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.
