Outline
Introduction
Parkinson's disease is a neurodegenerative brain disorder that affects the movement of the body. The disease is more prevalent and identified during 60 years of age. However, 5-10% of people have an early onset of the disease at 50. Men are affected by Parkinson's disease twice as much as women. The disease itself is not fatal, but it does come with certain complications. The disease is caused by loss of neurons that produce dopamine, especially in a region of the brain called substantia nigra.
Symptoms
Symptoms for Parkinson's disease arise gradually as age increases. They arise first during 50-60 years of age. The symptoms are very subtle and friends, family and close ones to the patient will be able to identify it first. Symptoms vary from person to person.
Usually, the patient will feel a slight tremor in one hand, which is usually dismissed as a sign of aging.
Common symptoms for patients diagnosed with parkinson’s are tremors in hands, arms, legs or head, feeling of stiffness in certain limbs and joints, struggling to initiate and continue movements such as walking, and impaired balance. Some other symptoms that have also been observed are changes in mental health, sleeping troubles, irregular bowel movement, loss of sense of smell, and restless legs.
Parkinsonian gait is a common symptom observed in many patients at the later stages of their Alzheimer's. The patient feels the need to bend forward and take smaller & quicker steps while walking. They also reduce swinging their legs. It has been noticed that sometimes symptoms may appear in just one side of the body in the beginning, but as the disease progresses, the symptoms become more severe in one side than the other.
Substantia Nigra: Controls movement & balance
The part of the brain that controls movement and balance is called substantia nigra. The neurons in this part of the brain produce a neurotransmitter called Dopamine. The dopamine producing neurons are damaged, causing movement related symptoms.
Scientists are still unsure of the reason behind the damage of the neurons. There are also damaged nerve endings that produce norepinephrine, which controls major body functions such as blood pressure, heart rate, etc.
This damage causes non-movement symptoms in patients such as fatigue, irregular bowel movements and change in bp during sudden movements.
Substances called Lewy Bodies are found in brain cells of Parkinson’s patients. They contain bundles of alpha-synuclein proteins and lessen the production of Dopamine which lead to Parkinson's disease.
Cause of Parkinson's disease?
The cause for Parkinson’s can be through heredity or genetic mutation. Experts believe that it is a combination of environmental factors as well as genetics.
Environmental factors include trauma to the head, exposure to increased amounts of pesticide and even location of dwelling.
How is it diagnosed?
There is no specific way to diagnose Parkinson's disease, neither is there any blood or lab treatments. The symptoms can be very similar to other similar disorders, so there’s a fair chance that the symptoms may be misdiagnosed.
Ultimately, an internist, family physician or neurologist diagnoses the patient according to their past medical reports and neurological examination.
They might also ask you to take Parkinson’s medication such as carbidopa-levodopa. If the patient’s health becomes better on using the medication, it can be confirmed that they have Parkinson’s. To examine whether a person has this disease, doctors take blood tests, lab tests, MRIs, brain ultrasounds and PET(Positron Emission Tomography) scans to rule out any possibility of diagnosing other similar disorders, as the symptoms are very similar to other neurodegenerative brain disorders.
Cure for Parkinson's disease
There is no cure for Parkinson’s disease, but treatment is given to patients according to their symptoms, medical history and age.
Doctors may advise lifestyle changes for the patient such as more aerobic exercises, physical therapy to help with balance and movement and a speech therapist to help with speech problems. Medications that will be prescribed mostly function as a replacement to dopamine.
Levodopa is a drug that converts to dopamine in the body. It is combined with the drug carbidopa to prevent levodopa from converting to dopamine outside of the brain. Hence, side effects like nausea are reduced. Over time, the effect of carbidopa-levodopa decreases. The patient may experience side effects like fatigue and dyskinesia(involuntary movement) from taking the drug, in which case the doctor will reduce the dosage.
2 forms of levodopa drug consumption
The drug can be taken in 2 forms - via inhaler or infusion. A feeding tube is surgically put into the patient’s stomach so the drug can enter their intestine directly via infusion. Levodopa drug needs to be taken at all times by the patient, until advised otherwise by the doctor. Stopping the intake of levodopa suddenly causes severe side effects to the body.
Other medications for Parkinson's disease
There are other drugs that can be prescribed. Dopamine agonists are drugs that imitate the function of dopamine in the brain. It lasts longer than levodopa, but still not as effective and efficient. MAO - B and COMT drugs alter the rate of metabolism of dopamine in the brain. MAO - B is usually taken with antidepressants to prevent severe (but rare) reactions to the drug. Amantadines are antivirals that help control dyskinesia (involuntary movement) and anticholinergic drugs help control tremors and stiffness in muscles.
Surgical treatments: DBS
Surgical treatment (other than levodopa infusion) is also available. Deep brain stimulation (DBS) is advised for patients whose bodies did not respond well to the prescribed drugs. Electrodes are put in a certain part of the brain. The electrode will be connected to a generator that will be put near the collarbone on the patient’s chest. The generator sends electrical impulses to the electrode, which passes it onto the brain. This process controls the symptoms of Parkinson’s disease.
However, there are certain risks to be considered. There is a chance of infection, strokes and brain hemorrhage. The surgery does not slow down the progress of the disease, but controls symptoms such as dyskinesia, rigidity and stiffness of muscles and difficult movement.
Sources
“Parkinson's Disease.” National Institute on Aging, U.S. Department of Health and Human Services, www.nia.nih.gov/health/parkinsons-disease#:~:text=Parkinson's disease is a brain,have difficulty walking and talking. medlineplus.gov/parkinsonsdisease.html www.parkinson.org/understanding-parkinsons/what-is-parkinsons www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055.
“Parkinson's Disease | PD.” MedlinePlus, U.S. National Library of Medicine, 15 July 2020, medlineplus.gov/parkinsonsdisease.html.
“What Is Parkinson's?” Parkinson's Foundation, www.parkinson.org/understanding-parkinsons/what-is-parkinsons.
“Parkinson's Disease.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Dec. 2020, www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055.
Tags: #degenerativediseases
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