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Thursday, October 24, 2019

Parkinson's Disease -Symptoms, Causes and Treatment | How to Prevent Parkinson's Disease

Parkinson's Disease
Parkinson's disease - a progressive, degenerative disorder of the central nervous system. Image Credit: Wikimedia Commons. Some changes are made in this image. 

Parkinson's Disease: Symptoms, Causes, and Treatment | How to Prevent Parkinson's Disease

Overview
Parkinson's disease (PD) is a progressive, degenerative, neurological disorder that primarily affects dopamine-producing neurons in a specific region of the brain and causes a person to lose control of his mobility, ability to speak and write, daily functioning, and so on. Parkinson’s disease symptoms include tremors, bradykinesia, muscle rigidity, postural instability, dyskinesia literally, dysarthria (difficulty speaking), dysphagia (difficulty swallowing), and micrographia (abnormally small or cramped handwriting). After the diagnosis of the disease, pharmacological or surgical treatments may help relieve symptoms, but there is no cure for this disease.


What is Parkinson's disease?

Parkinson's disease is a neurological disorder in which the patient's condition progresses and worsens over time. It affects a person's mobility, ability to speak and write, and is characterized by the appearance of abnormal physical movements on the person. The symptoms develop gradually; they may begin with very mild tremors in one hand, and over time the symptoms become more obvious. The person with Parkinson's disease suffers from slow movement, rigidity or stiffness. In a survey, it is found that males are more likely to develop Parkinson's disease than females. In most cases, symptoms begin to appear after age 50, but 4-5% of Parkinson's patients develop symptoms before they turn 40.
The name of the disease is referred to as the physician James Parkinson, the first person who described "paralysis agitans" knew the disease clinically.

Symptoms of Parkinson's disease

Symptoms of Parkinson's disease appear in the patient when the production of dopamine is reduced by 75-80%, and this decrease leads to a disturbance between dopamine and other chemicals in the base nuclei, such as Stericol, Glutamate. Symptoms of Parkinson's disease vary from person to person, and often begin to appear on one side of the body, followed by the other side later, the following is the main symptoms of Parkinson's disease:

Tremor: Tremor is one of the most common symptoms of Parkinson's disease  Tremor usually begins at one end, often in the hand or fingers and its appearance is shown very clearly at a time when the patient relaxes and does not engage in any activity.

Bradykinesia: Bradykinesia (slow motion) is one of the most common symptoms that cause disability and difficulty for the patient in the initial stages which hinders some of his work and daily activity. Parkinson's disease reduces mobility and slows it down, making simple tasks difficult and time-consuming, it takes a lot of time and effort, and steps may be shorter when walking, and the patient may have difficulty getting out of his seat.

Muscle Rigidity: This is one of the primary motor symptoms of Parkinson's disease, along with bradykinesia and tremor. Parkinson's disease can lead to muscle stiffness, causing pain and limiting the range of motion. The inability to relax causes muscles to become stiff.

Postural Instability: Postural instability (Loss of balance) is a major motor symptom of Parkinson's disease that usually appears in the late stages of the disease. The patient may have difficulty balancing and standing in a healthy position.

Dyskinesia Literally: Dyskinesia literally is characterized by tics, twitches, and spasms; by spasm of a group of muscles (dystonia), rapid, jerky movements (chorea); more complex slow writhing movements (athetosis). Involuntary movements (dyskinesia) may affect different parts of the body such as the legs, arms, and torso. The patient's ability to perform some spontaneous and involuntary movements, including blinking, smiling, and swinging the arms when walking, may be reduced. These symptoms appear when the levels of dopamine become too low.

Dysarthria and Dysphagia: Dysarthria (difficulty speaking) and dysphagia (difficulty swallowing) can be strongly determined for symptoms of Parkinson's disease. Speech problems caused by Parkinson's disease are speaking quietly, or quickly, or fluctuation, and hesitation before the speech. These cases can be assisted by referral to the speech therapist.

Micrographia: Micrographia (difficulty writing) is a secondary motor symptom of Parkinson's disease. The patient may have difficulty writing, and his line appears small. It is believed that micrographia (abnormally small or cramped handwriting) is a result of bradykinesia (the loss of spontaneous movement).




The Stages of Parkinson's Disease
There are five stages to the development of Parkinson's disease, that may include:

Stage I: At this stage, a person suffers from mild symptoms of Parkinson’s disease that do not generally interfere with his daily activities. The symptoms occur only on one side of the body. Some changes may occur in his walking, posture and facial expressions.
Stage II: At this stage, symptoms of Parkinson's disease begin to worsen, they can affect both sides of the body. During this stage, a person with the disease may live alone, but daily activities can be difficult for him.
Stage III: At this stage, a person with the disease falls more commonly. His movement slows down and he usually loses his balance. Symptoms significantly weaken his activities such as eating foods and wearing clothes but he is still not completely dependent on other people, he can do some activities even if very slowly and insecurely.
Stage IV: At this stage, the symptoms of Parkinson's disease become acute, intensive and deteriorating. The patient is unable to live alone, he needs help to carry out his daily activities, such as walking, wearing clothes and eating foods. During this stage, it is possible for the patient to stand without any help, but a walker may be needed to balance his movement.
Stage V: This is the most debilitating and advanced stage of Parkinson’s disease. The patient requires around-the-clock nursing care for all his daily activities. The person cannot stand in any way without assistance. During this phase, it is possible that the patient experiences hallucinations and delusions.

