The History Of Parkinson’s Disease Treatment
For many decades, doctors couldn’t treat Parkinson’s disease effectively, and thought it was a terminal illness. The drugs used to treat the symptoms of tremor in the late 1800s included arsenic, morphine, hemlock, and cannabis, according to Chrisopher Goetz’s review published in September 2011 in Cold Spring Harbor Perspectives in Medicine.
By the 1940s and 1950s, neurosurgeons began to perform surgery on the basal ganglia of the brain, which resulted in improvements in Parkinson’s disease symptoms. While this surgery was sometimes effective, it was also risky, and about 10 percent of patients died as a result of the operation.
Behaviors Seen In Parkinsons Disease Dementia
As dementia progresses, managing disorientation, confusion, agitation, and impulsivity can be a key component of care.
Some patients experience hallucinations or delusions as a complication of Parkinsons disease. These may be frightening and debilitating. Approximately 50 percent of those with the disease may experience them.
The best thing to do when giving care to someone experiencing hallucinations or delusions from Parkinsons disease dementia is to keep them calm and reduce their stress.
Take note of their symptoms and what they were doing before they exhibited signs of hallucinating and then let their doctor know.
This element of the disease can be particularly challenging for caregivers. Patients may become unable to care for themselves or be left alone.
Some ways to make caregiving easier include:
- sticking to a normal routine whenever possible
- being extra comforting after any medical procedures
- limiting distractions
- using curtains, nightlights, and clocks to help stick to a regular sleep schedule
- remembering that the behaviors are a factor of the disease and not the person
It Is Important To Note When Reading An Essay On The Shaking Palsy That Parkinson Was Working In Uncharted Territory
James Parkinson died on 21 of December 1824 on Kingsland Road, only a few hundred yards from the house where he grew up. His passing was much lamented by the Parish of St. Leonards, and was noted with regret in the Parish records, as well as in the Gentlemans Magazine.
For many years there was no monument to his achievements. However a plaque commemorating James Parkinson and his work was placed in the nave of St. Leonards church in 1955, the 200th anniversary of his birth. Unfortunately, no image of James Parkinson has survived, but through his prolific writings, we can generate a good idea as to nature of this man. What emerges is a portrait of someone who was very much a product of the enlightenment, and in many ways ahead of his time clinically, scientifically and politically.
The plaque in St Leonards church, Hoxton, London, commemorating Parkinson
What would James Parkinson think now about the Shaking Palsy? He would certainly marvel at the progress that has been made in terms of diagnosing and understanding the causes of the disease that now bears his name. It is likely that he would be pleased at the range of drugs now used to ease the symptoms that he described so clearly in his essay. But undoubtedly he would be both surprised and disappointed to discover that, two centuries after he had first noted the existence of the disease, there is still no cure for this devastating disorder.
The Person Who Parkinson’s Disease Is Named After
Parkinson’s disease is a brain condition that can cause sufferers to have random and uncontrollable shaking or trembling, poor nerve function, and eventually destroys the ability to move or speak normally. Boxing legend Muhammad Ali had the disease. The Parkinson’s Foundation reports that actors Michael J. Fox and Alan Alda, as well as singer-songwriter Neil Diamond , are also battling the illness. The Foundation also explains that shaking and trembling are not the only symptoms. Individuals might also suffer from a reduced ability to smell, as well as emotional issues like anxiety and depression.
But exactly who was Parkinson, and why is that name attached to what the Parkinson’s Foundation calls a “neurodegenerative disorder”?
The condition was named after an English doctor, James Parkinson. In 1817 Dr. Parkinson published a book regarding a condition he then called, “The Shaking Palsy.” The book was titled An Essay on the Shaking Palsy, and in it he described a series of symptoms he observed in six of his patients.
Which Medicines Are Used To Treat Parkinson’s Disease
Guidelines released by the Scottish Intercollegiate Guidelines Network recommend starting with a dopamine agonist, levodopa with a dopa-decarboxylase inhibitor or a monoamine-oxidase inhibitor. Other medicines are also sometimes used, usually in addition to one of these three main types of medication.
Some Other General Points
Stay as active as possible. Exercise regularly as much as you are able. This may not be possible when the condition is more advanced. However, it is something to consider when symptoms are not too bad. You may walk more slowly than before but a daily walk is good exercise and may help to loosen up stiff muscles. Well-meaning relatives or friends may tell you to rest and take things easy. However, as much as possible and for as long as possible, resist the temptation for others to do things for you just because it may be quicker.
Constipation is common in people with PD. Help to reduce the chance of this by having lots to drink and eat plenty of vegetables, fruit, and foods high in fibre. Exercise can also improve constipation. Sometimes laxatives may be needed to treat constipation.
