What is Parkinson’s Disease?

Parkinson’s disease is one of the most common progressive neurological diseases. Movement disorders are especially prominent in Parkinson’s disease. The disease is named after the English physician James Parkinson, who first described it in 1817. You can find more information below.

What is Parkinson’s disease?

Parkinson’s disease is a brain disease that causes tremors, stiffness, walking difficulties, balance and coordination problems. Parkinson’s symptoms usually begin gradually and worsen over time. As the disease progresses, people may have difficulty walking and speaking. They may also experience mental and behavioral changes, sleep problems, depression, memory difficulties and fatigue.

Both men and women can have Parkinson’s disease. However, the disease affects about 50 percent more men than women. A clear risk factor for Parkinson’s is age. Although most people with Parkinson’s first develop the disease at about age 60, about 5 to 10 percent of people with Parkinson’s have early-onset Parkinson’s disease with onset before age 50.

Early onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to certain gene mutations.

Parkinson’s disease stages

  1. Phase one: Individuals often experience mild symptoms that do not interfere with daily activities. Tremors and other movement symptoms occur on only one side of the body. They may also experience changes in posture, gait, and facial expressions.
  2. Stage two: Symptoms worsen on both sides of the body, including tremors, stiffness, and other movement symptoms. One can still live alone, but daily tasks are more difficult and longer.
  3. Third stage: This is considered the middle stage. Individuals experience loss of balance and slowness in movements. While still fully independent, these symptoms significantly impair activities such as dressing and eating. Falls are also more common in the third stage.
  4. Stage four: Symptoms are severe and limiting. Individuals can stand unaided, but movement likely requires a walker. People in the fourth stage need help with daily activities and cannot live alone.
  5. Fifth stage: Stiffness in the legs can make it impossible to stand or walk. The person needs a wheelchair or is bedridden. All activities require 24-hour nursing care. The person may experience hallucinations and delusions.

What causes Parkinson’s disease?

Parkinson’s disease occurs when nerve cells (neurons) in an area of ​​the brain that control movement break down or die. Normally these neurons produce an important brain chemical known as dopamine. When neurons die or deteriorate, they produce less dopamine, which causes Parkinson’s movement problems. Scientists still don’t know what causes dopamine-producing cells to die.

Parkinson’s patients also lose nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system that controls many of the body’s automatic functions, such as heart rate and blood pressure. Loss of norepinephrine is closely linked to some of the symptoms of Parkinson’s disease, such as fatigue, irregular blood pressure, reduced movement of food in the digestive tract, and a sudden drop in blood pressure when standing up from sitting or lying down.

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Many brain cells of Parkinson’s patients contain Lewy bodies, aggregates of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that affect Parkinson’s disease and Lewy body dementia.

Although some cases of Parkinson’s appear to be inherited and a few can be traced to specific genetic mutations, in most cases the disease occurs randomly and does not run in families. Many researchers now believe that Parkinson’s disease is caused by a combination of genetic factors and environmental factors such as exposure to toxins.

What are the symptoms of Parkinson’s disease?

Parkinson’s disease has four main symptoms:

  • Tremors in the hands, arms, legs, jaw or head ( essential trauma)
  • Stiffness of limbs and trunk
  • slowness of movement ( bredykinesia )
  • Impaired balance and coordination (sometimes causing falls)

Other symptoms may include depression and other emotional changes. Symptoms such as difficulty swallowing, chewing and speaking, urinary problems, constipation , skin problems and sleep disturbances may also be experienced.

The symptoms and rate of progression of Parkinson’s differ between individuals. Sometimes people dismiss early symptoms of Parkinson’s as effects of normal aging. In most cases, there are no medical tests to pinpoint the disease, so it can be difficult to diagnose properly.

The early symptoms of Parkinson’s disease are vague and appear gradually. For example, affected persons may experience mild tremors or have difficulty getting up from a chair. They may find that they speak too softly or that their handwriting is slow and appears cramped or small.

Friends or family members may be the first to notice changes in people with early Parkinson’s. They may find that the person’s face lacks expression or that the person is not moving an arm or leg normally.

Parkinson’s patients often develop a parkinsonian gait that includes a tendency to lean forward, small quick strides, and less swinging of the arms. They may also have trouble initiating or maintaining movement.

Symptoms usually begin in a limb on one side of the body or even on one side of the body. As the disease progresses, it eventually affects both sides. However, symptoms may be more severe on one side than the other.

Most people with Parkinson’s report that they experience sleep problems, constipation, decreased sense of smell, and restlessness in the legs before they experience stiffness and tremors.

How is Parkinson’s disease diagnosed?

A number of conditions can cause symptoms similar to Parkinson’s disease. People with Parkinson’s-like symptoms caused by other causes are sometimes said to have parkinsonism . While these disorders may initially be misdiagnosed as Parkinson’s, the response to medication, along with certain medical tests, can help differentiate them from Parkinson’s.

Since many other diseases have similar characteristics but require different treatments, it is important to make a definitive diagnosis as soon as possible.

Currently, there are no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s disease. Diagnosis is based on the person’s medical history and neurological examination. Improvement after starting medication is another important feature of Parkinson’s disease.

how is Parkinson’s disease treated?

Although there is no cure for Parkinson’s disease, medications, surgery, and other treatments can often relieve some symptoms.

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Medication

Medications prescribed for Parkinson’s include:

  • Drugs that increase the level of dopamine in the brain
  • Medications that affect other brain chemicals in the body
  • Medications to help control non-motor symptoms

The main treatment for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply.

Usually, people take levodopa along with another medicine called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy, such as nausea, vomiting, low blood pressure, and restlessness, and reduces the amount of levodopa needed to improve symptoms.

