Parkinson’s Disease

Parkinson’s disease is a neurodegenerative disorder which leads to progressive deterioration of motor function due to loss of dopamine producing brain cells. The cause of Parkinson’s disease is unknown but is probably due to a combination of genes and environmental factors.

Primary symptoms of Parkinson’s disease

  • Tremors – The classical tremors seen is the pill rolling tremor. However tremors can also occur in hands, arms, legs, jaw or head. Tremors most often occur when individual is resting and not while involved in task. Tremors may worsen when the person is excited, tired or stressed. In elderly sometimes the disease might not present with tremors but more with features of rigidity and bradykinesia with the individual appearing to be just slowing down and can be mistaken as just normal ageing.
  • Rigidity – The classical cog wheel rigidity is seen in Parkinson’s in contrast to the lead pipe rigidity seen in stroke. There is stiffness of the limbs and trunk, which may increase during movement. Rigidity may also produce muscle aches and pains and loss of fine hand movements can lead to cramped writing and make eating difficult.
  • Bradykinesia – Slowness of voluntary movement. Over time it may become difficult to initiate movement and to complete movement. Bradykinesia together with stiffness can also affect the facial muscles and result in an expressionless “mask-like” facies.
  • Postural instability – Impaired or lost reflexes can make it difficult to adjust posture to maintain balance. This may lead to falls.
  • Parkinsonian gait – Individuals with more progressive disease develop a distinctive shuffling walk with a stooped position and a diminished or absent arm swing. It may become difficult to start walking and to make turns. Individuals may freeze in mid stride and appear to fall forward while walking.

Secondary symptoms of Parkinson’s disease

While the main symptoms of Parkinson’s disease are movement related, progressive loss of muscle control and continued damage to the brain can lead to secondary symptoms. These vary in severity and not all individuals will experience them.

These secondary symptoms include

  • Anxiety, insecurity and stress
  • Confusion, memory loss and dementia (more common in elderly individuals)
  • Constipation
  • Depression
  • Difficulty swallowing and excessive salivation
  • Diminished sense of smell
  • Increased sweating
  • Male erectile dysfunction
  • Skin problems
  • Monotone voice
  • Urinary frequency and urgency

Stages of Parkinson’s disease

Stage 1 – Mild symptoms like tremors that do not interfere with daily activities and occur on one side of the body.

Stage 2 – symptoms worsen with walking problems and both sides of the body are affected.

Stage 3 – Main symptoms worsen with loss of balance and slowness of movement.

Stage 4 – Severity of symptoms require help and usually the person cannot live alone.

Stage 5 – Caregiver is needed for all activities and the person maybe bed bound.

What causes Parkinson’s disease?

A substance called dopamine acts as a messenger between two brain areas – the substantia nigra and the corpus striatum to produce smooth controlled movements. Most of the movement related symptoms of Parkinson’s disease are caused by lack of dopamine due to loss of dopamine producing cells in the substantia nigra. When the amount of dopamine is too low, communication between the substantia nigra and corpus striatum becomes ineffective and movement becomes impaired.  The greater the loss of dopamine the worse are the movement related symptoms.

The cause is still not known though genes plus probable free radical damage and inflammation start the cascade of events.

Treatment

Doctors have a number of drugs that will help the symptoms though there is no cure. A healthy lifestyle with high antioxidant intake and anti-inflammatory foods with reduction in toxins, proper sleep and exercise will be beneficial not only for prevention but also for those with the disease as it may slow down the progression. Some studies showed that co-enzyme Q10 might help, so no harm in trying. In the future stem cells could be the answer but studies are still under way and not proven yet.

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