Parkinson’s Disease

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    What is Parkinson’s Disease?

    Parkinson’s disease (PD) is a very common long-term neurological disorder, affecting 1% of all individuals over the age of 60 [1]. It is a degenerative disease that worsens over time (progressive). Most people with PD start developing symptoms once they are over the age of 50, however, 5% of people with PD develop symptoms when they’re under the age of 40 (also known as early-onset PD) [2]. Males are more likely to get PD than women, with a ratio of around 3:2 [3].

    It affects the central nervous system, and the most common symptoms in patients affect the motor system.

    How will having PD affect me?

    PD is not directly life-threatening, but the condition can put great strain on your body, and make you more vulnerable to more serious conditions. PD can affect the way you live your life every day, as it can make completing routine or simple tasks like eating, sleeping, walking or carrying objects more and more difficult. As the disease progresses, these tasks might even eventually become impossible. It can eventually take a toll on your relationships with your friends and family, and you might feel stressed, helpless or depressed as you get used to the changes in your life.

    However, you can take early steps and lifestyle changes in order to minimise the overall impact PD has on you and your caregivers. Though it will be challenging, you can continue to live a full, productive and happy life.

    What does having PD feel like?

    Not everyone who has PD will experience all of the symptoms, and some might experience more intense symptoms than others. People will also experience the progression of the disease at different rates. The most recognisable and common symptoms affect your motor movements, and emerge over weeks and months. In early stages of PD, you might not even think you need to see a doctor, or your doctor might find it difficult to recognise and diagnose PD. Early symptoms that will begin gradually include:

    Resting tremor. This refers to shaking movements that have a back and forth motion. This shaking usually starts in one of your hands or fingers. You might also move your thumb and forefinger together in a circular motion, which is known as pill-rolling

    Rigidity. Your muscles may feel stiff, inflexible and constantly tense in any part of your body, giving you pain and affecting your motion. 

    Bradykinesia. This refers to slowed movement, which can make everyday typical tasks feel very time-consuming, and simple tasks might feel more difficult. Your steps might become smaller when you walk and you might drag your feet. 

    As the disease develops, you might also start to experience more symptoms, like:

    • Loss of facial expression
    • Soft or monotone speech 
    • Voice softens after starting to speak loudly
    • Slurred speech
    • Difficulty chewing and swallowing
    • Neck/back pain
    • Stooped posture
    • Loss of balance and instability

    What are the causes of PD?

    PD results from death of the cells in a part of the brain called the substantia nigra, leading to low levels of dopamine, which plays an important role in regulating the movement of the body. Doctors do not know exactly why these cells die. 

    The exact cause of PD is unknown, but doctors believe it is due to a mix of inherited and environmental factors. If you have a family member affected by this disease, you are more likely to get it. People are also more likely to get PD if they have been exposed to some pesticides, herbicides or drugs and have had head injuries or a stroke before.

    How is PD diagnosed?

    If you find that you are experiencing one or more of the symptoms mentioned above, you should book an appointment to visit your doctor immediately. There is no single way to diagnose PD, so your doctor would need to evaluate the physical symptoms you’re experiencing together with your detailed family history and your own medical history. Imaging scans such as CTs and MRIs are not helpful in diagnosing PD, and so will not be used. Some tests might be used to rule out any other causes of your symptoms, if your symptoms are unusual.

    Your doctor might also perform a neurological examination, in order to test your gait, agility, balance and muscle tone.

    How can I manage PD?

    Right now, there is no cure for PD, but there are treatment options that can greatly relieve your symptoms. Many people respond well to treatment for PD and continue to live their normal lives with minor disruptions, especially with so many advances in treatment. However, a minority of patients can eventually become severely disabled because of PD. 

    Supportive treatments like physiotherapy and occupational therapy might help to relieve some symptoms of PD or keep them under control, and teach you how to carry out certain tasks with the level of mobility that you have. 

    Usually, doctors prescribe a combination of the drugs levodopa and carbidopa. Levodopa is converted into dopamine, which is used by nerve cells to replenish the supply of dopamine in your brain. Carbidopa ensures that this doesn’t happen before it reaches the brain. Your doctor might also recommend surgery for you, in order to regulate certain parts of your brain and improve your symptoms. Ask your doctor what the best treatment option for you might be.

    If you happen to have PD, don’t worry, and don’t be afraid to consult your doctor about the changes you’ll have to begin to make in your life to continue living healthily and happily. Talk to your friends and family too, and be open to telling them how you’re feeling about this diagnosis, because they will support you through it.

    Sources

    1. Parkinson Disease: Practice Essentials, Background, Anatomy. (2019, February 2). Medscape.com. https://emedicine.medscape.com/article/1831191-overview
    2. NHS Choices. (2019). Overview                    –            Parkinson’s disease. NHS. https://www.nhs.uk/conditions/parkinsons-disease/
    3. Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. The Lancet, 386(9996), 896–912. https://doi.org/10.1016/s0140-6736(14)61393-3
    4. How Parkinson’s Disease Is Diagnosed. (2011). John Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/how-parkinson-disease-is-diagnosed
    5. Parkinson’s Disease Information Page | National Institute of Neurological Disorders and Stroke. (2019). Nih.Gov. https://www.ninds.nih.gov/Disorders/All-Disorders/Parkinsons-Disease-Information-Page
    6. What are the Stages of Parkinson’s? | ParkinsonsDisease.net. (2017). ParkinsonsDisease.net. https://parkinsonsdisease.net/basics/stages/