What is Parkinson’s disease ? Here is the Deep Guide

Parkinson’s disease is, A growing nervous system disorder that affects movement. Symptoms arise gradually, sometimes rising with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly originates stiffness or slowing of movement. In the first stages of Parkinson’s disease, your face may show little or no expression. Your […]

Parkinson’s disease is,

A growing nervous system disorder that affects movement. Symptoms arise gradually, sometimes rising with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly originates stiffness or slowing of movement.

In the first stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing while walking. Your speech may become weak or mumbled. Parkinson’s disease signs worsen as your condition progresses over time.

However, Parkinson’s illness can’t be cured, medicines might significantly improve your symptoms. Occasionally, your surgeon may recommend surgery to regulate certain regions of your brain and increase your symptoms.

Parkinsonian Symptoms

Parkinsonian signs and symptoms can be different for every patient. Initial symptoms may be mild and go unseen. Symptoms often begin on one side of your body and usually remain more critical on that side, even after symptoms begin to affect both sides.

Parkinsonian signs and symptoms may involve:

Shaking

A tremor, or shaking, usually occurs in a limb, usually your hand or fingers. You may rub your thumb and forefinger back-and-forth, known as a pill-rolling tremor. Your hand may tremor when it’s at rest.

Problem while movement  (bradykinesia)

Over time, Parkinson’s may slow your movement, making easy tasks complex and time-consuming. Your steps may become shorter when you walk. It may be hard to get out of a chair. You may drag your feet as you try to move or walk.

 Muscles Stiffness

Muscle stiffness may transpire in any part of your body. The stiff muscles can be extreme and limit your range of action.

Impaired balance & posture

Your posture may become stooped. Also, you may have balance difficulties as a result of Parkinson’s illness.
Loss of automatic movements. You may have a reduced ability to perform unconscious actions, including blinking, laughing, or waving your arms when you walk.

Speech changes

You may speak softly, fast, slur, or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.

Hard to write 

It may become difficult to write, and your writing may seem small.

Parkinson stages

Parkinson’s disease has the following stages

1st Stage

In this stage, the patient has mild symptoms that do not interfere with his daily activities. Symptoms of tremors and other movement signs occur unilaterally. The patient can have a normal change in posture, facial expressions,  and walking.

2nd Stage

Here the tremors, rigidity and other symptoms affect occur bilaterally. Gait problems and poor posture are evident. The daily tasks are more difficult for the person at this stage.

3rd Stage

In this stage, loss of balance and slowness of movements are the main events. Falls are quite common. The patient is independent, but symptoms can significantly impair normal activities such as dressing and eating.

4th Stage

In this stage, symptoms are quite severe and limit the patient’s daily activities. The person can stand without assistance, but further movement may require a walker. The person is unable to live alone and needs someone’s help in routine works of life.

5th Stage

This is the most advanced stage. It causes stiffness in the legs and may make it impossible for the person to stand or walk. The person either requires a wheelchair or he is bedridden. The person may be dependent. The patient may have hallucinations and delusions.

When do I look for medication?

Talk to your doctor if you have any of the symptoms associated with Parkinson’s disease — not only to diagnose your condition but also to rule out other causes for your symptoms.

Causes of Parkinson’s disease

In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the signs are due to a lack of neurons that allow a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to symptoms of Parkinson’s disease.

The cause of Parkinson’s condition is unknown, but several factors appear to play a role, including:

Your genes

Research shows that specific genetic mutations that can cause Parkinson’s disease. But these are uncommon except in rare cases with many family members affected by Parkinson’s disease.

Although certain gene variations appear to increase the chance of Parkinson’s disease. However, a relatively small risk of Parkinson’s disease is seen for each of these genetic markers.

Environmental triggers

Exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s disease, but the risk is relatively small.
Researchers have also seen that many changes happen in the brains of people with Parkinson’s disease. Although it’s not clear why these changes occur. These changes include:

The presence of Lewy bodies. Clumps of specific substances within brain cells are microscopic markers of Parkinson’s disease. These are called Lewy bodies. The researchers believe that these Lewy bodies hold an essential clue to the cause of Parkinson’s disease.

Alpha-synuclein is found within Lewy bodies

Although many substances are found within Lewy bodies. However, scientists believe an important one is a natural and widespread protein called alpha-synuclein (a-synuclein). It’s found in all Lewy bodies in a clumped form that cells can’t break down. This is currently an important focus on Parkinson’s disease researchers.

 What are Risk factors for Parkinson’s disease?

Risk factors for Parkinson’s disease include:

Age

Young adults rarely encounter with Parkinson’s disease. It ordinarily begins in middle or late life, and the risk increases with age. People usually catch the disease around age 60 or older.

Ancestry

Having a close relative with Parkinson’s disease raises the possibility that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson’s disease.

Sex

Men are more likely to develop Parkinson’s disease than are women.

Exposure to toxins

Ongoing exposure to herbicides and pesticides may slightly increase your risk of Parkinson’s disease.

Complications

Parkinson’s disease is often accompanied by these additional problems, which may be treatable:

Cognitive problems

You may encounter cognitive problems (dementia) and thinking difficulties. These usually occur in the later stages of Parkinson’s disease. Such cognitive problems aren’t very responsive to medications.

Depression and emotional changes

You may experience sadness, sometimes in the very early Parkinson stage. Getting treatment for depression can make it more peaceful to handle the other challenges of Parkinson’s disease.

