Parkinson’s disease

Alternative Names

Parkinsonism

What is Parkinson’s disease

Parkinson’s disease is one of the most common nervous system disorders of the elderly. It is often develops after age 50. However Parkinson's disease may occur in younger adults and can affect both men and women. In some cases, Parkinson's disease occurs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.

Nerve cells use a brain chemical called dopamine to help control muscle movement. When the nerve cells in the brain that make dopamine are slowly destroyed, disease occurs. Without dopamine, the nerve cells in that part of the brain cannot properly send signals. This leads to the loss of muscle function. The damage gets worse with time.

Children may also develop Parkinson’s because the nerves are not as sensitive to dopamine. But it is rare in children.

The term "parkinsonism" belongs to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders such as secondary parkinsonism or certain medications.

Signs and symptoms

PD Symptoms include:

• Automatic movements (such as blinking) slow or stop
• Constipation
• Difficulty swallowing
• Drooling
• Impaired balance and walking
• Lack of expression in the face (mask-like appearance)
• Muscle aches and pains
• Movement problems
• Difficulty starting or continuing movement, such as starting to walk or getting out of a chair
• Loss of small or fine hand movements; writing may become small and difficult to read; eating becomes difficult
• Slowed movements
• Stooped position
• Rigid or stiff muscles, often beginning in the legs
• Shaking, tremors
• Tremors usually occur in the limbs at rest, or when the arm or leg is held out
• Tremors go away during movement
• Over time, tremor can be seen in the head, lips, tongue, and feet
• May be worse when tired, excited, or stressed
• Finger-thumb rubbing (pill-rolling tremor) may be present
• Slowed, quieter speech and monotone voice

Other symptoms:

• Anxiety, stress, and tension
• Confusion
• Dementia
• Depression
• Fainting
• Hallucinations
• Memory loss

Symptoms may be mild at first. Sometimes the patient may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.

Possible complications

Parkinson's disease is not fatal, but it can decrease longevity. It is quickly progresses in older patients, and may lead to severe inability within 10 - 20 years. Older people also tend to have freezing and greater declines in mental function and daily functioning than younger people. If PD starts without signs of tremor, it is likely to be more severe than if tremor had been present.

The disease can seriously impair the quality of life in any age group. The physical and emotional impact on the family should not be underestimated as the patient becomes increasingly dependent on their support.

What causes

The exact cause of Parkinson s disease is still not known. Researchers think that Parkinson s is probably due to a combination of genetic and environmental factors:

• Genetic Factors.Some genetic factors play a strong role in early-onset Parkinson's disease, an uncommon form of the disease. The latest researches suggest that multiple genetic factors may also be involved in some cases of late-onset Parkinson's disease.
• Environmental Factors. Scientists say that environmental factors are not the only one that cause Parkinson's disease, but they may trigger the condition in people who are genetically susceptible.

Study results implicate pesticides and herbicides as possible factors in some cases of Parkinson's disease. A higher incidence of parkinsonism has long been noted in people who live in rural areas, particularly those who drink private well water or are agricultural workers.

Prevention

As it written above the exact cause of Parkinson's is unknown, there are no definitive ways to prevent the disease. However, some research has shown that caffeine which is found in coffee, tea and cola may reduce the risk of developing Parkinson's disease.

Treatment

These are the common Parkinson's disease drugs to control its symptoms:

• Levodopa: It is known as L-dopa, levodopa is the most commonly used drug to control the Parkinson's disease symptoms. It breaks down in the body to form dopamine and is usually consumed orally along with carbidop, a drug to keep levodopa from untimely conversion to dopamine outside the brain and also to avoid side effects like nausea, sleepiness and vomiting.
• Dopamine Agonists: It is not as effective as levodopa; dopamine agonists imitate the actions of dopamine in the brain and make the nerve cells to functions normal. However, the medication can also trigger some side effects like hallucinations, sleepiness, water retention and low blood pressure.
• MAO B Inhibitors: These drugs keep the breakdown of dopamine present naturally or formed by levodopa by suppressing the functionality of an enzyme monoamine oxidase B (MAO B) which metabolizes this chemical messenger in the brain. Though rare, these inhibitors also have some ill effects like confusion, headache, hallucinations, nausea or dizziness.
• Catechol O-methyltransferase (COMT) Inhibitors: Likewise, these medications also prevent the dopamine breakdown in the body. They are usually given with levodopa when the dopamine replacement medications lose their effectiveness. Its side effects are involuntary movements (dyskinesias), urine discoloration, dizziness, nausea, confusion or hallucinations.
• Anticholinergics: Anticholinergics are usually given during the early Parkinson's disease stages to control the tremors or shaking associated with it. Confusion, impaired memory, constipation, dry mouth, etc. are some of its adverse effects.
• Glutamate (NMDA) Blocking Drugs: Similarly these medications are also given during the early stages of Parkinson's disease in order to control the involuntary movements (dyskinesia).