Parkinson disease
Definition:
Parkinson’s disease is a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness, and difficulty with balance and coordination. Symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and talking. They may also have mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue. While virtually anyone could be at risk for developing Parkinson’s, some research studies suggest this disease affects more men than women. It’s unclear why, but studies are underway to understand factors that may increase a person’s risk. One clear risk is age: Although most people with Parkinson’s first develop the disease after age 60, about 5% to 10% experience onset before the age of 50. Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.
What causes Parkinson’s disease?
The basal ganglia, a region of the brain that regulates movement, experiences nerve cell impairment and/or death, which results in the most noticeable signs and symptoms of Parkinson’s disease. These nerve cells, or neurons, normally generate the crucial brain neurotransmitter dopamine. Movement issues linked to the condition are brought on by decreased dopamine production as a result of the neurons’ degeneration or death. Scientists are still unsure of what causes neurons to degenerate.
How common is this disease?
Parkinson’s disease is very common overall, ranking second among age-related degenerative brain diseases. It’s also the most common motor (movement-related) brain disease. Experts estimate that it affects at least 1% of people over age 60 worldwide.
Symptoms of Parkinson’s disease:
Parkinson’s has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Muscle stiffness, where muscle remains contracted for a long time
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Other symptoms may include:
- Depression and other emotional changes
- Difficulty swallowing, chewing and speaking
- Urinary problems or constipation
- Skin problems
Stages of Parkinson’s disease:
- Stage 1
Parkinson’s is the mildest form. It’s so mild, in fact, you may not experience symptoms that are noticeable. They may not yet interfere with your daily life and tasks. If you do have symptoms, they may be isolated to one side of your body.
- Stage 2
The progression from stage 1 to stage 2 can take months or even years. Each person’s experience will be different.
At this moderate stage, you may experience symptoms such as:
- muscle stiffness
- tremors
- changes in facial expressions
- trembling
Muscle stiffness can complicate daily tasks, prolonging how long it takes you to complete them. However, at this stage, you’re unlikely to experience balance problems. Symptoms may appear on both sides of the body. Changes in posture, gait, and facial expressions may be more noticeable.
- Stage 3
At this middle stage, symptoms reach a turning point. While you’re unlikely to experience new symptoms, they may be more noticeable. They may also interfere with all of your daily tasks. Movements are noticeably slower, which slows down activities. Balance issues become more significant, too, so falls are more common. But people with stage 3 Parkinson’s can usually maintain their independence and complete activities without much assistance.
- Stage 4
The progression from stage 3 to stage 4 brings about significant changes. At this point, you will experience great difficulty standing without a walker or assistive device. Reactions and muscle movements also slow significantly. Living alone can be unsafe, and possibly dangerous.
- Stage 5
In this most advanced stage, severe symptoms make around-the-clock assistance a necessity. It will be difficult to stand, if not impossible. A wheelchair will likely be required. Also, at this stage, individuals with Parkinson’s may experience confusion, delusions, and hallucinations. These complications of the disease can begin in the later stages.
Parkinson’s treatment:
Treatment for Parkinson’s relies on a combination of:
-lifestyle changes
-medications
-therapies
Adequate rest, exercise, and a balanced diet are important. Speech therapy, occupational therapy, and physical therapy can also help improve communication and self-care. In almost all cases, medication will be required to help manage the various physical and mental health symptoms associated with the disease.
Drugs and medication used to treat Parkinson’s disease
A number of different drugs can be used to treat Parkinson’s.
-Levodopa
Levodopa is the most common treatment for Parkinson’s. It helps to replenish dopamine.
About 75 percent of cases respond to levodopa, but not all symptoms are improved. Levodopa is generally given with Carbidopa. Carbidopa delays the breakdown of levodopa which in turn increases the availability of levodopa at the blood-brain barrier.
-Dopamine agonists
Dopamine agonists can imitate the action of dopamine in the brain. They’re less effective than levodopa, but they can be useful as bridge medications when levodopa is less effective.
Drugs in this class include bromocriptine, pramipexole, and ropinirole.
Parkinson’s surgery
Surgical interventions are reserved for people who do not respond to medication, therapy, and lifestyle changes.
Two primary types of surgery are used to treat Parkinson’s:
- Deep brain stimulation
During deep brain stimulation (DBS), surgeons implant electrodes in specific parts of the brain. A generator connected to the electrodes sends out pulses to help reduce symptoms.
- Pump-delivered therapy
In January 2015, the Food and Drug Administration (FDA) approved a pump-delivered therapy called Duopa. The pump delivers a combination of levodopa and carbidopa. In order to use the pump, your doctor will have to perform a surgical procedure to place the pump near the small intestine.
