon monoxide, can result in Toxin-induced Parkinsonism. This condition is common in people who are addicted to substances that may be tainted with traces of these toxins.

Other conditions that cause and accompany Parkinsonism symptoms include Shy-Drager syndrome, a neurological disorder; Wilson's disease, progressive supranuclear palsy, Hallervorden-Spatz syndrome, Huntington's disease, Alzheimer's, post-traumatic encephalopathy, olivopontocerebellar atrophy, and Creutzfedt-Jakob disease.

People who have had strokes, are afflicted with encephalitis, meningitis, multiple systems atrophy, various traumas to the head, and corticobasal degeneration are also likely to exhibit symptoms of Parkinsonism.

PARKINSONISM DIAGNOSIS

There is no exact diagnostic test to determine Parkinsonism. The doctor will take the patient's medical history, and closely observe the visible symptoms the patient exhibits. In the normal course of examination, the doctor will also perform several neurological tests to determine the presence of any brain damage.


In its early stages, it is difficult, even for a seasoned neurologist, to ascertain whether the symptoms of Parkinsonism stem from Parkinson's disease, or from some other condition that may exhibit similar symptoms. There are no laboratory procedures available to diagnose Parkinsonism. Only as the disease progresses and advances can a proper diagnosis be established from an extended observation of the patient.

PARKINSONISM TREATMENT

Targeting the underlying condition that causes the symptoms treats Parkinsonism. While there is no known cure for the disease at present, there is a wide range of medications that can provide relief from its symptoms.

Based on the degree of progression and the severity of the symptoms of Parkinsonism, not all afflicted persons will require medication. This is because no two persons exhibit the same range and number of symptoms. Medication is tailored to for each patient’s condition based on how the disease has disrupted his or her everyday activities.

One such potent medication is Levodopa, derived from L-Dopa, a natural substance taken from animals and plants. Levodopa acts by replenishing the brain's diminishing supply of dopamine in order to delay the progression of the Parkinsonism symptoms.

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