Parkinson’s

Parkinson’s disease is the one affecting a person’s ability to control normal body movements. Certain nerves present in the brain produce a chemical called dopamine. This chemical mediator also called neurotransmitter, is the one through which nerve cells control these movements. In Parkinson’s disease, the nerve cells responsible for producing dopamine are destroyed, eventually leading to low levels of dopamine. When this happens, there are going to be encountered numerous issues in controlling a person’s body movements. Parkinson’s is the cause of a wide range of symptoms and complications.

 

Parkinson’s Overview and Facts

The treatment for Parkinson’s can control the symptoms in the early stages of the disease. It is recommended that treatment is started as soon as possible after diagnosing. The symptoms of this affection can seriously affect the daily activities of the patient. The ability to work will become impossible. A patient should not wait until the symptoms become unbearable and should seek for help the moment they notice the very first signs of the affection. It is not a good practice to wait until the symptoms interfere with one’s daily life and this is the reason why one should see a doctor for regular check-ups and even more often when it is about other serious conditions.

Symptoms of Parkinson’s occur in older persons, aged at least 50. Yet, the affection is evolving extremely slow and sometimes it can go fully unnoticed. This is the reason why following a treatment scheme in time is paramount. Medications can control the symptoms of the Parkinson’s disease to some extent, but once the affection is getting stronger, the treatment is going to become more and more ineffective. The evolution of this disease will cause a variety of complications which are hardly kept under control.

There is a link between Parkinson’s and risk factors that are still being under research. These risk factors that are implied can be either genetic factors, can be related to age, environmental toxins or antioxidants. Although the studies that are being developed at the moment might answer some of the questions present, experts do not know what is the main cause of Parkinson’s disease apparition.

 

The Cause of Parkinson’s

As mentioned before, in the present there are ongoing studies to help specialists determine whether the cause of Parkinson’s disease is generic or not. Just a few patients from the ones who suffer from Parkinson’s have a relative who suffered from this affection as well. However, some specific genes (the underlying unit of heredity, consisting of deoxyribonucleic acid) can be considered one of the causes of Parkinson’s disease. These abnormal genes can be discovered at young ages when special tests are recommended.

Yet, low levels of dopamine (defined above as a chemical mediator) which are involved in motion control can show signs that are similar to Parkinson’s while the disease is not installed completely. The lack of this type of neurotransmitter can occur when the nerve cells in a certain part of the brain are destroyed entirely or highly deteriorated. The exact cause of this damage in the nerve cells is unknown at this moment.

 

Parkinson’s Symptoms

Like in the case of any other disease, the symptoms of Parkinson’s differ depending on the severity of the affection, depending on the patient’s medical status or the stage of the disease. Symptoms may develop in the latest stages of the disease when treatment is no longer effective. Some patients do not encounter any symptoms at all.

Common symptoms

  • Tremors (slow/regular tremors) in a person’s hands, arms or legs. The tremoring caused by Parkinson’s occurs when the patient is awake, conscious, either sitting down or standing and it gets worse when the person moves the affected part of the body
  • Muscle rigidity and pain are the most common signs at the onset of the disease. Because patients tend to avoid using the affected area of their body, the muscles become stiff. This rigidity that is encountered as an effect of not using the muscles can affect any part of the body and can eventually lead to muscle fatigue and ankylosis.
  • Slow/limited movements (medically called bradykinesia) is encountered when the patient tries to move immediately after getting up from a resting position. When the patient tries to lift themselves from a chair even the slightest effort can be difficult because of the muscle pain and rigidness.
  • The weakening of muscles in the face and neck area. When this symptom appears, speaking and swallowing will become unbearable and very difficult, affecting one’s quality of life to the extreme. The patients may also start sneezing, coughing uncontrollably or lose saliva. Speaking will be mostly composed of whispering and babbling. Since the face muscles are going to be weakened entirely, the patient will experience a very fixed facial expression, known as the Parkinsonian mask.
  • Difficulty in walking, postural stability. People who suffer from Parkinson’s cannot make more than just a few small steps. Patients usually crawl their legs and adopt a very unusual position while walking. The affected people can encounter trouble while moving backward. Since balance is so affected, it can lead to serious consequences because the patient may be falling on the ground very often.

