PARKINSON’S DISEASE
Parkinson’s Disease (PD) is a slowly
progressive, degenerative disease of the brain. It affects nerve cells in the
area of the brain called the basal ganglia, which are important in determining
how your body moves.
Parkinson’s disease does not affect
everyone the same way and progresses at different rates. However, most cases
begin on only one side of the body and may worsen and spread to the other side
as the disease progresses.
he main signs and symptoms include:
l Tremors: involuntary shaking (predominantly of the hands) is usually
the first symptom. The jaw or lips are also commonly involved; less often
involved are the arms, legs, tongue, and face. In most cases, tremors will
occur at the rest and may not interfere with daily activities or become
bothersome to the patient.
l Bradykenisia: slowness of movement, which is the major cause of
disability in PD and tends to be interpreted by patients as “weakness.” It can
eventually lead to difficulty with walking manifested by a stooped posture,
inability to initiate gait, and short shuffling steps. PD patients may also
lack facial expression and blink less often.
l Rigidity: stiffness in the limbs and trunk of the body caused by
increase in muscle tone; this is seen in about 90% of the patients.
l Postural instability: impairment of the reflexes controlling the
posture, leading to a sense of imbalance with an increased tendency to fall;
this symptom does not occur until late in the disease process.
l Decreased or lost sense of smell (may precede all other symptoms)
l Increased risk of dermentia with age, onset, and severity of PD.
l Depression.
l Sleep problems
l Trouble chewing, swallowing or speaking.
l Difficulty writing legibly (very small compact handwriting)
l Hallucinations (side-effect of medications).
l Urinary and constipation problems
Causes and risk factors
l For reasons not yet understood, the nerve cells in the substantia
nigra that produce dopamine are dying. When 60-80% of dopamine is lost,
symptoms such as tremor, slowness of movement, stiffness, and balance problems
occur.
l Gender. PD occurs only slightly more commonly in men than women.
l Age. The disease usually begins between the ages of 50 to 60 years,
but can occur earlier.
l Scientists are still studying the genetic and environmental factors
that may lead to PD.
Management and treatment
Currently there is no cure for Parkinson’s
Disease, but many people with Parkinson’s enjoy an active lifestyle and a
normal life expectancy. The main categories of management of PD include
medication and surgery. Certain lifestyle changes may also help make living
with PD easier.
Medications:
Medication is the first line of defense for
PD patients. There are many options that may be used alone or in combination to
control symptoms.
l Levodopa/Carbidopa
l Dopamine agonists
l MAQ-B
l COMT
l Anti-depressants
Therapy:
Although specific exercise cannot stop the
progression of PD, improving muscle strength can help patients feel more
confident and capable.
Surgery:
When management with medication fail die to
fluctuations in the response, lack of effectiveness, or development of side
effects such as dyskinesias, surgical options may be considered.
l Deep-brain stimulations (DBS)
l Pallidotomy
l Thalamotomy
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