Parkinson’s Disease

What is Parkinson’s Disease?

Parkinson’s Disease occurs in older people, who are almost always over sixty years old. The disease leads to a loss of normal movements, and a peculiar stiffness of the muscles takes place. This affects facial appearance, the attitude of the body and walking. Weakness and a rhythmic tremor usually occur. This disease was first described by James Parkinson, an English physician, who described it in a monograph written in the 18th century, which has since become famous.

Parkinson’s Disease Causes

The exact cause is not clear, but it is related to the general decline of life from the 50th to the 70th year. It is more common in males, and is probably associated with the reduced blood flow through the brain, associated with advancing arteriosclerosis.

Parkinson’s Disease Symptoms

Onset is slow and insidious. A gradual rigidity of the muscles of the face, neck and later trunk and limbs usually take place. The face tends to become expressionless and devoid of emotional reaction. After a period it assumes a fixed, masklike appearance. The voice tends to lose its normal inflection, and becomes monotonous. The neck stiffness is often marked, and the patient tends to carry the neck and head as one piece, in a statue like manner.

Likewise the eyes will move rather than the body when checking objects not directly in the line of vision. Due to the stiffness the body adopts a stooping posture and the gait is deprived of its usual spring and supple manner as the patient tends to take small sliding steps. Also too, handwriting becomes small and shaky as muscle weakness occurs, and is accentuated by the muscle rigidity.

Tremors are usually present, starting in the hands and forearms. Frequently spilling a cup of tea because of the shakiness is an early indication of the disease. Excitement and self-consciousness aggravate the tremors, but they tend to disappear during sleep. The movements of the fingers are often described as a “cigarette-rolling” movement, and are typical. Many normal movements are not possible.

Mental acuity is usually preserved, except in severe and advanced cases. Often the awareness of having a chronic disorder produces mental depression. There is usually good control over the bladder and bowels and sensations are preserved.

Parkinson’s Disease Treatment

The treatment of Parkinson’s disease is a specialized one, and must be under the competent care of a physician with a good knowledge of current forms of therapy. The therapy is often best handled by psychiatrists or neurologists who specialize in this field. In the past few years enormous advances have been made involving powerful medications. However some are known to produce fairly severe side effects in some patients.

The advent of Levodopa (L-dopa) several years ago greatly improved the management of the disease. The dosages must be specific to the needs of the patient. Usually a small dose is given three times a day with meals. This may be increased if the patient can tolerate it, but this should vary according to the reaction of the patient. This is now included in other medical compounds. Another drug called Amantadine hydrochloride is also sometimes prescribed. It has noted to have more beneficial results and fewer side effects, but is not so powerful. Bromocriptine, another recent drug, is also being used with good results. Certain “spasmolytic” preparations also remain in use, as they are still believed to assist in breaking muscle spasm.

Often exercising of the affected muscles along with massage are helpful in relieving or checking the onset and progress of muscle rigidity. Encouragement to maintain normal activities as long as possible is also important.

Also, a special coated form of Levodopa called Prodopa has been developed. This special coating means that it is not dissolved and absorbed until it reaches the lower bowel. In this manner, it is possible that many of the adverse side effects may be eliminated. The development of other related products is inevitable. There is also a place for surgery with these patients, and the development of neurosurgery may appreciably benefit certain patients who do not receive help from medical chemotherapy.