Parkinson's disease is a neurological disorder that affects movement, muscle control, and balance. The disease was named after James Parkinson, the English physician who first described it in 1817. A progressive disorder, Parkinson's disease is associated with the reduced production of dopamine (an important neurotransmitter) by the brain. It characteristically produces progressive muscle rigidity, impaired movement, involuntary tremors and dementia.
Causes and Incidence
Parkinson's is one of the most common crippling diseases and strikes 2 in every 1000 people, most often those over 50. Incidence increases in people with repeated brain injuries, including professional athletes and those abusing pshychoactive drugs.
Although the exact cause is unknown, it has been established that a dopamine deficiency prevents affected brain cells from performing their normal function within the central nervous system. Recent research suggests that multiple genetic factors may also be involved in some cases of late onset Parkinson's disease.
Signs and Symptoms
Mainly muscle rigidity, impaired movement and an insidious resting tremor that begins in the fingers, increases during stress or anxiety and decreases with purposeful movement and sleep. The gait lacks normal parallel movement and sufferers acquire a high pitched monotone voice. Other symptoms include; drooling, walking with the body bent over, slurred speech (dysarthria) and difficulty in swallowing (dysphagia). Parkinson's does not affect the intellect. A large proportion of People with Parkinson's disease also have hyperthyroidism.
Diagnosis is based on age, history and the characteristic clinical picture, but conclusive diagnosis is only possible after ruling out other causes of tremor, involutional depression, cerebral arteriosclerosis and intracranial tumors. Smell tests can help differentiate Parkinson's disease from other conditions with similar symptoms.
Patients often have increased iron accumulation in brain areas related to the condition and elevated levels of manganese are also often present.
Although there is no known cure for Parkinson's disease, treatment can help control symptoms, improve patient quality of life and keep functionality as long as possible. Treatment consists of drugs, physical therapy and in severe disease states unresponsive to drugs, surgery or fetal cell transplants. New anecdotal evidence seems to hold out hope for relief from powerstrip patches.
Levodopa is usually given during the early stages and dosages are increased until symptoms are relieved or side effects appear. Because side effects of Levodopa can be serious, it is usually given in combination with carbidopa. Selegiline an enzyme inhibiting agent enhances the therapeutic effect of dopamine and the use of entacapone allows less frequent doses.
In some cases of advanced stage Parkinson's disease, surgery may help to control motor problems. Deep brain stimulation, the current standard surgical practice for Parkinson's disease, has largely replaced the older operations. Pallidotomy and thalamotomy are surgical procedures that destroy brain tissue in regions of the brain associated with Parkinson's symptoms, such as dyskinesia, rigidity, and tremor. Cobalt therapy can be used and Zonisamide a drug used to treat epilepsy, is showing promise in Parkinson's new treatment treating tremors, motor problems, and involuntary movements in patients with Parkinson's disease.