One should remember that tremoring is the first, biggest, most important sign of the Parkinson’s apparition. Even though this tremor does not alter the quality of life initially, if left uninvestigated and untreated, it can result in serious damage later on. As the disease progresses, encountering tremors will extend to other sides of the body, starting to influence the way a patient is living his life. Emotional and physical stress can make the tremor found in Parkinson’s patients more obvious. It is highly important to sleep the right amount of time, to relax completely at the end of the day. This way, tremors are reduced, and the patient will be able to complete a certain task. Although this is the most visible sign of Parkinson’s, nearly half of the people who encountered tremors in their lives do not suffer from this affection. Tremor can have other different causes that can be eliminated in time. The most common cause of non-Parkinsonian tremors is stress and it can lead to poorly diagnosed Parkinson’s.

Other symptoms

Since the disease causes different types of symptoms depending on the patient’s condition, here are some of the side-effects of Parkinson’s:

  • Dexterity and coordination are visibly diminished. The patient will start observing changes in handwriting. The way a person who’s suffering from Parkinson’s writes is different: one is going to start to write smaller than before. Also, if the patient was previously practicing a sport or had athletic skills, these will decrease, and daily activities will become harder to complete (e.g. dressing up).
  • The patient can encounter muscle cramps or joint damage and might require special treatment for coping with them.
  • Greasy skin and dandruff are also more evident than before.
  • Digestive and urinary problems will appear. One of the most frequent symptoms would be constipation.
  • Involuntary effects in certain body functions such as sweating, sexual dysfunctions, orthostatic hypotension etc. These are often attributed to the treatment scheme used to keep Parkinson’s under control.
  • Inability to move every now and then. This can occur during walking down the street without no visible trigger.
  • Sleeping issues (insomnia), mood swings and unorganized thinking.

When a patient finds out that he suffers from Parkinson’s, there are high chances of developing anxiety or depression. People who are not resistant to strong emotions will have trouble in getting used to the idea. This can be one cause of insomnia and the other one is represented by the inability to change the sleeping position during the night because of the muscle pain and rigidness. A person affected by Parkinson’s can easily become passive and undecided. Parkinson’s patients will try to get away from their families and remain inactive during the whole day, which is not encouraged by any means. Depression is very common in people suffering from Parkinson’s and it can be caused by both chemical changes and the reaction to the actual diagnosis. However, with appropriate treatment, the physical and psychical state of the patient can be visibly improved.

It is important to know that one in three patients develop dementia at some point, which is similar in those suffering from Alzheimer’s disease. Depression will contribute to memory loss and confusion, which will make the diagnosis harder to decide. Because Parkinson’s usually affects the elderly, loss of memory, hallucinations and imaginative dreams can be present without an additional generating cause. Some of the signs are reversible while others are not.

Comparing the symptoms

Before presupposing one is suffering from Parkinson’s, there should be taken into account the following afflictions with similar symptoms. When tremor, muscle stiffness, slow movements, and balance issues are encountered, the person can also be suffering from Parkinson’s syndrome (heterogeneous degenerative disease – progressive supranuclear palsy), Alzheimer’s, lesions present in the central nervous system, thyroid disorders, liver diseases, infections in the central nervous system, myocardial infarction, poisoning, intoxications or even psychiatric disorders.

 

Parkinson’s Risk Factors

The risk factors attributed to this condition are very difficult to identify since the cause of the disease is not yet discovered. Age is the only risk factor for Parkinson’s. A family history of Parkinson’s doesn’t increase the risk of developing this condition in a certain patient. Familial cases of Parkinson’s with early onset can yet be quite dangerous for younger people showing signs.

