Parkinson's disease

Ever seen an elderly person with a stooped posture walking slowly, with a shuffle? Many times, you might have noticed them, thinking that such posture and walk are the consequences of aging. However, these people might have been suffering from a condition called Parkinson’s disease.

For the first time, an English doctor namely James Parkinson described Parkinson’s disease (PD) in 1817 as “shaking palsy” in his paper and the disease was named after him subsequently. In US, Parkinson’s disease affects 1.5 million people. The incidence of Parkinson’s disease in persons over the age of 60 is one for every 100. Every year 50,000 more people are diagnosed with Parkinson’s disease.

h2 class="adjust">Signs and symptoms

Parkinson’s disease is a long lasting and progressive illness of the nerve cells of the brain that control movement of the muscles. These nerve cells produce a neurotransmitter (chemical) called dopamine which transmits signals between various parts of the brain.

When these nerve cells get damaged, they do not produce dopamine, and this causes abnormal triggering of the nerve cells. No one knows as how the nerve cells of the brain get damaged. As the disease progresses, the symptoms become worse.

Parkinson’s disease rarely occurs in young people of less than 20 years of age, and in such cases, it is called Juvenile Parkinsonism.

Signs and symptoms

Not all people who suffer from Parkinson ’s disease exhibit similar symptoms, and these symptoms of Parkinson’s disease vary from person to person and the stage of the disease. These people may have the following Parkinson’s disease symptoms:

  • Shaking

  • Trembling of the hands, legs, jaw or head which may become worse when the patient is at rest, and become better when the patient moves.

  • Handwriting may also become instable and shaky

  • Rigidity or stiffness in the limbs and the trunk is easily visible in these people

  • Stooping posture

  • Loss of balance or instable posture

  • Slowness in movements which is termed as bradykinesia

  • Problems with chewing and swallowing

  • Posture

  • Digestion

  • Urination

  • Skin and sleeping problems

Due to all these reasons, these people face difficulty in performing normal movements such as walking and doing daily chores such as buttoning cloths or cleaning. Parkinson’s disease may also cause loss of memory. All these can cause depression in the patient.

Causes

The exact cause of Parkinson’s disease is unknown, however, research studies have shown that specific mutations of the genes may be associated with Parkinson’s disease. These mutations in the genes could be inherited or caused by environment changes. Certain toxins or certain viruses in the environment may also trigger Parkinson’s disease.

Various changes in the brains of the people affected by Parkinson’s disease are observed which include:

  • Absence of dopamine:Though it is not clearly understood, lack of dopamine in the brains of the persons could be a trigger.

  • Reduced norepinephrine levels:In the person with Parkinson’s disease, the nerve cells producing another neurotransmitter norepinephrine are damaged resulting in low production of this chemical. This neurotransmitter is necessary for the control of certain autonomic functions such as blood pressure.

  • Unusual lewy bodies:Certain protein clumps called as Lewy bodies are observed in the brains of the people suffering from Parkinson’s disease. It is not clear as to what is the role of these lewy bodies in causing Parkinson’s disease.

Making the most of it

Though Parkinson’s disease was discovered two centuries ago, till date there is no cure. Parkinson’s disease generally affects seniors above the age of 60 and men are mostly affected. The symptoms of Parkinson’s disease can be easily controlled through proper medication and in advanced stages even surgery can be taken up. Person with Parkinson’s disease may learn to live their life with the condition. A healthy diet and regular exercise can do a lot by keeping the body strong. A good support system is necessary to help cope with the condition, and for carrying out normal activities of daily life.

There are no specific tests to diagnose Parkinson’s disease. Sometimes X-ray tests are conducted to rule out other diseases causing the same symptoms. The diagnosis of Parkinson’s disease can be based on the following exams.

Examination of medical history:Your doctor may ask you about the medications you may be taking and enquire whether anybody in your family had the suffered from Parkinson’s disease.

Physical exam:  The exam may include testing your ability to do some simple tasks such as walking, coordination of your limbs and simple usual tasks.

The examinations may confirm that you have Parkinson’s disease, if you have

  • Two or three Parkinson’s disease signs such as shaking, tremors, slow motion or rigidity or stiffness of muscles

  • If the symptoms are observed only on one side of the body

  • Trembling and tremors become more pronounced when at rest such as shaking of hands increases when you are sitting in a chair

  • If the symptoms improve when a medication namely Levodopa is given

There is no particular treatment of Parkinson’s disease as it cannot be cured. But the symptoms can be controlled through medicines. Some of the medicines used to control the symptoms include Levodopa, carbidopa, bromocriptine, selegiline, pramipexole, ropinirole and tolcapone. Your doctor may also recommend physical therapy to improve your mobility. Sometimes stimulation of your brain through deep brain surgery may be undertaken in people with advanced stages of Parkinson’s disease.