Definition and Overview

Parkinson’s disease is a neurological condition that causes a group of nerve cells in the brain’s substantia nigra to deteriorate progressively until they eventually die. Although small, this group of nerve cells is responsible for producing dopamine, which is a chemical neurotransmitter moving between the substantia nigra and the corpus striatum, the parts of the brain that coordinates proper muscle movement. Once these nerve cells die and dopamine production ceases, a person’s nerve function is compromised, rendering him unable to control his own body movements.

Causes

There is no known cause as to what triggers the impairment and eventual death of the nerve cells affected by Parkinson’s disease. The strongest theory as to the cause of this condition suggests that it is hereditary. However, this genetic element is not always present in all Parkinson’s cases. Although it is strongly believed to be the cause of early onset Parkinson’s, genetics is not wholly to blame.

It is also believed that exposure to certain environmental toxins, both internal and external, may play a role in the deterioration of the dopaminergic neurons. Studies show that these toxins may include carbon monoxide, carbon disulfide, manganese, and harmful pesticides.

Key Symptoms


Parkinson’s disease has a general list of symptoms, such as:

  • Slowed down muscle movements
  • Difficulty walking or rolling over
  • Monotonous speech
  • Loss of balance
  • Abnormal stiffness of the trunk and extremities
  • Fainting
  • Tremors
  • Lightheadedness
  • Difficulty swallowing
  • Difficulty urinating
  • Bradykinesia or the slowing down of bodily movement
  • Abnormal gait
  • Freezing spells
  • Stooped posture
  • Changes in voice and speech
  • Constipation
  • Depression
  • Fear
  • Anxiety
  • Confusion
  • Dementia
  • Fatigue
  • Urinary problems
  • Sexual dysfunction

Even before Parkinson’s disease truly sets in, some early warning signs sometimes present themselves. These warning signs include:

  • Having a small handwriting
  • Changes in handwriting
  • Sleeping problems
  • Muscle tension
  • Loss of the sense of smell
  • Balance problems
  • Nerve pain
  • Constipation
  • Unexplained excessive sweating
  • Drooling or excessive saliva production
  • Stooping or slouching
  • Dizziness

Who to See and Types of Treatments Available

If you experience the symptoms of Parkinson’s disease, medical attention is crucial. Your primary care provider or family physician can check your symptoms and run tests to come up with an accurate diagnosis.

Once your condition is confirmed as Parkinson’s, your doctor will refer you to specialists focusing on the treatment of this disease.

The primary goal of Parkinson’s treatment is to restore the patient’s ability to balance his body. To do so, doctors recommend medications or brain surgery depending on the stage of the disease and the specific symptoms that the patient experiences.

Medications - Medications that can increase the levels of dopamine in the body are the most commonly prescribed treatment for Parkinson’s, particularly because they are easier and less invasive. Drugs specifically designed to treat and help manage Parkinson’s disease are highly effective and can help the patient manage and cope with the disease. These medications include:

  • Levodopa or L-dopa – This is the most commonly prescribed medication for the treatment of Parkinson’s. This drug is metabolized into dopamine, thus improving a person’s control over his body movements. However, while taking L-dopa, medical supervision is needed as this drug can interfere with the absorption of nutrients from food and the efficacy of vitamin supplements, especially those of vitamin B6. Levodopa also tends to lose its effectiveness as time passes, which is why many doctors delay L-dopa medication for as long as it is possible.

  • Carbidopa – Although not considered as a Parkinson’s medication, carbidopa can help relieve the symptoms of the disease. The combination of L-dopa and Carbidopa is commercially available but goes by the name Sinemet.

  • COMT inhibitors – These refer to medications that are taken alongside L-dopa in order to effectively provide relief from Parkinson’s symptoms. These work by blocking enzyme mechanisms and breaking down L-dopa.

Surgical Procedures:

  • Pallidotomy – Pallidotomy is a surgical treatment option that destroys the globus pallidus, which has been shown to become overactive in Parkinson’s cases. Once destroyed, symptoms such as balance problems, tremors, and bradykinesia, are lessened considerably.

  • Thalamotomy – Thalamotomy is a surgical procedure focusing on the thalamus, the part of the brain that causes tremors. This surgery partially destroys the thalamus so that tremors will no longer occur. However, since this procedure only relieves one symptom of Parkinson’s disease, it is not usually recommended.

  • Deep brain stimulation - Parkinson’s disease may also be treated by implanting a brain stimulator in the brain. Compared to other surgical options, brain stimulator implantation is safer and presents fewer complications. Thus, this newer surgical option has become the popular surgical choice as of late, especially among Parkinson’s sufferers whose conditions can no longer be managed by medication alone.

Take note, however, that all forms of surgery used to treat Parkinson’s, including brain stimulator implants surgery, are only considered if the disease can no longer be controlled by medications.

Several other treatment methods for Parkinson’s are currently being developed. However, regardless of what kind of treatment a Parkinson’s sufferer selects, the purpose remains the same, and that is to:

  • Maintain good quality of life
  • Encourage mobility and function
  • Relieve tremors and muscle rigidity
  • Improves posture
    References:

  • Schuepback W.M.M., Knudsen K., Rau J., et al. (2013). “Neurostimulation for Parkinson’s Disease with Early Motor Complications.” The New England Journal of Medicine.

  • Okun M.S. (2012). “Deep-Brain Stimulation for Parkinson’s Disease.” The New England Journal of Medicine.
  • Jankovic J. “Parkinson’s disease: Clinical features and diagnosis.” Journal of Neurology, Neurosurgery, & Psychiatry.
  • National Parkinson Foundation
  • American Parkinson Disease Association Inc.
  • The Parkinson’s Institute
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