How Is Parkinson’s Disease Treated
If a doctor thinks a person has Parkinson’s disease, there’s reason for hope. Medicine can be used to eliminate or improve the symptoms, like the body tremors. And some experts think that a cure may be found soon.
For now, a medicine called levodopa is often given to people who have Parkinson’s disease. Called “L-dopa,” this medicine increases the amount of dopamine in the body and has been shown to improve a person’s ability to walk and move around. Other drugs also help decrease and manage the symptoms by affecting dopamine levels. In some cases, surgery may be needed to treat it. The person would get anesthesia, a special kind of medicine to prevent pain during the operation.
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
Parkinsons Disease Can Be Misdiagnosed
In the early stages, it can be difficult to diagnose Parkinsons disease. The early symptoms of the disease can come and go. You might think you are just stiff or having cramps. Or, you might think that this is just part of the aging process. But if the symptoms keep on coming back, you will eventually go to the doctor. He may tell you that it may take more time before he can make a definite diagnosis. This can lead to much anxiety, of course.
If you think you might have Parkinsons disease, below are some things to keep in mind, especially if your doctor has not yet diagnosed you. Remember, diagnosing PD can be hard, even for a highly trained neurologist:
- There are no blood tests or lab tests that can diagnose the disease for certain. It is usually diagnosed based upon medical history, a clinical exam and symptoms.
- Four typical signs of PD are rigidity, slow movement, tremors and postural instability. If you are experiencing these symptoms, especially if they began on one side of the body, your doctor may diagnose you with the disorder.
Note that even if you have three classic symptoms of PD, you still may not have it! To decrease the chance that you will be misdiagnosed, your doctor may have you take several drugs that treat Parkinsons such as levodopa. If your symptoms get better when you take the drug, you probably have PD. If you do not get better after a period of levodopa therapy, your tremors may be due to another cause.
PD and Progressive Supranuclear Palsy
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What Causes Parkinson’s Disease
Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinson’s also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinson’s contain Lewy bodies, unusual clumps 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 impact Parkinsons disease and Lewy body dementia.
What Are The Causes
The cause of Parkinson’s is largely unknown. Scientists are currently investigating the role that genetics, environmental factors, and the natural process of aging have on cell death and PD.
There are also secondary forms of PD that are caused by medications such as haloperidol , reserpine , and metoclopramide .
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Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
What Are The Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.
Parkinson disease dementia can cause problems with:
- Speaking and communicating with others
- Problem solving
- Forgetfulness
- Paying attention
If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.
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Living With Parkinsons Disease
Depending on severity, life can look very different for a person coping with Parkinsons Disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the diseases progression. Besides movement issues Parkinsons Disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinsons are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in your other medications can affect your Parkinsons symptoms, you should remind each member of your healthcare team to send a copy of your clinic note after every appointment.
Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.
How Does Parkinsons Disease Affect The Body
Recognising the signs
A combination of signs can help a doctor make an early diagnosis. If Parkinsons disease is diagnosed early, the chances of being able to treat and manage the condition are greater. Individual signs may not be an indication of Parkinsons disease. Some signs such as loss of smell could be caused by an infectious illness, or joint stiffness by conditions like arthritis.
Parkinsons is most commonly diagnosed with a very physical examination and assessment of a persons medical history. There are very specific markers for diagnosis which doctors use to assess for possible Parkinsons disease. These markers have a lot to do with a combination of very specific signs and symptoms and if recognised early enough, can be better managed.
1. Primary motor symptoms
2. Secondary motor symptoms
Other motor symptoms include:
Some individuals may also experience the following:
- Hunched over / stooped posture – When standing, the body may begin to slouch or lean inwards, causing a hunched over appearance.
- Impaired gross motor coordination
- Impaired fine motor dexterity and motor coordination
- Difficulties with swallowing or chewing
- Cramping
- Production of excess saliva and drooling
- Sexual dysfunction
- Dystonia
- Akathisia
3. Non-motor symptoms
Symptoms that do not involve physical movement or coordination, and often precede motor problems, can include:
Symptoms are initially mild, even if they develop suddenly, and typically affect one side of the body at first.
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Toxic Substances That Have Been Linked To Parkinsons Disease
There are numerous environmental toxins that researchers have tied to the neurological disorders known as parkinson disease. Here are some that have been linked:
- Agent Orange This was a chemical defoliant used in Vietnam that is already tied to cancer. While there is no definitive link with Parkinsons, the VA at least believes that there is a possibility that the two are tied.
- Solvents Some studies have shown a link between Trichloroethylene, a substance contained in many solvents, and Parkinsons.
- PCBs polychlorinated biphenyls were extensively used in the 1970s. They have been often found in the brains of people who have suffered from Parkinsons.
- Pesticides and herbicides -substances such as insecticides, pesticides and herbicides contain chemicals that researchers have strongly linked with higher incidences of Parkinsons. One of the leading contributors is considered to be Paraquat. For information on Paraquat Parkinsons lawsuits, look here.
