Parkinsonism

Parkinson’s disease is caused due to absence of chemical messengers called as dopamine present in the brain. This is due to death or injury to the cells producing dopamine.

Toxins present in the environment (pesticides, herbicides, industrial chemicals and metals), infections (Influenza and other viral infections) or some genetic factors may be responsible for the change in dopamine producing cells. Toxins, infections or other triggers may produce large amount of oxygen free radicals in the body. These free radicals may be responsible in causing damage to the nerve cells.

Exposure to toxins, being man, increasing age and family history of Parkinson’s disease are the risk factors for Parkinson’s disease.

Symptoms of Parkinson’s disease may not be realized for months or years. Initially there may be hardly visible tremors in one hand. Tremors are more evident in resting position. Most commonly back and forth rubbing of the forefinger and thumb called as pill-rolling is seen. Symptoms are seen only in one side of the body and get worse. There is a gradual freezing or slowing of the movement. In some cases tremors may not be there.

There is an inability to initiate the movement. While walking the steps may be short and shuffling. There may be difficulty in starting the process of walking. Stooped posture and imbalance are common but are mild. There may be stiffness of neck and limbs due to which there may be range bound movements and the state is painful. Muscles may become rigid.

There may be digestive problems.

Lack of unconscious automatic acts may be there like smiling, blinking and swinging the arms while walking. There may be speech changes; it may become soft, rapid, repetitions of words, hesitation before speaking or monotonous speech.

There may be dementia (memory and mental clarity problems). There may be anxiety, depression, daytime sleeping and other sleep problems. Smell sense may get impaired.

A tremor is the characteristic signal of Parkinson’s disease. No definite tests are available for the diagnosis of Parkinson’s disease. The symptoms of the condition are seen in many other illnesses. The condition is diagnosed on the basis of medical history, family history of the disease and neurological examination.

There is no treatment available for Parkinson’s disease but symptoms can be treated. Treatment is aimed at removing disabilities and balancing the problems of the disease. Treatment includes lifestyle changes and medications. Lifestyle changes include healthy diet, physical therapy, mental exercise, speech therapy and physical exercise.

Medications increase the supply of dopamine to the brain and improve the movements and tremors. Medications include Dopamine antagonists, levodopa, MAO B inhibitors, Catechol O-methyltransferase inhibitors and antiviral and anticholinergic drugs. There are several side effects of medications and should be discussed with the physician.

Changes in the behavior are anticipated while treatment is going on; if the changes are disproportionate with the character of the patient then it should be discussed with the doctor.

Physical therapy is given to increase muscle tone and muscle strength which can increase mobility and range of motion.

Surgery is also a treatment option in advanced stage disease and when medications do not work well. Deep brain stimulation is most often used for people with advanced form of the disease with no response to medications.

Dietary modifications are also suggested depending on the kind of drug give. They also should be discussed with the physician.

The Parkinson’s disease itself is not life threatening but it reduces the life expectancy than the normal individual. Generally it required 20 or more years to be fatal.

Complications may cause death due to pneumonia, choking and falls.

There may be constipation, urinary and sleep problems, sexual dysfunction, problems in chewing and swallowing and depression.

There may be complications of treatment for Parkinson’s disease; hallucinations, jerking movements or involuntary twitching of the arms or legs, reduced blood pressure while stand up and sleepiness. Some motor complications may be life threatening.

If there are symptoms of Parkinson’s disease then it is important to get diagnosed for it. Diagnosis and treatment in early stage can delay or manage the symptoms for several years.