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Parkinson’s Disease

The brain is the control center of the body which processes incoming signals and sends out messages to various parts of the body. It does this by the way of electrical impulses and different types of chemicals. One of these important chemicals is dopamine that is produced and secreted by certain types of nerve endings. In Parkinson’s disease there is mainly a deficiency of dopamine and often another chemical secreted by nerves known as norepinephrine. This arises with the gradual destruction of dopamine producing nerves (dopaminergic neurons).

Causes

Neurodegenerative disorders are any type of disease with ongoing damage to the nerves (neurons). Parkinson’s disease is among the most common neurodegenerative disorder seen particularly in the elderly. Unlike some of the other neurodegenerative disorders, the cause of Parkinson’s disease is unknown. It seems to be linked to a family history and to date several genes have been identified. However, genetic factors appear to account for a minority of cases.

It appears that certain environmental factors like exposure to some toxins and infections by viruses may also be somehow linked to Parkinson’s disease but the mechanism is still unclear. Parkinson’s disease is more commonly seen in older individuals, often starting after the age of 40 years and most often detected in the 50s. It is also more common in men than women.

Signs and Symptoms

When the nerves are damaged or lacking essential chemicals that allow it to communicate with each other then normal transmission of signals are affected. The activities controlled by the affected part of the brain and nerves will therefore be disrupted. This is most evident in the difficulty with actions performed by the muscles in the body.

One of the most common and early symptoms of Parkinson’s disease is a tremor – a type of uncontrollable shaking that is initially most prominent in the hand, particularly the thumb and forefinger. With time, the disease affects the motor activity to a larger extent and other symptoms like slowed motion becomes evident. This is known as bradykinesia. The slowness of movement will be seen as freezing while walking, taking short shuffling steps and performing physical activities very slowly. Other movements that are somewhat unconscious yet under voluntary control is also affected like smiling, blinking and even swinging of the arms during walking.

As time passes and the disease progresses, other muscle related symptoms become obvious. The muscles become stiff, sometimes to the point of causing pain, and hampers normal movement. It becomes difficult to maintain balance and a stooping posture is often seen in Parkinson’s disease patients. There is changes in the voice and difficulty with swallowing as the muscles of the voice box and throat are affected. Parkinson’s disease is not fatal but the effects it has on the body can be life-threatening particularly with injuries sustained due to impaired movement. Mental ability and memory is affected in the late stages but not in all patients and dementia may also be present years or even decades after the condition starts.

Treatment

There is no specific test that will conclusively verify that a person has Parkinson’s disease. Instead the diagnosis is made by a doctor based on the signs and symptoms that are present. Other disorders of the brain and nerves which may cause similar symptoms first need to be excluded. Even though Parkinson’s disease may be diagnosed, treatment may not be commenced immediately if the symptoms are very mild.

Eventually though the Parkinson’s patient will need to start medication like levodopa. This chemical is converted into dopamine thereby replenishing the low dopamine levels. It may be used simultaneously with other drugs to ensure that it is only converted to dopamine in the brain and then delay its breakdown by enzymes in the body. Some drugs are used solely to reduce the symptoms like tremors but levodopa is the main and most effective medication for Parkinson’s disease.

With time the body becomes increasingly tolerant to levodopa and the dose has to be gradually increased. Unfortunately levodopa, particularly the higher doses, have a number of side effects. Despite advances in medical science, there is still no cure for Parkinson’s disease.


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