Some medicines taken for other conditions can interfere with dopamine and make PD worse. These may be prescribed for such things as mental illness, sickness, vertigo and dizziness. Check with your doctor if you are unsure about any medicines that you take.
Driving. If you are a driver you should tell the DVLA and your insurance company if you develop PD. Your insurance may be invalid if you do not. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.
How Does A Person With Parkinson’s Feel
Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk.
Don’t Miss: Is Parkinson’s Disease Fatal
What Is Parkinsons Disease
Parkinsons disease is a condition that affects the brain, resulting in a progressive loss of coordination and movement. It is the most common form of parkinsonism disorders and is sometimes called idiopathic or primary parkinsonism.
The disease is named after a British physician, James Parkinson, who first described it in An Essay on the Shaking Palsy in 1817.
In Parkinsons disease, nerve cells, also called neurons, in a region of the brain called the substantia nigra begin to malfunction or die, a process called neurodegeneration. Some of the neurons are responsible for producing a chemical called dopamine. Dopamine acts as a neurotransmitter, which is passes signals between neurons. It is essential in sending messages from the brain to direct muscle movement and coordination.
Parkinsons is a progressive disease, which means symptoms get worse over time. As more dopamine-producing neurons die, the levels of dopamine in the brain decrease until patients are unable to control normal movements. This progression is very slow, and symptoms usually are visible after about 70 to 80 percent of the nerve cells have been lost.
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
- 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.
Read Also: Parkinsons Symptoms Come And Go
Who Develops Parkinson’s Disease
PD mainly develops in people over the age of 50. It becomes more common with increasing age. About 5 in 1,000 people in their 60s and about 40 in 1,000 people in their 80s have PD. It affects men and women but is a little more common in men. Rarely, it develops in people under the age of 50.
PD is not usually inherited and it can affect anyone. However, one type of PD, which appears in the small number of people who develop it before the age of 50, may be linked to inherited factors. Several family members may be affected.
Who Gets Parkinsons Disease
About 1 million people in the United States have Parkinsons disease, and both men and women can get it. Symptoms usually appear when someone is older than 50 and it becomes more common as people get older.
Many people wonder if youre more likely to get Parkinsons disease if you have a relative who has it. Although the role that heredity plays isnt completely understood, we do know that if a close relative like a parent, brother, or sister has Parkinsons, there is a greater chance of developing the disease. But Parkinsons disease is not contagious. You cant get it by simply being around someone who has it.
You May Like: What Are Early Warning Signs Of Parkinson’s Disease
What Causes Parkinson’s Disease
PD is a disorder of the nervous system. A small part of the brain, called the substantia nigra, is mainly affected. This area of the brain sends messages down nerves in the spinal cord to help control the muscles of the body. Messages are passed between brain cells, nerves and muscles by chemicals called neurotransmitters. The brain cells in the substantia nigra produce dopamine, the main neurotransmitter.
If you have PD, a number of cells in the substantia nigra become damaged and die. The exact cause of this is not known. Over time, more and more cells become damaged and die. As cells are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain causes nerve messages to the muscles to become slowed and abnormal.
How Is Parkinsons Disease Dementia Diagnosed
No single test can diagnose Parkinsons disease dementia. Instead, doctors rely on a series or combination of tests and indicators.
Your neurologist will likely diagnose you with Parkinsons and then track your progression. They may monitor you for signs of dementia. As you get older, your risk for Parkinsons dementia increases.
Your doctor is more likely to conduct regular testing to monitor your cognitive functions, memory recall, and mental health.
You May Like: How Long Can A Person Live With Parkinson’s Disease
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
What Are The Symptoms
The symptoms of Parkinsons disease include tremors or trembling difficulty maintaining balance and coordination trouble standing or walking stiffness and general slowness.
Over time, a person with Parkinsons may have trouble smiling, talking, or swallowing. Their faces may appear flat and without expression, but people with Parkinsons continue to have feelings even though their faces dont always show it. Sometimes people with the disease can have trouble with thinking and remembering, too.
Because of problems with balance, some people with Parkinsons fall down a lot, which can result in broken bones. Some people with Parkinsons may also feel sad or depressed and lose interest in the things they used to do.
The symptoms of Parkinsons disease appear gradually and get worse over time. But because Parkinsons disease usually develops slowly, most people who have it can live a long and relatively healthy life.
Also Check: Parkinsonism Prognosis
From The Outset It Is Clear That He Was Well Aware Of How Devastating The Disease Could Be
The major difference between Parkinsons definition and the modern understanding of Parkinsons disease is with regard to his final observation, the importance of non-motor symptoms, as there is an increasing realisation that dementia is an important part of the symptomatic spectrum of Parkinsonism.
