Parkinsons

Parkinson’s disease is a condition in which a portion of your brain deteriorates, resulting in increasingly severe symptoms over time. While this disorder is best known for affecting muscle control, balance, and mobility, it can also affect your senses, thinking capacity, mental health, and other areas.

Parkinson’s disease develops naturally with age, and the average age at which it begins is 60 years old. It is slightly more prevalent in men or persons born male (DMAB) than in women or people born female (DMAB) (DFAB).

While Parkinson’s disease is traditionally associated with old age, it can strike adults as young as 20. (though this is extremely rare, and often people have a parent, or child with this condition)

What is the prevalence of this condition?

Parkinson’s disease is the second most common age-related degenerative brain illness. It is also the most frequent motor (movement) brain disorder. According to experts, it affects at least 1% of adults over the age of 60 worldwide.

What effect does this have on my body?

Parkinson’s disease deteriorates a specific area of your brain called the basal ganglia. As this area deteriorates, you lose the skills you formerly had control over. Parkinson’s disease produces a significant change in the chemistry of your brain, according to research.

Under normal conditions, your brain uses chemicals called neurotransmitters to control how your brain cells (neurons) connect with one another. Parkinson’s disease causes a lack of dopamine, one of the most critical neurotransmitters.

When your brain sends activation signals to your muscles, it fine-tunes your movements utilising dopamine-requiring cells. That is why Parkinson’s disease symptoms such as slower movements and tremors are caused by a shortage of dopamine.

The symptoms of Parkinson’s disease worsen and extend as the disease develops. Later stages of the disease frequently impact how your brain works, resulting in dementia-like symptoms and depression.

What’s the distinction between Parkinson’s disease and parkinsonism?

Parkinsonism is a catch-all term for Parkinson’s disease and other illnesses with comparable symptoms. It can refer to disorders other than Parkinson’s disease, such as multiple system atrophy or corticobasal degeneration.

What are the signs and symptoms?

Loss of muscle control is one of Parkinson’s disease’s most well-known symptoms.

Symptoms of motor dysfunction

Parkinson’s disease motor symptoms, or movement-related symptoms, include the following:

1. Slower motions (bradykinesia) – This symptom is required for a Parkinson’s disease diagnosis. People who have this interpret it as muscle weakness, however it is caused by muscle control issues rather than a lack of strength.
2. A tremor that occurs while the muscles are at rest – This is a rhythmic shaking of muscles that occurs in around 80% of Parkinson’s disease cases. Resting tremors are distinct from essential tremors, which do not occur when muscles are at rest.
3. Rigidity, also known as stiffness – Parkinson’s disease is characterised by lead-pipe rigidity and cogwheel stiffness.  When moving a body part, lead-pipe rigidity is a constant, unchanging stiffness. Cogwheel stiffness occurs when tremor and lead-pipe rigidity are combined. It gets its name from the jerky, stop-and-go nature of its movements (think of it as the second hand on a mechanical clock).
4. Unsteady posture or walking gait – Parkinson’s disease causes a slumped or stooped stance due to slower movements and stiffness. This commonly manifests as the condition progresses. When a person walks, they will take shorter, shuffling strides and use their arms less. It may take many steps to turn when walking.

Other motor signs may include:

Blinking less frequently than normal. This is also a sign of poor facial muscle control.

1. Having difficulty swallowing (dysphagia) –  This is caused by a loss of throat muscle control. It raises the risk of complications such as pneumonia or choking.
2. Exceptionally quiet speaking voice (hypophonia) –  This is due to decreased muscle control in the neck and chest.

Nonmotor symptoms

Several symptoms that are unrelated to movement and muscular control are possible. Non-motor symptoms were once thought to be risk factors for this disease if they appeared before motor symptoms. However, there is mounting evidence that these symptoms can manifest in the early stages of the disease. This suggests that these symptoms could be warning indicators that appear years, if not decades, before motor problems.

