Definition of Parkinson’s Disease
Parkinson's disease is a progressive, neurodegenerative disease that occurs when the neurons within the brain responsible for producing the chemical dopamine become impaired or dies. Dopamine is essential for the smooth control and coordination of the movement of voluntary muscle groups. Once approximately 80% of the brain's dopamine producing cells no longer function, the symptoms of Parkinson's disease begin to appear.
British physician, James Parkinson in the early 1800s, brought this to light and the disease was named after him. Parkinson's disease may be termed as a progressive movement disorder that is distinguished by marked slow movements, tremors, and unstable posture. Parkinson's disease occurs in a person when the cells in any of the movement-control centers of the brain start to die for mysterious reasons. Due to the loss of dopamine, from a small region in the brain, called the substantia nigra, tremors in the body begin and movement of a person slows down.
Parkinson’s disease is a neurological condition that specially affects the aged. Despite extensive research and recent drug therapies, Parkinson’s disease is still a progressive and incurable disease.
Symptoms of Parkinson’s disease
There are several symptoms of the Parkinson’s disease, though these symptoms may vary from person to person. It has been observed that most people ignore the subtle early signs; as a result the disease may be undetected for a long time.
People with idiopathic Parkinson's disease develop several symptoms over time, but they typically develop the primary symptoms bradykinesia, tremor, rigidity, and parkinsonian gait. Most people with Parkinson's do not develop all of the symptoms associated with the disease. In most patients, symptoms begin on one side of the body. The disease may progress quickly or gradually over years. Many people become profoundly disabled and others function relatively well.
Symptoms may vary from day to day or even moment to moment. There is no clear reason for the fluctuation of symptoms. Variance may be attributable to the disease process or to anti-parkinson’s medications.
Some of the general symptoms of the Parkinson's disease are as follows:
Tendency for slowed motion over the years. The disease has been known to reduce the ability for voluntary movement. This is seen even in the simplest of day to day activities.
Rigidity of muscles is another symptom of the Parkinson's disease. Those with this disease experience stiffness in the limbs and neck areas. At times this stiffness is severe limiting all movements due to extreme pain.
Tremors, (uncontrollable shaking), in the hands, fingers, forearm, or foot tend to occur when the limb is at rest but not when performing tasks. Tremors may occur in the mouth and chin, as well. Most people identify this with Parkinson's disease because it is one of the most eye catching and prominent symptoms. However it must be noted that many of those actually diagnosed with Parkinson’s may not have this symptom at all. Most of the time the tremors or shaking, begins with the hands.
Changes in speech, like slurring, repeating of words, hesitating before speaking are also some of the symptoms to be seen with those having Parkinson’s disease.
Dementia or problems with memory and mental clarity are often seen in the later stages of those with Parkinson's disease.
Other common symptoms of the Parkinson’s disease are-Impaired posture, imbalance, problem with automatic movements and changing of facial expressions, lack of blinking, difficulty walking, stooping posture, shuffling gait, postural instability, impaired balance, impaired coordination, difficulty swallowing and voice/speech changes.
Types of Parkinson’s Disease
Drug-induced Parkinson - This is a reversible form of Parkinson, which can occur from the use of certain drugs like, chlorpromazine, haloperidol, metoclopramide and reserpine. In such cases, taking minimum doses of these medicines or even switching to alternative medicines often cure the problem.
Striatonigral Degeneration - is a form of Parkinson’s disease where the substantia nigra is only mildly affected. In this type of Parkinson’s disease, the disease progresses very rapidly and patients are very rigid.
Arteriosclerotic Parkinson’s Disease - is a condition where the brain’s blood vessels are damaged due to multiple small strokes. In this type of Parkinson’s disease tremors are rarely seen.
In dementia related Parkinson’s disease, loss of mental agility and memory is a common trend.
Recent research has shown that Parkinson’s disease may occur due to Toxin-pollution too. People affected by carbon disulfide, manganese dust, and carbon monoxide are prone to this.
Parkinson’s disease at times accompanies other conditions, especially those who have other neurological problems.
Causes of Parkinson's disease
Though research regarding the exact cause of Parkinson’s disease is ongoing, a number of reasons have been identified which may lead to this disease. The lack of a chemical messenger, called dopamine, in the brain is said to be the main cause for the Parkinson’s disease. Some of the factors that lead to this situation are:
Genetic factors- hereditary factors are largely responsible for this disease.
Medications- Drugs taken over a prolonged period like haloperidol, chlorpromazine, (for Psychiatric disorders) and others such as metoclopramide for nausea and epilepsy drugs such as valproate, are known to be the harbingers of Parkinson’s disease, however stopping them might correct the situation.
Environmental factors- leading to exposure of herbicides and pesticides can also lead to Parkinson’s disease.