The centrepiece of the essay is Parkinsons report of a typical history for the Shaking Palsy, illustrated with a series of six cases from in and around Hoxton, sharing a number of characteristic symptoms. Although varying in detail , these contain a wealth of information that neurologists today would recognise from their own interaction with Parkinsons disease patients.
The contents and first page of An essay on the Shaking Palsy, written by James Parkinson in 1817
Much is made in the essay of the inadequacy of the treatments available to sufferers. The optimism of Parkinsons humanist tendencies prompted him to suggest that: there appears to be sufficient reason for hoping that some remedial process may ere long be discovered, by which, at least, the progress of the disease may be stopped. Sadly it was to be 140 years before the work of Arvid Carlsson and others eventually led to the development of levodopa as a symptomatic treatment for the Shaking Palsy, and we still await an intervention that actually retards the progress of the disease.
Pathological & Clinical Manifestations
Current therapies for PD are purely symptomatic and do not alter either disease progression or the underlying neuropathology that includes intraneuronal deposits of insoluble proteins known as Lewy bodies and loss of pigmented neurons in the substantia nigra. These neurons normally project processes to the striatum where they produce and secrete the neurotransmitter dopamine.
Progressive loss of these dopaminergic neurons in PD reduces the capacity of the remaining nerve endings in the striatum to synthesize dopamine in sufficient quantities. The resulting dopamine deficit alters the normal neural circuitry in a region of the brain called the basal ganglia, which is important for initiating voluntary movement, and gives rise to the clinically recognized motor symptoms of PD which include muscle rigidity, bradykinesia, resting tremor, and difficulty in maintaining upright posture.
Other brain areas where dopamine is not the primary neurotransmitter are also affected by Lewy body pathology indicating that PD pathology, is more widespread and not specific to dopamine-producing neurons. This multisystem degeneration likely underlies the psychiatric disturbances prevalent in PD patients. For example, depression and dementia affect ~50% of PD patients, and the rate of cognitive decline in PD dementia is comparable to that in Alzheimer’s disease.
Also Check: What Do Parkinson’s Patients Usually Die From
What Not To Eat If You Have Parkinson’s
Eat too many sugary foods and drinks as these can negatively impact your immune system. Opt for naturally sweetened food and reduce your sugar intake to manage Parkinson’s symptoms. Eat too much protein. Consuming lots of beef, fish, or cheese may affect the effectiveness of certain Parkinson’s medications.
Diseases Named After People
When French neurologist Georges Gilles de la Tourette discovered a medical condition in 1885 characterized by involuntary verbal and motor tics, he likely had no idea his name would soon be synonymous with the condition. Yet today, this rather common syndrome is known as Tourette’s .
Hundreds of illnesses, syndromes and diseases are named after the people who discovered them. These eponyms include Crohn’s disease, Kaposi’s sarcoma and Hodgkin’s disease, to name a few. Today, however, the World Health Organization wants to end the practice of naming medical conditions after people . The reason? The group often receives complaints from those who feel stigmatized when a disease is named after them or something they hold dear, or who suffer economic losses as a result. To wit: The swine flu isn’t actually transmitted by pigs, but after an outbreak in 2009, some countries banned pork imports. After the Norovirus genus was named, a Japanese individual complained because “Noro” is a common surname in Japan .
Others respond that naming a disease after a person or place makes it more memorable and descriptive than blandly giving it a technical moniker. Also, using a person’s name is often a good way of paying tribute to the doctor or scientist who may have been the first person to discover the disease. Let’s look at the stories behind 10 diseases named after people.
Read Also: Parkinson’s Stage 5 Life Expectancy
The Future: Parkinson’s Clinical Trials
Researchers are continuously working on ways to slow the progression of Parkinson’s disease, restore lost functioning, and help prevent the disease from developing in the first place. You can find out if you or a loved one is right for one of hundreds of clinical trials for Parkinson’s Disease at the Fox Trial Finder.
James Parkinson And Parkinsons Disease
Parkinson’s disease was formally recognized in James Parkinson’s 1817 classic paper, “An Essay on the Shaking Palsy.”
Parkinson was a doctor in London who observed what are now known as the classic symptoms of Parkinson’s disease in three of his patients, and in three people he saw on the streets of the city. His essay contained clear descriptions of some of the main symptoms: tremors, rigidity, and postural instability. He theorized that the disease developed because of a problem in the brain’s medulla region.
Although Parkinson encouraged the medical community to study the disease and had hoped for a cure, his essay received little attention until 1861. It was then that French neurologist Jean-Martin Charcot and his colleagues distinguished the disease from other neurological conditions and termed it “Parkinson’s disease.”
Recommended Reading: Propranolol Increased Total Peripheral Resistance