Parkinson’s disease

Parkinson’s disease is a neurological disorder of the central nervous system that affects movement, tremor, rigidity and postural instability. Parkinson’s signs and symptoms can be different for everyone.

Parkinson’s disease is the second most common degenerative disorder of the central nervous system after Alzheimer’s disease.

It is estimated that 1% of the individual over the age of 65 are diagnosed with this disorder. As the disease progress, it leads to cognitive and behavioural problems such as dementia, insomnia and irritability.

It is a non-fatal condition that impairs the quality of life of patients. The individual often has pain and slurred speech.

It is onset between 40-75 years old age. It is the most prevalent neurodegenerative characterised by lesions in the basal ganglia, predominantly in the Substantia Nigra.Nerve cells damage in the brain causes dopamine levels to drop leading to the symptoms of Parkinson’s.

Causes

In Parkinson’s disease, certain nerve cells(neuron) usually many symptoms occur due to loss of neurons that decrease the level of dopamine in the brain activity leading to impaired movement and other clinical symptoms of Parkinson’s disease.

Although, there are no specific reasons for Parkinson’s disease, but some factors can develop:

1) Medicine — that can be the development of Parkinson’s disease, metoclopramide, reserpine, antipsychotic, tetrabenazine and some stimulants as cocaine and Amphetamine.

2) Received head trauma as in boxing, football.

3) certain neurodegenerative disorders: multiple systems atrophy and progressive supramolecular palsy.

4) exposure to a toxin: cyanide, carbon monoxide, organic solvents.

5) certain brain lesions such as tumor

6) metabolic and other disorders: chronic liver failure and hyperthyroidism.

Signs and symptoms

Generally, it has been detected in 40-70 years, old people.

1) Tremor

2) stiffness and slowness of movement

3) loss of dexterity

4) deterioration of hand writing

5) difficulty in arising from a chair or turning in bed

6) abnormalities in gait and posture

7) postural hypotension

8) depression

9) difficulty in maintaining balance and walking

Signs

1) Generally, tremors are first noticed in hands and fingers , later on involving legs, face and tongue.

2) Rigidity presence in limbs

3) postural abnormalities as flexion of the head, trunk, flexion of knees and elbows

4) By testing quick movement and rapid alternative movement( e.g. touch on the nose, slap on hands ) slowness and decreased movement detected.

5) patients having infrequent eye blinking

6) A fixed expressional face

7) Abnormalities in gait

Risk factors and complications

1) Age – people usually develop the disease around 60 or more.

2) Heredity- having a close relationship with Parkinson’s disease increases the chances of developing others.

3) Sex- Men are more likely to develop than women

4) Exposure to toxins – ongoing exposure to herbicides and pesticides may slightly increase the risk of Parkinson’s disease.

Complications

1) Thinking difficulties

2) depression and emotional changes

3) chewing and eating problems

4) sleep disorders

5) bladder problems

6) constipation

7) fatigue

8) sexual dysfunction

Diagnosis

Diagnosis depends on the medical history, signs and symptoms and a neurological and physical examination

Lab test

Blood test to rule out other conditions

Imaging test- MRI, CT scan, PET scan and ultrasound of the brain

ECG, CSF test

Neurological testing may help to locate intellectual impairment

Treatment

There is no standard treatment for Parkinson’s disease. The treatment differs for each person. Depends on history, signs and symptoms and other complication as well.

It can not be cured completely, but Medication and other techniques can help for controlling the symptoms. In some advanced cases, surgery may be advised.

1) Medication

2) Physical exercise as aerobic etc

3) Inhaled cardidopa- levodopa

4) MAO B inhibitors as Acilect, zelopar

5) Anticholinergics: Trihexiphenidyl, Benzotropine

6) surgical procedure: Deep brain stimulation

Besides it, lifestyle modification is also necessary like getting more rest and exercise, positive thoughts and living with enthusiasm.

Sinemet( cardidopa- levodopa) is the mainstay of therapy in most cases.

So, I hope, I tried my best to explain briefly about Parkinson’ disease.

Dr S. K.jha

4 Comments

  1. Rajesh Raj says:

    Good

    Liked by 1 person

  2. Sonu prakash says:

    Good job sir

    Like

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