Prolonged exposure to damaging environmental factors such as pesticides, chemicals, polluted water and so on may increase the risk of developing Parkinson’s, but this matter has not been demonstrated scientifically. As mentioned before, the symptoms and the evolution of this disease varies tremendously from one person no another. No treatment is known for entirely curing the disease, but to keep it under control. Also, the emotional status of a person may worsen the present symptoms and can help the disease develop faster.

 

Parkinson’s Diagnosis

As for diagnosis, there are two steps one should know about:

  • Early diagnosis

Screening tests are not involved during this first step of Parkinson’s diagnosis. This is mostly based on medical history, a neurological examination and some questions about the patient’s life. If there are worrying signs, one can move on to the second step.

  • In-depth investigations

Even though there are absolutely no laboratory tests out there that could diagnose Parkinson’s disease, some in-depth investigations might help. Blood tests should be taken into consideration to eliminate the possibility of suffering from thyroid or liver disorders, while an MRI should be performed to rule out a myocardial infarction or a central nervous system tumor. The Positron Emission Tomography is capable of detecting low levels of dopamine in the brain, thus diagnosing Parkinson’s disease. However, this investigation is expensive, and it is not covered by insurance, so just a few number of people use it to determine whether they are sick or not.

 

Parkinson’s Treatment

At first, Parkinson’s patients may not need treatment. When the symptoms are mild, and they do not require any kind of intervention, the doctor will choose to postpone the medication since it has side-effects. Once the symptoms become troublesome, treatment is required, combined with exercise, physiotherapy, occupational therapy and so on. Staying in shape and adopting a healthy lifestyle altogether might help in reducing the unpleasant symptoms of Parkinson’s.

When treatment for Parkinson’s is required, there are several options one can take into account. Initial treatment often includes dopamine agonists such as pramipexole or ropinirole. Non-dopaminergic drugs are used in early stages: amantadine, monoamine oxidase inhibitors, anticholinergics etc. The patient should be kept under careful supervising during the whole period of the treatment since the patient might encounter side-effects.

Surgery is effective in just a few cases of people suffering from Parkinson’s. The treatment scheme should be chosen according to each patient’s needs and requirements. The doctor should consult the patient before making any decision and should consider what the patient’s desires and expectations.

The most important part of keeping Parkinson’s under control is to adopt a healthy lifestyle, as mentioned before. There are a number of measurements that – once taken – can visibly improve the symptoms. The patient should be advised to use his energy for strictly necessary activities since this is going to help him remain active and independent. Regular exercising combined with a balanced diet is important in keeping the symptoms in bearable conditions. Maintaining the tonus, coordination, and resistance is a must. Since a person in an advanced stage of Parkinson’s will be limited in terms of movement and daily activities, modifying the treatment and giving up some habits is also required. Speech therapists can help the patient express themselves easier.

Final stage treatment

When the symptoms are no longer bearable, and the disease progressed to a final stage, most people will develop bradykinesia. The treatment for this stage implies Levodopa, the most commonly used medicine to keep Parkinson’s under control. Yet, this treatment scheme is well-known for the numerous side effects. Levodopa is absorbed into the small intestine, it enters the nervous system and is transformed into dopamine eventually. This transformation can occur in peripheral tissues, which is the reason why it has so many side effects. Peripheral degradation needs to be inhibited, the reason why Levodopa is combined with other types of medicine, like dopamine agonists. This treatment is used for reducing the symptoms of Parkinson’s visibly and stimulate the brain activity. It is a safe, reliable medicine scheme and can be used at all stage of the disease, but it is recommended for the most extreme cases and stages.

Last updated on March 2nd, 2018

Editorial Team

Academic Association of Medicine is the go to resource for all health related issues. We are an independent body that seeks to offer general information on various health topics and unbiased reviews on health products.

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