Parkinson’s Disease

Parkinson’s disease is a progressive degenerative disease of the cells of the brain that commonly afflicts the middle-aged and elderly people. In Parkinson’s disease, the motor neurons (or the brain cells that are responsible for controlling body movement) gradually degenerate and die. This degeneration of motor neurons leads to various difficulties in movement although it can effect learning and memory as well.

Symptoms

At the onset of the condition, most symptoms of Parkinson’s disease are barely noticeable. However, as years pass by and as more motor neurons die, the symptoms become more prominent and, eventually, debilitating.

• Tremors are usually the first sign that is seen in Parkinson’s disease. A tremor is a repeated, involuntary shaking of a particular body part. In Parkinson’s, tremors are usually first seen in the hands. It is characterized as a resting tremor or tremor that intensifies when the hand is at rest.  It is sometimes known as pill-rolling tremor.
• Bradykinesia is the slowing of body movements. As the motor neurons are destroyed, it becomes more and more difficult for a person with Parkinson’s disease to carry out movement. Bradykinesia can be seen in the form of:
• Slow and small steps
• Slow and soft speech
• Slurred speech
• Decreased reaction time or dull facial expressions
• Decreased reflexes like blinking
• Slow and squiggly writing
• Parkinson’s disease is also characterized by muscle rigidity. This makes it even more difficult for patients with Parkinson’s disease to move or ambulate. This makes it difficult for them to perform their activities for daily living and increases tendency for accidents like falls.
• In its more advanced stages, Parkinson’s disease can affect the cognition of an individual and lead to dementia (or difficulties in thinking).
• Bodily processes like digestion and urination can also be slowed down. This can lead to swallowing problems, constipation, and difficulty in urination.

This “slow-motion” life in a fast-paced world can make it difficult for a Parkinson’s disease patient to cope up and could lead to depression.

Risk Factors

The actual cause for the degeneration of the motor neurons in Parkinson’s disease is still not known. However, risk factors that increase the chances for an individual to develop Parkinson’s disease have been identified. These include:

• Age - Age is the strongest risk factor for Parkinson’s disease. Most patients with Parkinson’s disease are older than 60 years old. However, it is not unheard of to diagnose Parkinson’s disease at 40 or even younger ages as in cases of Young-Onset Parkinson’s disease.
• Genetics - A person is at higher risk of developing Parkinson’s disease if his/her parents or grandparents had Parkinson’s disease.
• Toxins - Scientists have linked the development of Parkinsonian symptoms to exposure to certain toxic chemicals like herbicides and insecticides.
• Sex - Parkinson’s disease is 1.5 times more likely to develop in males than in females.

Diagnosis

Diagnosis of Parkinson’s disease is usually done by a neurologist (or brain doctor) based on history and physical examination alone. The neurologist will ask for the onset and severity of the symptoms and perform a thorough neurologic examination of the patient. Diagnostic tests are usually not needed except when the neurologist is considering other causes of the symptoms. These other tests could include a brain MRI, brain ultrasound, or other imaging studies of the brain.

The diagnosis of Parkinson’s disease is sometimes confirmed through a therapeutic trial. This means that the symptoms of the disease should improve upon administration of medications that are designed for Parkinson’s disease.

Treatment

There is no cure yet for Parkinson’s disease. Management of the disease aims only to prevent or slow down the progression of the condition and alleviate the symptoms. This is done by giving medications that increase the levels of dopamine (a chemical in the brain). Examples of these medications are levodopa, dopamine agonists, MAO-B inhibitors, and COMT inhibitors. In more advanced cases, Deep Brain Stimulation (DBS) is done by surgically putting electrodes in the brain that act to stimulate the brain and dampen the symptoms of Parkinson’s disease.

Other helpful steps that could help the Parkinson’s patient cope up with the disease are:

• A healthy diet
• Regular exercise and physical therapy (to improve muscle rigidity)
• Safer clutter-free home environment (to prevent falls)
• Join local support groups and learn about the disease