Risk Factors of Parkinson’s disease
Some of the factors that might lead to Parkinson’s disease are-
Heredity factors are often responsible for a person to get into Parkinson’s disease. Having first degree relatives with Parkinson's disease increases the risks of developing the disease.
Belonging to the male sex is one of the factors that can lead to Parkinson’s disease. Men are more susceptible to the disease than women.
People who are aged seem to be more prone to the Parkinson's disease. The disease usually sets in mid life or even late life, and the risk increases with advancing age.
People who are constantly exposed to toxins are at a risk of contracting the Parkinson's disease.
Conventional Treatments of Parkinson’s disease
To-date Parkinson's disease has no medicine that reverses the process. The healing process through conventional treatments is based on a wholesome package that includes experimentation with medication, physiotherapy, life style changes, dietary changes and specific exercises.
While there is no known cure for Parkinson's disease, several medications have shown the potential to ease the symptoms of the disease. The therapies most commonly used are designed to replace or mimic dopamine in the brain. While not a cure, certain surgical procedures may also ease the symptoms of the disease. However, surgery is recommended only as a last resort.
The first response to Parkinson's disease treatment can be very effective, but over a period the change is more subtle than dramatic. Parkinson’s disease may be controlled by;
Bromocriptine: A dopamine agonist. There are also other dopamine agonists but their role is uncertain (caberfoline, rapinirole).
Selegiline: A type-B monoamine oxidase inhibitor that inhibits dopamine catabolism in the brain.
Amantadine: Increases synthesis and release of dopamine and has a weak antiparkinsonian effect.
Anticholinergic drugs: Will reduce tremor but have little effect on bradykinesia.
Your doctor will decide which medications are best for you based on your age and particular symptoms. In young patients levodopa therapy is often delayed and patients are started on dopamine agonists initially. This is because effects of levodopa wear off over time whilst dopamine agonists have shown to be effective, with less motor fluctuations. If you are older than 70 you may be commenced on levodopa medications straight away.
Depression is a frequent co-morbidity with Parkinson's disease but it is generally recommended to avoid anti-depressant medications as they can worsen symptoms. In particular, certain drugs called monoamine oxidase inhibitors (MAOIs) are contraindicated in patients receiving levodopa drugs.
Some surgical options are available for Parkinson's disease such as deep brain stimulation. These have shown promise for patients with advanced disease with motor fluctuations. However, they are still largely experimental and very expensive.
You will also have input from a variety of multidisciplinary services such as occupational therapy, speech pathology, physiotherapy, dietetics, social work and counseling. These services will help to overcome some of the particular problems encountered with Parkinson's disease in your daily life.
Patients Medical’s Parkinson’s Disease Treatment
Patients Medical’s goals for treatment varies for each person, but in most cases, our treatment for Parkinson's disease is designed to maintain the overall quality of life, improve mobility and function, reduce rigidity, reduce tremors, reverse slowed movements, improve posture, gait, balance, speech, and writing skills and maintain mental sharpness.
Exciting new research published by Italian researchers and presented at the 12th International Congress on Hyperbaric Medicine confirms the profound effectiveness HBOT. Here at Patients Medical we have found that the effectiveness of HBOT, (Hyperbaric Oxygen Treatment), reduces symptoms of Parkinson's disease as demonstrated by the various researchers.
At Patients Medical it is our goal to cater to each individual patient’s needs. We accomplish this using our various stages of diagnosis and then applying our holistic methods of treatment based on research by modern science. Hyperbaric Oxygen Treatment, which has been known to significantly reduced symptoms of facial expression, slowness of movement, rigidity, posture, sleep, and mobility is being used at our Hyperbaric Center along with intravenous supplement administration. This indigenously developed protocol has received FDA approval for research evaluation.
Definitions of Various Terms
Dopamine - A catecholamine neurotransmitter and hormone (153 D), formed by decarboxylation of dehydroxyphenylalanine (dopa). A precursor of adrenaline and noradrenaline.
Dementia - An organic mental disorder where the patient suffers from general loss of memory and intellect impairing judgment and abstract thinking as well as changes in personality.
Bradykinesia - is slowness in voluntary movement. It produces difficulty initiating movement as well as difficulty completing movement once it is in progress. The delayed transmission of signals from the brain to the skeletal muscles, due to diminished dopamine, produces bradykinesia. Bradykinesia and rigidity that affects the facial muscles can result in an expressionless, "mask-like" appearance.
Parkinsonian gait - is the distinctive unsteady walk associated with Parkinson's disease. There is a tendency to lean unnaturally backward or forward, and to develop a stooped, head-down, shoulders-drooped stance. Arm swing is diminished or absent and people with Parkinson's tend to take small shuffling steps. Someone with Parkinson's may have trouble starting to walk, appear to be falling forward as they walk, freeze in mid-stride, and have difficulty making a turn.
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