Non-motor symptoms (with potential early warning signs highlighted) include:

• Symptoms of the autonomic nervous system Orthostatic hypotension (low blood pressure when standing up), constipation and gastrointestinal difficulties, urine incontinence, and sexual dysfunctions are examples of these.
• Depression.
• Sense of smell loss (anosmia).
• Periodic limb movement disorder (PLMD), rapid eye movement (REM) behaviour disorder, and restless legs syndrome are all examples of sleep disorders.
• Difficulties thinking and concentration (Parkinson’s dementia).

How is it identified?

Parkinson’s disease is typically diagnosed clinically, which means that your doctor examines your symptoms, asks you questions, and reviews your medical history. Some diagnostic and laboratory tests are available, although they are usually required to rule out other illnesses or causes. However, most blood tests aren’t required until you don’t respond to Parkinson’s disease treatment, which can signal you have another ailment.

What tests will be performed to determine the severity of this condition?

Various imaging and diagnostic tests are available when healthcare providers suspect Parkinson’s disease or need to rule out other illnesses. These are some examples:

• Examinations of the blood (these can help rule out other forms of parkinsonism).
• CT scan- computed tomography.
• Genetic analysis.
• Magnetic resonance imaging (MRI).
• PET (positron emission tomography) scan.

Is there a treatment for it, and is there a cure?

Parkinson’s disease is now incurable, however there are numerous treatments to manage its symptoms. Treatments can also differ from person to person, based on their individual symptoms and the effectiveness of certain treatments. The primary treatment for this illness is medication.

A secondary therapy option is to have a device implanted in your brain that delivers a small electrical current (this is known as deep brain stimulation). There are some experimental treatments available, such as stem cell-based therapy, but their availability varies, and many are not available to persons with Parkinson’s disease.

What drugs and therapies are used?

Medication therapies for Parkinson’s disease are classified as either direct or symptomatic. Direct therapy is directed towards Parkinson’s disease. Symptom treatments only address specific aspects of the condition.

Medications

Parkinson’s disease medications work in a variety of ways. As a result, medicines that do one or more of the following are likely:

1. Dopamine – Medications such as levodopa can boost the amount of dopamine available in your brain. This medicine is almost always effective, and when it isn’t, it’s usually due to another type of parkinsonism rather than Parkinson’s disease. Long-term usage of levodopa has side effects that reduce its effectiveness.
2. Dopamine emulation – Dopamine agonists are drugs that mimic the effects of dopamine. Dopamine is a neurotransmitter that causes cells to behave in a specific way when a dopamine molecule attaches to them. Dopamine agonists can bind to cells and cause them to act similarly. Delaying the initiation of levodopa is more typical in younger people.
3. Dopamine metabolism inhibitors – Natural processes in your body break down neurotransmitters like dopamine. Medication that prevents your body from degrading dopamine allows more dopamine to be available to your brain. They’re very helpful early on, and they can also aid in the latter stages of Parkinson’s disease when paired with levodopa.

Several drugs are available to address particular symptoms of Parkinson’s disease. The following symptoms are frequently treated:

• Sexual and erectile problems.
• Tiredness or drowsiness.
• Constipation.
• Sleep issues.
• Depression.
• Anxiety.
• Hallucinations and other signs of psychosis.

Treatments may have complications or negative effects.

The consequences and side effects of Parkinson’s disease therapies are determined by the medications themselves, the severity of the ailment, any underlying health issues you have, and other factors. Your healthcare professional is the best person to tell you more about the possible side effects and consequences. They can also advise you on how to reduce the impact of those side effects or difficulties on your life.

When should I consult my doctor or seek medical attention?

• You should see your healthcare practitioner as suggested, or if you detect changes in your symptoms or drug efficacy. Medication and dosage changes can make a significant difference in how Parkinson’s affects your life.
• When should I go to the emergency room.
• Your healthcare practitioner can advise you and provide information about signs or symptoms that indicate you should go to the hospital or seek medical attention. In general, if you fall, you should seek medical attention, especially if you lose consciousness or have an injury to your head, neck, chest, back, or abdomen.