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Parkinson’s Disease

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Parkinson’s disease (PD) affects 50,000-60,000 people each year in the United States. This disease is the 14th leading cause of death in the United States. There is no cure for Parkinson’s disease. But with the advanced medical science today, it is easier to manage Parkinson’s disease and subdue the symptoms to some extent.

What is Parkinson’s Disease?

Parkinson’s disease is a progressive neurodegenerative condition that affects movement. It occurs due to low levels of dopamine, a brain chemical. This chemical is very important in imparting quick, coordinated movements. Dopamine levels drop when some brain cells die. This makes people affected with Parkinson’s slow and their movements take longer to complete. There is no known cure for Parkinson’s as yet. However, medications help manage the symptoms.

Who Are Affected By Parkinson’s?

Parkinson’s is a very common disease and affects 1 in 500 people. It is commonly seen in older people. The risk slightly increases, if one has a family history of Parkinson’s.

Symptoms of Parkinson’s  Disease

Parkinson’s is a progressive condition. It gradually develops with only a few visible symptoms. One may initially suffer from a slight tremor in one hand. In some, the movements become slow or stiff.

Early stages of Parkinson’s are marked with stiffness or no expressions on the face. In some, the arms may not swing when walking. Gradually, the speech becomes slurred or soft.

The symptoms tend to vary in individuals. Initial symptoms are very mild and go unnoticed. With time the symptoms worsen and may affect both sides of the body. The four main symptoms of Parkinson’s include:

  • Shaking or tremor
  • Bradykinesia, that is, slow movements
  • Stiffness in the arms, legs or trunk
  • Problems balancing, that is, postural instability that appears as the disease progresses

Secondary symptoms of Parkinson’s include:

  • The swing of the arm on the affected side gets reduced
  • The handwriting becomes small, cramped, called as micrographia
  • Hypomimia, that is, loss of facial expressions
  • Hypophonia, that is, muffled speech or low voice volume
  • Retropulsion, that is, tendency to fall backwards
  • Freezing, that is, inability to walk forward and getting stuck in one place
  • Reduction in automatic reflexes like blinking of the eye
  • Shuffled walk due to slight dragging of the foot

Some of the non-motor symptoms of Parkinson’s include:

  • Hallucinations
  • Sleep disturbances
  • Constipation
  • Depression
  • Pain
  • Oily skin or dandruff
  • Low blood pressure on standing
  • Excessive sweating
  • Loss of sense of smell
  • Drooling

Causes of Parkinson’s Disease

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Although it is known that nerve cells in the brain break down and die, leading to Parkinson’s, it is still unknown what causes them to die. The death of cells causes decrease in levels of dopamine. This causes abnormal brain activity, leading to symptoms of Parkinson’s. Some of the possible causes may include:

  • Specific gene mutations that may lead to Parkinson’s
  • Exposure to toxins or certain environmental factors leading to nerve cell death

Ongoing research is carried out all over the world, to find the exact cause of Parkinson’s disease.

How Does The Doctor Diagnose Parkinson’s Disease?

The doctor may conduct a physical examination and take a detailed medical history. He will conduct a detailed neurological examination that will help him observe the agility of the arms and legs, muscle tone, gait and balance. The doctor will also observe if the four obvious signs of Parkinson’s are present. These include:

  • Tremor or shaking
  • Slowness of movement
  • Rigidity or stiffness in arms, legs or trunk
  • Postural instability

The doctor will prescribe medication called carbidopa-levodopa. This is a Parkinson’s disease medication. If one shows improvement in symptoms after taking the medications, it will confirm the diagnosis as Parkinson’s.

Management of Parkinson’s Disease

Parkinson’s has no cure till date. It is managed with medications and lifestyle changes. Medications prescribed for this condition includes:

  • Carbidopa-levodopa
  • Dopamine agonists
  • Catechol O-methyltransferase (COMT) inhibitors
  • Anticholinergics
  • Amantadine

In some patients, surgical procedures such as deep brain stimulation (DBS) may be suggested.

Exercise is an important part of managing Parkinson’s. It will be very beneficial to the patient in the long run.

Parkinson’s disease leads to different experiences in different people. If you notice stiffness or rigidity in your movements or slowness of movements, talk to your doctor. Early diagnosis will help managing the symptoms better. Remember, although called as a ‘disease’, Parkinson’s is not contagious. For more details, talk to a doctor and get more information related to Parkinson’s disease.

Written by: Saptakee sengupta
Date last updated: March 29, 2015

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