You may also experience other emotional changes, such as apprehension, anxiety, or loss of motivation.

Swallowing problems

You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.

Problems while eating and chewing 

Late-stage Parkinson’s disease affects the muscles in your mouth, making the eating process difficult. This can lead to choking and poor nutrition.

Hard to Sleep

People with Parkinson’s disease often have sleep problems. These include waking up frequently throughout the night, getting up early, or falling asleep during the daytime.

People may also experience rapid eye movement sleep behavior disorder. This disorder involves acting out your dreams. Medications may help your sleep problems.

Lose Control on Urine Process

Parkinson’s disease may cause bladder problems. These include being unable to control urine or having difficulty urinating.

Costiveness

Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.
You may also encounter:

Blood pressure Up and Down

You may feel unsteady or lightheaded when you stand due to a sudden drop in blood pressure (orthostatic hypotension).

Smell dysfunction

You may experience problems with your sense of smell. You may have difficulty identifying certain odors or the difference between odors.

Exhaustion

Many people with Parkinson’s disease lose energy and experience fatigue, especially later in the day.

Distress and Pain 

Some people with Parkinson’s disease experience pain, either in specific areas of their bodies or throughout the body.

Sexual dysfunction

Some people with Parkinson’s notice a decrease in sexual desire or performance.

Prevention Against Parkinson’s disease

Because the cause of Parkinson’s is unknown, proven ways to prevent the disease also remain a mystery.

Some study has shown that regular aerobic exercise might reduce the risk of Parkinson’s illness.

Some other examination has revealed that people who drink caffeine — which is found in coffee, tea, and cola — get Parkinson’s disorder less often than those who don’t drink it.

However, it is still not understood whether caffeine protects against getting Parkinson’s, or is related in some other way. Currently, there is not enough evidence to suggest drinking caffeinated beverages to protect against Parkinson’s. Green tea is also linked to a decreased risk of developing Parkinson’s illness.

Parkinson’s Treatment

Parkinson’s disease is incurable. Although scientists have found Parkinson’s treatment. You can control your symptoms through the use of medications. However, some cases may require surgery.

You must include aerobic exercise in your routine. A speech therapist can help improve your speech problems.

Parkinson’s treatment include medications and surgical treatment

Medications

Medications may help you manage problems with walking, movement, and tremor. These medications either increase the level of dopamine or substitute it.

Medications your doctor may prescribe include:

  • Carbidopa-levodopa.

    Levodopa is the most effective medication in Parkinson’s disease. It naturally passes into your brain and converts to dopamine. Levodopa is often combined with carbidopa, which prevents levodopa from early conversion to dopamine outside the brain. This prevents the side effects of levodopa such as nausea, light-headedness.

  • Carbidopa-levodopa infusion.

    Duopa is the name of the medication brand. It is available in a gel form. It is administered directly to the small intestine through a feeding tube. Duopa is used in patients in the advanced Parkinson stage of the disease. It is also used in those who do not respond correctly to carbidopa-levodopa.

  • MAO B inhibitors.

    These medications include safinamide (Xadago), selegiline (Eldepryl, Zelapar), and rasagiline (Azilect). They prevent the catabolism of dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO B). It can cause nausea and insomnia

  • Catechol O-methyltransferase (COMT) inhibitors.

    Entacapone (Comtan) prolongs the effect of levodopa therapy by blocking the enzyme that causes the catabolism of dopamine. An enhanced levodopa effect can cause involuntary movements (dyskinesia)

  • Amantadine.

    It provides the short-term relief of symptoms of mild and early Parkinson’s stages can be controlled. It may be used along with carbidopa-levodopa therapy during the later stages of  disease for the control of involuntary movements (dyskinesia)

Surgical procedures

Deep brain stimulation. In this procedure, surgeons implant a medical device called a “brain pacemaker” or “neurostimulator” which transmits electrical impulses into the brain nuclei. It treats movement disorders in Parkinson’s disease.

It is mostly offered to the advanced Parkinson’s disease patients who have unstable medication (levodopa) responses. DBS helps in stabilization of medication fluctuations along with a reduction in involuntary movements (dyskinesia), rigidity, tremor, and helps in improving the slowing of movement.

Parkinsonism

Parkinsonism is any condition that causes a combination of the movement abnormalities seen in Parkinson’s disease — such as slow movement, impaired speech, tremor,  or muscle stiffness —due to the loss of neurons containing dopamine.

Not every parkinsonism affected person is suffering from Parkinson’s disease. There are other causes of parkinsonism, hence called the secondary parkinsonism)

Other causes of Parkinsonism

  • Medications, that treat psychosis, nausea, and other psychiatric disorders
  • Head trauma injury, including the injuries in boxing
  • Neurodegenerative disorders, such as progressive supranuclear palsy, multiple system atrophy, and Lewy body dementia
  • Toxin exposure, such as industrial exposure to organic solvents, cyanide, and carbon monoxide
  • Lesions in the brain, such as tumors, or increased intracranial pressure
  • Metabolic disorders, such as liver failure, and Wilson’s disease

How to manage Parkinsonism

You can manage Parkinsonism in the following ways

  • Discontinue the medications that caused the condition.
  • Take Parkinson’s disease medications — a carbidopa-levodopa combination known as (Sinemet, Duopa, or Stalevo) would help you

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