Parkinson's disease
Parkinson's disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing ("dopaminergic") neurons in a specific area of the brain called substantia nigra.
The cause remains largely unknown, but several factors appear to play a role, including:
Genes. Researchers have identified 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.
However, certain gene variations appear to increase the risk of Parkinson's disease but with a relatively small risk of Parkinson's disease 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.
Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement, Gait and balance problems
In the early stages of Parkinson's disease, your face may show little or no expression, Loss of automatic movements or handwriting changes. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time
In addition to movement-related symptoms, Parkinson’s symptoms may be unrelated to movement ("non-motor"). People with PD are often more impacted by their non-motor symptoms than motor symptoms. Examples of non-motor symptoms include: apathy, depression, constipation, sleep behavior disorders, loss of sense of smell and cognitive impairment.
Complications
Parkinson's disease is often accompanied by these additional problems, which may be treatable:
Thinking difficulties. You may experience 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 depression, sometimes in the very early stages. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson's disease.
You may also experience other emotional changes, such as fear, anxiety or loss of motivation. Doctors may give you medications to treat these symptoms.
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.
Chewing and eating problems. Late-stage Parkinson's disease affects the muscles in your mouth, making chewing difficult. This can lead to choking and poor nutrition.
Sleep problems and sleep disorders. People with Parkinson's disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day.
People may also experience rapid eye movement sleep behavior disorder, which involves acting out your dreams. Medications may help your sleep problems.
Bladder problems. Parkinson's disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
Constipation. Many people with Parkinson's disease develop constipation, mainly due to a slower digestive tract.
You may also experience:
Blood pressure changes. You may feel dizzy 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.
Fatigue. Many people with Parkinson's disease lose energy and experience fatigue, especially later in the day. The cause isn't always known.
Pain. Some people with Parkinson's disease experience pain, either in specific areas of their bodies or throughout their bodies.
Diagnosing Parkinson’s disease
There’s no specific test for diagnosing Parkinson’s. Diagnosis is made based on health history, a physical and neurological exam, as well as a review of signs and symptoms.
Imaging tests, such as a CT Brain or MRI Brain, may be used to rule out other conditions. A dopamine transporter (DAT) scan may also be used. While these tests don’t confirm Parkinson’s, they can help rule out other conditions and support the doctor’s diagnosis.
The first step to living well with Parkinson’s disease is to understand the disease and the progression:
It is possible to have a good to great quality of life with Parkinson’s disease. Following the adequate recommended therapies such as dopaminergic medications and regular exercise are essential in successfully treating symptoms. People with PD need this medication because they have low levels or are inadequate dopamine in the brain, mainly due to impairment of neurons in the substantia nigra.
It is important to understand that people with PD first start experiencing symptoms later in the course of the disease because a significant amount of the substantia nigra neurons have already been lost or impaired.
Although there is no cure, treatment options vary and include medications and surgery to improve the quality of life. While Parkinson’s itself is not fatal, disease complications can be serious.
Treatment:
Treatment for Parkinson’s relies on a combination of lifestyle changes, medications, and therapies. Adequate rest, exercise, and a balanced diet are important. Speech therapy, occupational therapy, and physical therapy can also help to improve communication and self-care.
In almost all cases, medication will be required to help control the various physical and mental health symptoms associated with the disease.
There are many dopaminergic medications are available for mild to moderate PD. Advanced therapies like deep brain stimulation, Apomorphine injections and continuous dopaminergic therapies like Apomorphine pump and levodopa infusion are also available.