Age And Genetic Factors Are Not Everything
The rate of Parkinsons disease globally has exceeded far faster than the population has aged according to the American Parkinson Disease Association.
Cases of the disease are up by several multiples over the past decades. From 1990 to 2015, the cases of the disease globally more than doubled, suggesting that there is far more at work. From 2015 to 2040, cases are expected to double once again. This is far higher than the rate of aging in the population.
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Medications And Parkinson’s Symptoms
Taking certain medicationsspecifically ones that block the action of dopaminecould cause Parkinson’s disease symptoms. It’s a condition called drug-induced parkinsonism, and while it isn’t Parkinson’s disease itself, it can look and feel a lot like it.
Here are some of the drugs can cause Parkinson’s disease symptoms:
- Antipsychotics
- Anti-nausea medications
- Drugs that treat hyperkinetic movement disorders
Keep in mind that even though these medications could cause symptoms similar to Parkinson’s, they don’t cause the disease itself. And most of the time, the symptoms go away within hours or days once you stop taking that drug, per the Parkinson’s Disease Society.
In some cases, the Parkinson’s symptoms don’t go away after a person stops taking the medication that led to them, and they’re eventually diagnosed with Parkinson’s disease.
Researchers don’t think that the medication was the cause of Parkinson’s in those cases, but that those individuals’ dopamine levels were already depleted, and the side effects of the drugs revealed their underlying Parkinson’s disease. Put another way, the medication was the “straw that broke the camel’s back,” according to the American Parkinson Disease Association.
Research on what causes Parkinson’s disease continues to grow. If you experience symptoms of Parkinson’s, such as a tremor, slowed movement, balance problems, or changes in your speech or writing, connect with a doctor to diagnose the condition.
Reasons Why Parkinsons Disease Occurs
The scientific reason given for Parkinsons disease is that the patient has lost nerve cells in the part of the brain called the substantia nigra. A very important chemical called dopamine is produced by the substantia nigra. The loss of the ability to produce dopamine contributes to the early stages of Parkinsons disease.
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How Is A Diagnosis Made
Because other conditions and medications mimic the symptoms of PD, getting an accurate diagnosis from a physician is important. No single test can confirm a diagnosis of PD, because the symptoms vary from person to person. A thorough history and physical exam should be enough for a diagnosis to be made. Other conditions that have Parkinsons-like symptoms include Parkinsons plus, essential tremor, progressive supranuclear palsy, multi-system atrophy, dystonia, and normal pressure hydrocephalus.
Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
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Parkinson’s Disease Symptoms: Life Expectancy
Even though Parkinson’s disease is a serious, progressive condition, it is not considered a fatal illness. People who have Parkinson’s disease usually have the same average life expectancy as people without the disease.
But when the disease is in its advanced stages, Parkinson’s symptoms can lead to life-threatening complications, including:
- Falls that lead to fractured bones
- Pneumonia
- Choking
Thinking about the progression of Parkinson’s disease can be frightening. But proper treatments can help you live a full, productive life for years to come. And researchers hope to one day find ways to halt the progression of Parkinson’s and restore lost functioning.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
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Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.
Incidence Of Parkinsons Disease
Its estimated that approximately four people per 1,000 in Australia have Parkinsons disease, with the incidence increasing to one in 100 over the age of 60. In Australia, there are approximately 80,000 people living with Parkinsons disease, with one in five of these people being diagnosed before the age of 50. In Victoria, more than 2,225 people are newly diagnosed with Parkinsons every year.
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Surgery For People With Parkinsons Disease
Deep brain stimulation surgery is an option to treat Parkinsons disease symptoms, but it is not suitable for everyone. There are strict criteria and guidelines on who can be a candidate for surgery, and this is something that only your doctor and you can decide. Surgery may be considered early or late in the progression of Parkinsons. When performing deep-brain stimulation surgery, the surgeon places an electrode in the part of the brain most effected by Parkinsons disease. Electrical impulses are introduced to the brain, which has the effect of normalising the brains electrical activity reducing the symptoms of Parkinsons disease. The electrical impulse is introduced using a pacemaker-like device called a stimulator. Thalamotomy and pallidotomy are operations where the surgeon makes an incision on part of the brain. These surgeries aim to alleviate some forms of tremor or unusual movement, but they are rarely performed now.
Early Signs Of Parkinsons
Most people who are diagnosed with Parkinsons are 60 years of age or older, but early onset Parkinsons is possible, too.
In the first and second stages, the signs of Parkinsons are usually mild. Although 60-80% of the dopamine-producing cells in your brain are gone, you will still be able to go about your usual day-to-day activities.
Some of the most common symptoms during these stages include:
- tremors in the hands, arms, feet, or other body parts when resting
- stiffness and rigidity in muscles
- Bradykinesia , which can also cause a mask-like appearance of the face due to a lack of facial expressions.
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