People with Parkinson’s should never stop taking levodopa without telling their doctor. Stopping the drug suddenly can cause serious side effects, such as inability to move around or difficulty breathing.

Other medications used to treat Parkinson’s symptoms include:

  • Dopamine agonists to mimic the role of dopamine in the brain
  • MAO-B inhibitors to slow down an enzyme in the brain that breaks down dopamine
  • COMT inhibitors that help break down dopamine
  • amantadine, an ancient antiviral drug to reduce involuntary movements
  • Anticholinergic medications to reduce tremors and stiffness

Remember, your doctor will decide which medicine to take and how.

deep brain stimulation

Deep brain stimulation, or DBS for short, may be appropriate for Parkinson’s patients who do not respond well to medications. DBS is a surgical procedure that surgically places electrodes on a part of the brain and connects them to a small electrical device implanted in the chest.

The device and electrodes painlessly stimulate the brain to help stop many of the movement-related symptoms of Parkinson’s, such as tremors, slow motion, and stiffness.

Other treatments

Other treatments may be used to help with Parkinson’s disease symptoms. These treatments include physical, occupational, and speech therapies that help with walking, voice disorders, tremors, stiffness, and decline in mental function. Other supportive therapies include a healthy diet, exercises to strengthen muscles and improve balance.

What are the side effects of the treatment?

During drug therapy, side effects such as movement disorders, nausea and vomiting, and circulatory or digestive disorders may occur. Sometimes those affected complain of states of confusion, delusions, hallucinations, and psychological symptoms such as depression or sleep disturbances. Fatigue and sleep attacks may also occur.

In addition, behavioral disorders such as gambling addiction, shopping addiction, pathological eating behavior and hypersexuality may occur. With some dopamine agonists used only in exceptional cases, an increase in connective tissue may occur in the heart valves or in the area of ​​the lungs.

If the drug is stopped abruptly after a long period of regular use, a rapid deterioration in mobility with difficulty swallowing, palpitations and profuse sweating may occur. Such a Parkinson’s crisis can also be triggered by the use of certain additional medications or by serious infectious diseases.

How should Parkinson’s patients be fed?

Nutritional tips for people with Parkinson’s include:

  • Choose a diet that includes plenty of grains, vegetables and fruits, provides vitamins, minerals, fiber and complex carbohydrates, and can help reduce your fat intake.
  • Limit sugar intake. A diet high in sugar can contain too many calories and too few nutrients. It can also contribute to tooth decay.
  • Reduce your salt and sodium intake to reduce your risk of high blood pressure .
  • Include foods high in antioxidants (important for overall brain health) in your diet. These include brightly colored and dark colored fruits and vegetables.
  • Balance the food you eat with physical activity.
  • Choose a diet low in fat, saturated fat and cholesterol to reduce your risk of heart attack and certain types of cancer and help you maintain a healthy weight.
  • Maintain a healthy weight to reduce high blood pressure, heart disease, stroke, certain cancers and common types of diabetes . Your doctor can help you determine what a healthy weight means to you.
  • Consume alcoholic beverages, empty calories, and foods in moderation or not at all. Drinking alcohol can cause many health problems and accidents.
  • Drink enough water (eight glasses a day) and eat fiber-rich foods such as brown rice, whole grains, fruit and beans to relieve digestive difficulties and constipation.
  • Take your medication with a glass of water. It can help your body break down medication more efficiently.
  • Limit sugar intake, alcohol, and caffeine, especially before bedtime, as they can disrupt sleep.
  • Talk to your doctor about whether you should increase your vitamin D intake. Vitamin D is found in fortified milk and dairy products, egg yolks, and fatty fish such as tuna, mackerel, and salmon. These help maintain bone health.
  • Snack on small amounts of walnuts, cashews, and other nuts to promote brain health. Also, try to include fruits that contain beneficial antioxidants and foods that may have anti-inflammatory effects on the brain, such as salmon, tuna, and dark green leafy vegetables.
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Do Parkinson’s patients dream?

In REM sleep behavior disorder, the person lives their dreams come true. Because these dreams often involve being chased or attacked, people will shout, punch, kick, or even jump out of bed.

REM is the period of sleep in which we dream. Normally the brain inhibits muscle movement during this time. In Parkinson’s patients, the brain pathways that suppress muscle activity are disrupted and people can act by perceiving their dreams as if they were real.

What causes Parkinson’s disease?

Five groups of complications are distinguished in Parkinson’s disease. These include motor complications, falls, involuntary nervous system disorders, neuropsychiatric problems, and sleep disturbances.

In motor complications, a distinction is made between fluctuations in motor activity and increased involuntary movements. One of the main problems faced by Parkinson’s patients is falls. These increase with age and are divided into balance disorders and freezing (permanence in movement).

Involuntary disorders of the nervous system include disorders of blood pressure regulation, which can be recognized as dizziness in an upright position. In addition, constipation, increased urge to urinate at night, and arousal disorders often occur from treating tremors with beta-blockers. Disturbed temperature regulation, nonspecific pain and swallowing disorders are also involuntary complications.

Neuropsychiatric problems manifest themselves in depression, hallucinations, memory disorders and behavioral disorders such as anxiety, panic attacks and internal tension. Sleep disturbances are among the most common problems in 75% of Parkinson’s patients. Those affected often die as a result of severe swallowing disorders, infections, and falls.

How long does a Parkinson’s patient live?

Individuals with Parkinson’s disease live slightly shorter lives compared to healthy individuals in the same age group. Patients usually begin to develop the disease around age 60, and most die between 10 and 20 years after diagnosis. However, a patient’s current age and general health factor may affect the accuracy of this estimate.

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