Parkinson’s disease is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson’s disease, the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson’s disease, face may show little or no expression, or arms may not swing when patient walk. Patient speech may become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over timeCauses: Genetic mutations that can cause Parkinson’s disease , Exposure to certain toxins or environmental factors may increase the risk of Parkinson’s disease , The presence of Lewy bodies(Clumps of specific substances within brain cells are microscopic markers of Parkinson’s disease. Called Lewy bodies )Symptoms : Tremor , Slowed movement (bradykinesia) , Rigid muscles , Impaired posture and balance , Loss of automatic movements , Speech changes , Writing changes Complications: Thinking difficulties , Depression and emotional changes , Swallowing problems , Sleep problems and sleep disorders, Bladder problems , Constipation , Blood pressure changes ,Smell dysfunction, Fatigue , Pain , Sexual dysfunction .
Prevention: caffeine — which is found in coffee, tea and cola — may reduce the risk of developing Parkinson’s disease , regular aerobic exercise , Diagnosis: signs and symptoms, and a neurological and physical examination , tests such as blood tests, to rule out other conditions , Imaging tests — such as MRI, ultrasound of the brain, SPECT and PET scans — may also be used to help rule out other disorders , carbidopa-levodopa, a Parkinson’s disease medication Significant improvement with this medication will often confirm your diagnosis of Parkinson’s disease. TREATMENT: Parkinson’s disease can’t be cured, but medications can help control symptoms In some later cases, surgery may be advised, lifestyle changes, especially ongoing aerobic exercise , physical therapy that focuses on balance and stretching also is important , A speech-language pathologist may help improve your speech problems. Medications: Medications may help manage problems with walking, movement and tremor .
These medications increase or substitute for dopamine, a specific signaling chemical (neurotransmitter) in brain.-Carbidopa-levodopa, -Carbidopa-levodopa infusion (medication is made up of carbidopa and levodopa, it’s administered through a feeding tube that delivers the medication in a gel form directly to the small intestine) -Dopamine agonists (pramipexole (Mirapex), ropinirole (Requip) and rotigotine (given as a patch, Neupro). A short-acting injectable dopamine agonist, apomorphine (Apokyn), is used for quick relief.MAO-B inhibitors (include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). They help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO-B). This enzyme metabolizes brain dopamine. Side effects may include nausea or insomnia. Catechol-O-methyltransferase (COMT) inhibitors. Entacapone (Comtan) This medication increases the effect of levodopa therapy by blocking an enzyme (Catechol-O-methyltransferase) that breaks down dopamine Anticholinergics benztropine (Cogentin) or trihexyphenidyl These medications help control the tremor associated with Parkinson’s disease .Amantadine. Amantadine alone to sprovide short-term relief of symptoms of mild, early-stage Parkinson’s disease. Surgical procedures : Deep brain stimulation In deep brain stimulation (DBS), surgeons implant electrodes into a specific part of brain. The electrodes are connected to a generator implanted in the patient chest near collarbone that sends electrical pulses to brain and may reduce your Parkinson’s disease symptoms. Surgery involves risks, including infections, stroke or brain hemorrhage. Some people experience problems with the DBS system or have complications due to stimulation .
By – HOD – Dr. Mohammed Aslam Ahmed
Department of Physiotherapy
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