Parkinson’s Disease Explained

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Parkinson’s disease has gained some notoriety over the years. It is well identified by patients early and many a times they seek attention as they notice a change in the way they perform their daily activities.

It doesn’t matter who you are. Parkinson’s disease can affect anyone of us, especially if there are risk factors. Celebrities such as boxing legend Mohammed Ali, Hollywood actor Michael J Fox and singer Johnny Cash have all suffered from Parkinson’s disease.

So what is Parkinson’s disease? In this article, I will briefly discuss this problem and how it is treated.

Introduction to Parkinson’s Disease

The human brain is amazing. Besides the millions of functions it performs simultaneously, the human brain also controls how we move. The way we walk, how we pick up things, how we write etc. is all controlled by our brain.

In order to function correctly, our brain relies on certain chemicals. These chemicals are responsible for maintaining the function of the individual cells in the brain called neurons.

There are a number of different conditions where there is a chemical imbalance in the brain. One such condition is called Parkinson’s disease. This condition is well recognised and affects millions of people in the world.

Today, we shall take a look at what Parkinson’s disease is and how it affects us.

What is Parkinson’s disease?

The textbook definition of Parkinson’s disease is that it is a ‘chronic and progressive movement disorder’.

In simple terms, this means that Parkinson’s disease is a condition which develops over many years. It worsens as time progresses.

The human brain is composed of different parts that perform different functions. In Parkinson’s disease, a particular part of the brain called the ‘substantia nigra’ is affected.

The substantia nigra, just like any other part of the brain, is composed of small nerve cells called neurons. The neurons in the substantia nigra produce a chemical called dopamine.Dopamine is responsible for movement and coordination.

In Parkinson’s disease, the neurons in the substantia nigra are damaged and degenerated. This results in reduced dopamine production.

The lack of dopamine would only mean that movement and coordination activities become impaired. Due to this, different movement problems occur which are listed in the next section.

What Are The Causes Of Parkinson’s Disease?

Despite extensive clinical research, no clear cause of Parkinson’s disease has been identified. It is common in individuals over the age of 60 though it may occur at a lot younger age. Typically, there appear to be both genetic factors and environmental factors that play a role in the development of Parkinson’s disease.

If one were to look at genetics alone, it appears that around 15% to 25% of patients who have Parkinson’s disease also have a relative with the condition. Scientific researchers have found a number of different gene mutations that can cause the condition.

Among environmental factors, the use of well water, manganese, exposure to pesticides and living in rural areas has been linked to the development of Parkinson’s disease. Certain medications have also been linked to the development of drug induced Parkinson’s disease.

Symptoms Of Parkinson’s Disease

There are typically four symptoms of Parkinson’s disease. Some organisations have described even more symptoms.

The most common symptom encountered is a resting tremor.

This is described in the books as a ‘pill rolling tremor’ where the thumb and index finger shake in a way as if a pill is being rolled between them.

Below is a video of a typical Parkinson’s disease tremor.

Muscle stiffness is another symptom that seen in Parkinson’s disease. The classic description of the muscle stiffness is ‘rigidity’. When attempting to bend the arm or leg, the medical practitioner will find that it is a lot harder to do when compared to someone who does not have muscle rigidity.

Besides the tremors and rigidity, another symptom encountered is called bradykinesia i.e. slowness of movement. Patients may begin to walk a lot slower than normal and demonstrate a short step gait like they are shuffling their feet when walking. Due to this difficulty in maintaining a normal posture, individuals with Parkinson’s disease are more prone to falling backwards.

In addition to this, some patients may experience slight memory disturbance and urinary problems. The handwriting of the individual may become shaky and small (called micrographia). An expressionless face with reduced facial movements may be seen.

SYMPTOMS THAT INDICATE PARKINSON'S DISEASE

1. Resting tremor of the hand or jaw

2. Slow walking with a look like almost about to fall (called festinant gait)

3. Stiff movements of arms and legs

4. Blank facial expression – Mask like face

5. Small crowded handwriting (micrographia)

6. Trouble sleeping

7. Excessive sweating

Diagnosis and Treatment

A diagnosis of Parkinson’s disease is made from clinical examination by a neurologist. There are no specific tests that can confirm the diagnosis.

The primary treatment of Parkinson’s disease is medical therapy. The aim of this therapy is to restore the levels of dopamine in the brain.

Dopamine releasing drugs are used in the treatment. These medicines have to be taken as prescribed by the neurologist. Many patients however figure out over a period of time when to increase their medication dose.

As the disease progresses, additional support is required from different healthcare specialties such as physiotherapists and occupational therapists.

parkinson's disease

Walking aids may be needed, nursing care at home may be required and basic day to day activities such as washing and dressing up often require assistance in advanced cases.

The dependence of the patient on others increases as time passes, and this dependence can sometimes lead to extreme degree of frustration and even depression. Surgical treatments such as deep brain stimulation have emerged with some success.

The degenerative nature of Parkinson’s disease makes it one that has a very guarded prognosis.

Unfortunately, it is a condition that can not only make one lose their independence completely, but can even strip them of their dignity.

Family support is essential in looking after patients with Parkinson’s disease. Nursing care is now available at home for patients with Parkinson’s disease.

With medical therapy and constant monitoring, patients with Parkinson’s can carry on for many years leading a relatively normal life.

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Dr Vivek Baliga B
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Dr Vivek Baliga B

Consultant Internal Medicine And Cardiovascular Sciences at Baliga Diagnostics Pvt Ltd
Dr Baliga is a consultant in Internal Medicine and Cardiology with an interest in diabetes and cardiovascular disease. He received his training in India and the UK where he completed his post graduate training and his doctorate. He then completed his MBA from University of Phoenix, USA. He has completed the post graduate program in Cardiology from Johns Hopkins University and participated in the Advanced Certificate Course in Diabetes from the Cleveland Clinic, USA. He also holds a Post Graduate Diploma in Lipid Management from Middlesex University, UK. He is the managing partner of Baliga Diagnostics, Bangalore. He is also the founder of HeartSense and is a keen advocate of patient empowerment, having written almost every article on this website and more. In his spare time, he enjoys running and spending time with his son. Find Dr Vivek Baliga on LinkedIn here - http://heartsense.in/linkedin.
Dr Vivek Baliga B
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