Cause of Parkinson's Disease

The central nervous system in the human body has a key role in the association of voluntary body movements, through integrated regulation within the basal nuclei (basal ganglia). The nerve fibers are present and the inputs of these basal nuclei are interconnected in a complex way. When any part of the basal nuclei in the human body is damaged, this is clearly reflected in the patient such as involuntary movements of the person, muscle tension disorder, slow movement, the nature of the patient's stature in walking or even standing.
Parkinson's disease is caused by a lack of dopamine inside the brain, due to a disruption or damage in the dopamine production in the substantia nigra (arcuate nucleus), which is one of the basal nuclei at the base of the brain. Dopamine is the chemical transmitter that runs between neurons and contributes to the functioning and transmission of neurotransmitters in order to achieve physical motor regularity in humans. Substantia nigra (black substance) is charged with the production of dopamine in the brain. Any movement we normally make is a product of the interaction between the various parts of the brain, such as the pyramidal, extrapyramidal, cerebellar balance, and so on.
Scientists have found that Parkinson's disease is related to heredity in some people. This disease can affect both men and women.




Treatment of Parkinson's disease

Parkinson's disease cannot be cured, but medications can often help control symptoms significantly. In some cases, the patient may need to undergo certain surgical procedures.

Pharmacological Treatment of Parkinson's Disease
Medications help to control and control the problems of walking, movement, and tremor. Parkinson's treatment relies mainly on increasing the concentration of dopamine, an important neurotransmitter in the brain, whose deficiency is associated with Parkinson's disease. Medications significantly improve symptoms at the beginning of treatment, but the effectiveness of medicines decreases as the disease progresses over time. Medications used to treat Parkinson's Disease and tremor may include:

SINEMET® (Carbidopa-Levodopa): SINEMET® is used for the treatment of Parkinson's disease and syndrome. It is a combination of carbidopa and levodopa. Levodopa is the most effective treatment for tremor. Inside the brain, levodopa is converted into dopamine, while added carbidopa reduces the side effects of levodopa. As the disease progresses, the effectiveness of levodopa may become less stable, and the patient may experience involuntary physical movements after high doses of levodopa.

Dopamine Agonists: Dopamine agonists are less effective than levodopa but they work longer and can be used in conjunction with levodopa to improve its effectiveness, especially during periods when levodopa stops working. Examples include Pramipexole and Ropinirole. The side effects of these medicines are similar to those of levodopa.

Amantadine: Amantadine is used to relieve minor symptoms of Parkinson's disease in the early stages, and can be given along with levodopa during the later stages of Parkinson's disease to reduce its side effects.

Catechol-O-methyltransferase (COMT) inhibitors: An example of this group is Entacapone, which prolongs the action of levodopa by inhibiting the enzyme that breaks down dopamine. Side effects include increased risk of diarrhea and involuntary physical movements.

Monoamine Oxidase Inhibitors:  MAO-B inhibitors may include Selegiline, Rasagiline. These medications prevent the destruction of dopamine in the brain by inhibiting the monoamine oxidase enzyme. They have some side effects such as nausea and insomnia.

Anticholinergics: These medications have been used for many years to contribute to the control of tremor associated with Parkinson's disease. However, its modest benefits and multiple side effects, such as memory impairment, constipation, dry mouth, and difficulty urinating, have limited use in tremor treatment. Examples include benztropine and trihexyphenidyl.


Note: The medicines mentioned here are for informational purposes only; we do not recommend any type of medication. Consult your doctor before taking any type of medicine for the treatment of Parkinson's disease.

Surgical Treatments for Parkinson's Disease
Surgical procedures used in the treatment of Parkinson's disease include:

Deep Brain Stimulation: In this surgery, electrodes are inserted into a specific area of ​​the brain, using MRI and recording the activity of brain cells during the procedure. A device that releases electrical impulses is also implanted under the collarbone or in the abdomen, providing an electrical impulse to the brain. This procedure is usually used if pharmacological treatments fail to alleviate the patient's condition and at least four years after the disease. Studies show that the process is useful for at least five years. Deep brain stimulation is more effective for people with disruptive shivers and some side effects from the use of medications.

Duopa Therapy: Duopa therapy is a surgical procedure in which a small hole is made in the stomach wall to place a tube that reaches the intestines. The tube is connected to a pump to deliver levodopa and carbidopa in the form of a gel directly to the intestine through this tube instead of a pill. This method of treatment aims to improve absorption and to reduce the time periods during which an oral medication does not work. This surgical procedure is used to treat people with advanced Parkinson's disease, which responds well to levodopa, especially if the patient has daily fluctuations in the movement that last for more than three hours and do not respond to pharmacological treatments.




How to Prevent Parkinson's Disease

There are no obvious ways to prevent Parkinson's disease as the exact cause is unknown, even then it can be prevented by:
⇨Keeping away from environmental toxins as much as possible.
⇨Taking a short nap (15 to 30 minutes) after lunch.
⇨Avoiding drugs and head injuries.
⇨Doing aerobic exercise regularly
⇨Giving the body adequate rest.
⇨Avoiding malnutrition and lack of enzymes, because proper nutrition is necessary to prevent the body from diseases in general and brain injury in particular, so it is advisable to eat as much of the vegetables and fruits rich in dietary fiber, fish, and foods with a high content of fatty acids and omega-3.

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