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Parkinson's Disease

  • Posted on- Mar 25, 2016
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Parkinson's disease is a motor system disorder that affects the motor skills of an affected person. This condition has an adverse impact on the central nervous system of the person. Its prognosis is very difficult as no one can accurately predict how the disease would affect a person. Parkinson's disease generally affects people above the age of 50. The condition can be difficult to diagnose. There are no blood tests to diagnose Parkinson's disease, and it can be diagnosed with the help of medical history of the person and a neurological examination.

Parkinson's disease affects both men and women. In humans a chemical called dopamine is produced by the nerve cells in the brain, and it helps in the transmission of messages from the brain to the muscles of the body. When this condition sets in, the production of dopamine gets reduced, as the dopamine-producing brain cells start degenerating. This makes it impossible for the brain to send signals to any of the muscles in the body. The exact cause of this reduction in the production of dopamine is not known exactly.

Causes of Parkinson's disease

Although Parkinson's is referred to as a disease, its definite cause has not been specified. Common causes that have been indicated as being responsible for causing Parkinson's disease include genetics, toxins, cerebral anoxia, head trauma and drug related issues. Despite these causes, an ailment qualifies as a disease because of a collection of signs and symptoms which emerge together. In order to qualify as a disease, the problem would have to have a root cause incorporating that a single cure should work in every Parkinson's case.


Symptoms

  • Tremors: These usually begin with a slight trembling of the hand, or even a single finger, or the forearm. Tremor can also occur in the foot. These tremors have a tendency of occurring when the limb is at rest, disappearing while carrying out tasks. Sometimes the chin and mouth can also tremble. Although most people find tremors very distressing, it is generally not disabling.
  • Bradykinesia: This is basically a slowing down of voluntary movement. Not only does difficulty occur when movement is initiated, but it is also difficult to complete the movement once it is set in motion. Bradykinesia occurs due to the reduction of dopamine, which causes delay in the transmission of signals from the brain to the muscles.
  • Impaired Balance: This is caused because of the loss or impairment of the reflexes that help in adjusting the posture required for maintaining balance. It is common for people suffering from Parkinson's disease to lose their balance and fall.
  • Rigidity of Muscles: Stiffness of the muscles can cause pain in the muscles and create a mask-like, expressionless face. This symptom has the tendency of increasing during movement. Rigidity can also affect the neck and limbs.
  • Impairment of Speech: Often, there is difficulty in speaking, and the voice usually becomes very soft and monotonous. This symptom is also known as hypophonia.
  • Impairment of Automatic Movements: Swinging the arms while walking, smiling, and blinking are movements that occur automatically. These are affected in a person afflicted with Parkinson's disease, either by being reduced or completely lost. Sometimes this results in unblinking eyes and a staring, fixed expression. Others may lose their gesticulating ability or look animated while speaking.
  • Difficulty in Swallowing: This usually occurs in the advanced stages of the disease. This symptom is also known as dysphasia, and causes drooling, coughing, or choking. However, except rarely, most people affected by this symptom have the ability to eat food on their own.
  • Parkinsonian Gait: The unsteady gait associated with this disease is one of its characteristic symptoms. People afflicted with this disease have a tendency of either leaning forward or backward unnaturally. They also develop drooped-shoulders, head-bent-down, and generally stooped stance. They have a tendency of taking shuffling, small steps, known as festination. They have difficulty in starting to walk, seem to be falling forward while walking, freeze in the middle of their stride, and find it difficult to turn.
  • Dementia: Although it is usually associated with Alzheimer's disease, it can also occur, albeit rarely, with Parkinson's disease, occurring in its later stages. The onset of this symptom is usually marked with a slowing down of thought processes and difficulty in concentration.


Treatment

Only after conducting a neurological examination and knowing your medical history the neurologist will prescribe you the necessary drugs or therapies. Unfortunately, there is no cure for this dreadful brain disease, but there are certain medications and therapies that help control the symptoms, simply by restoring the levels of dopamine in the brain.

Medications

  • Levodopa: Also known as L-dopa, is the most commonly used drug to control the symptoms of this dangerous disease. It breaks down in the body to form dopamine and is usually consumed orally along with carbidopa, a drug to keep levodopa from untimely conversion to dopamine outside the brain and also to avoid side effects, like, nausea, sleepiness, and vomiting.
  • Dopamine Agonists: Though not as effective as levodopa, dopamine agonists imitate the actions of dopamine in the brain and make the nerve cells function normally. However, the medication can also trigger some side effects, like, hallucinations, sleepiness, water retention, and low blood pressure.
  • MAO B Inhibitors: These drugs keep the breakdown of dopamine present naturally or formed by levodopa by suppressing the functionality of an enzyme monoamine oxidase B (MAO B), which metabolizes this chemical messenger in the brain. Though rare, these inhibitors also have some ill effects, like, confusion, headache, hallucinations, nausea, or dizziness.
  • Catechol O-methyltransferase (COMT) Inhibitors: Likewise, these medications also prevent the dopamine breakdown in the body. They are usually given with levodopa when the dopamine replacement medications lose their effectiveness. Their side effects are involuntary movements (dyskinesias), urine discoloration, dizziness, nausea, confusion, or hallucinations.
  • Anticholinergics: Anticholinergics are usually given during the early stages of Parkinson's to control the tremors or shaking associated with it. Confusion, impaired memory, constipation, dry mouth, etc., are some of its adverse effects.
  • Glutamate (NMDA) Blocking Drugs: These medications are also given during the early stages of the disease in order to control the involuntary movements (dyskinesia).

Surgery

Conditions when these medications don't prove to be useful, surgical treatment methods including, ablation, deep brain stimulation, and pallidotomy may be performed to control the symptoms. Ablation is a procedure wherein, the affected part of the brain that produces abnormal chemical or electrical impulses is destroyed or ablated. This procedure is less commonly used in comparison to deep brain stimulation in which, the affected region is deactivated by an implanted electrode, connected through a wire running underneath the skin to a stimulator and battery pack in the patient's chest.

Alternative Therapies

Along with medications, physical therapy and massage can also help in fortifying and toning the underused muscles, and give stiff or rigid muscles a better range of motion. Speech therapy for improving speaking and swallowing, and yoga, meditation, as well as some simple activities like walking, swimming, etc. can also help build body strength and improve balance.

Along with medications, physical therapy and massage can also help in fortifying and toning the underused muscles, and give stiff or rigid muscles a better range of motion. Speech therapy for improving speaking and swallowing, and yoga, meditation, as well as some simple activities like walking, swimming, etc. can also help build body strength and improve balance.

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