Parkinson’s disease or PD is a progressive degenerative disorder of the central nervous system affecting patients’ speech and motor skills. The condition is a part of movement disorders as characterized by different problems in physical motion. The disease can also cause chronic progressive parkinsonism. Other names for the condition are idiopathic PD and primary parkinsonism which can stem from various causes like drugs, trauma and underlying medical disorders.
About 20 out of every 100,000 people are diagnosed with Parkinson’s Disease. It has a prevalence of 0.2% with over 1 million Americans afflicted. The condition is age-specific and around 1% of people over 60 years of age has it. About 10% of all patients are diagnosed with the condition before they turn 50. Being progressive means that PD symptoms get worse over time and can be disabling in advanced stages. Some good news is that people get to have several productive years before and after diagnosis and the condition is very much treatable.
PARKINSON'S DISEASE SIGNS AND SYMPTOMS
Signs and symptoms of Parkinson’s Disease can vary depending on the stage and severity of the disease. Patient’s physical condition may play a role as well as to how intense symptoms manifest. The earliest signs are very mild and may be difficult to notice such as shaky hands, stooped posture and a blank facial expression. There are 4 main symptoms of PD such as tremors which are described as rhythmic shaking in the hands even if the person is at rest. Rigid trunk and limbs are due to tensed, stiff or aching muscles. The person may present slowed movement and perform tasks in a more delayed manner. Finally, patients have lack of balance and coordination as evidenced by shuffling gait.
Parkinson’s Disease patients will present both motor and non-motor symptoms. As for motor symptoms, affected individuals will have “cogwheel” rigidity when passively moving the limbs, absence of movement, lack of postural reflexes, micrographia, masked faces, festination and dystonia or sustained twisting muscle contractions usually involving the feet and ankles. The person may also develop problems in speech and swallowing. Hypophonia is described as soft speech and the person may also be drooling or talk in a non-intelligible manner. Dysphagia or difficulty swallowing puts the person at risk for aspiration and pneumonia. Patients feel tired most of the time and have impaired fine and gross motor coordination.
Image: Parkinsons Disease
PARKINSON'S DISEASE DIAGNOSIS
As for non-motor symptoms, mood disturbances are expected such as depression, anxiety, apathy and abulia. Cognitive disturbances are described as lack of ability to comprehend and analyze data. The person may also have dementia together with hallucinations, delusions, difficulty remembering things and parananoia. Short term memory loss can occur sometimes. Sleep, sensation and autonomic disturbances can also result such as vivid dreams or nightmares, impaired visual control and sensitivity, nocturia, constipation, weight loss and altered sexual function.
Some cases of Parkinson’s Disease are described as idiopathic or having no known specific cause. Genetics may also play a role although there is no definitive scientific basis of it. Toxin exposure is also suggested to be a cause since some individuals may have been in contact with harmful substances and materials for a long time predisposing them to disease development later on in life. Others may have genetic traits making them more vulnerable to toxins. Head trauma seem to have an effect as those with severe injuries are 8 to 11 times more likely to have the disease. Antipsychotic medications used to treat schizophrenia and the like can induce Parkinson’s Disease symptoms due to altered dopamine levels.
PARKINSON'S DISEASE TREATMENT
Parkinson’s Disease is highly treatable but incurable. At present, there is still no known true cure for the disorder although several treatment approaches can effectively help people cope with the long term effects of the disease. Levodopa or L-dopa is one of the most common therapeutic drugs given to patients. More dopamine agonists also render positive results such as bromocriptine, pramipexole and lisuride. These are extra useful for those having fluctuations and dyskinesias from high levodopa doses. Symptoms can be relieved by MAO-B inhibitors such as selegiline and rasagiline.
Aside from Levodopa and dopamine agonists, anticholinergics can also work by blocking the effect of the brain chemical acetylcholine which then balances normal dopamine levels. COMT inhibitors are great when used in conjunction with levodopa by blocking the enzyme COMT allowing more levodopa to reach the brain. There is no specific drug that can render absolute results for all Parkinson patients. Treatment through medications can vary depending on the individual’s symptoms, disease severity, response and tolerance as well as lifestyle habits. Medications are known to have good effects anywhere from 5 to 10 years.
Non-pharmacologic treatment approaches include speech therapy, physical exercise such as dance, yoga and stretching. Surgery and deep brain stimulation may also be performed. Gene therapy, neuroprotective treatments and neural transplants are suggested remedies that are still being thoroughly tested to prove true efficacy. Neurosurgery may be done on certain patients.
Three common forms are thalamotomy which involves cutting some areas in the brain to reduce tremors, pallidotomy which involves placing a lesion on a brain part to reduce dyskinesia and deep brain stimulation which involves placing a stimulator in the brain to reduce tremors. Other means of alternative treatment include Botox and Qigong. Patients should try as much to stay healthy as possible mentally and physically through a good and nutritious diet, regular activity and adequate sleep and rest.
The patient’s significant others should also be vigilant in helping him or her learn coping methods. Help the patient in orientation since the disease can cause memory loss and dementia. People should also help affected individuals when moving or communicating.
PARKINSON'S DISEASE TREATMENT
Currently, there is no known preventive measure for Parkinson’s Disease although suggested drug and toxic causes may be avoided by steering clear of harmful agents like pesticides, herbicides and pollution. Some studies suggest that taking statins may reduce the risk. Healthy lifestyle habits will very much help in keeping people healthy throughout their younger years minimizing the chances of developing PD later on in life.
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