Parkinson's Disease
is a disorder of the nervous system that occurs most commonly in the
middle-aged and elderly, although approximately 10 percent of sufferers
are under age 40. Parkinson's disease is progressive with symptoms
become worse over time. But although Parkinson's may eventually be
disabling, the disease often only progresses gradually. The main characteristic
of Parkinson's Disease are:
Tremors, or the involuntary and rhythmic movements of the hands, arms,
legs and jaw, is a primary feature.
Muscle rigidity, or stiffness of the limbs, occurs in all muscle groups
but is most common in the arms, shoulders or neck.
Gradual loss of spontaneous movement, which often leads to a variety
of problems such as “freezing”, decreased mental skill
or quickness, voice changes, decreased facial expression.
Gradual loss of automatic movement, including eye blinking and decreased
frequency of swallowing.
Unsteady walk (bradykinesia).
Impaired speech.
Difficulties in swallowing, but only common as the disease progresses.
Associated
Features:
People with Parkinson's
may also suffer from any of a long list of associated symptoms however
it is important to note that different patients experience different
symptoms.
Depression
Dementia
Sleep
Disturbance
Speech Problems
Sexual
Problems
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Dementia
Cause:
The cause of Parkinson's
remains unknown. However, theories involving oxidative damage, environmental
toxins, genetic factors, and accelerated aging have been put forward
by researchers as potential causes for the disease. There are also
a number of drugs which can emulated Parkinson's if taken excessively
or over extended periods of time. These include:
Haloperidol
(Haldol, Halperon)
Chlorpromazine (Thorazine, Sonazine),
Compazine
Compro
Valproate (Depacon)
Treatment:
Parkinson's disease is treatable.
The drug levodopa, commonly known as L-dopa, has been the main treatment
in the past. L-dopa however, can cause side effects, and tends to
become less effective when taken for prolonged periods.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Cognitive Behavioral
Therapy may be used to assist in establishing coping patterns to overcome
some of the symptoms of Parkinson's. However this will only give only
a temporary solution.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Besides
levodopa
the following drugs are being utilized in Parkinson's treatment:
Amantadine
Bromocriptine
Pergolide
Pramipexole
Ropinirole
COMT Inhibitors
Selegiline
Trihexyphenidyl
Benztropine
Direct
Medical Procedures involve:
Deep
Brain Stimulation:
The brain is stimulated using small electrodes implanted in the
brain. These electrodes are connected to a small devise which generates
a pulse sending continuous, high frequency electrical stimulation
to the brain via the implanted electrodes, positioned in the thalamus.
This form of stimulation helps control messages in the brain, thereby
suppressing tremor.
Thalamotomy:
In thalamotomy, a radiofrequency energy current is used to destroy
a small, but specific, portion of the thalamus. The objective is
to permanently stop tremors by placing a small lesion in a specific
nucleus of the thalamus.
