PARKINSON’S DISEASE

Parkinson’s disease, also called paralysis agitans or shaking palsy is a movement disorder. Cases of PD are reported at all ages, though it is uncommon in people younger than 40.

This disease is more common among men and usually occurs after 60 years.

The average age at which symptoms begin in the USA. is 58-60.

The nerve cells in the part of the brain which control movements are mainly affected. The nerve cells (neurons) which make the chemical called dopamine either don’t work sufficiently or are completely destroyed. The real cause behind this had never been identified. Though, many risk factors have been enumerated in literature.

Symptoms:

Persons suffering from Parkinson’s disease need not present with every common symptom. The number of symptoms and their intensities are known to vary with every individual. Most common signs & symptoms of Parkinson’s include:

• Tremors felt in the fingers, hands, arms, legs, jaw and face. Initially these tremors are mild and visible only while resting. Eventually they become visible even during routine movements.
• Rigidity is another symptom. Persons suffering often feel stiffness or inflexibility in their muscles. Muscles normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of motion.
  Muscular movements like walking, running, dancing, sitting, grasping objects with fingers all seem very stiff. Rigidity can cause pain and cramping. The sense of fluidity in these movements is lost. In advanced conditions, even the facial muscles become very rigid, thus giving an appearance of an expressionless face, something akin to wearing a mask.
• Bradykinesia or slowness of movements usually accompanies the sensation of stiffness and rigidity. A person with bradykinesia will probably also have incomplete movements, difficulty initiating movements and sudden stopping of ongoing movement.
  There is increasing inability to perform tasks which require rapid alternating movements.
• Loss of balance and in coordination of movements results in frequent falls when beginning to walk or run.
• Gait: There is a ‘shuffling’ gait characterized by short steps, with feet barely leaving the ground, producing an audible shuffling noise. Small obstacles tend to trip the patient.
• Decreased arm swing.Turning ‘en-bloc’, rather than the usual twisting of the neck and trunk and pivoting on the toes, PD patients keep their neck and upper body rigid, requiring multiple small steps to accomplish a turn. Stooped, forward-flexed posture both when sitting and standing. Festination: a combination of stooped posture, imbalance, and short steps. It leads to a gait that gets progressively faster and faster, often ending in a fall.
• Dystonia: abnormal, sustained, painful twisting muscle contractions, usually affecting the foot and ankle, interfering with gait. However, dystonia can be quite generalized, involving a majority of skeletal muscles; such episodes are very painful and completely disabling.
  They may go through periods of “freezing”, which is when a person feels stuck to the ground and finds it difficult to start walking. The slowness and incompleteness of movement can also affect speaking and swallowing.
  • Speech: the voice becomes very soft. Later, the sound turns hoarse and monotonous. Occasionaly, the speech becomes excessively rapid, soft, and poorly-intelligible.
    Gradual progress in the disorder causes an inability to understand the meaning & essence of speech. Also, there is difficulty in deciphering the facial expressions seen on others when conversing.
  • Drooling: Weak swallowing and stooped posture causes drooling of saliva.

More symptoms which are seen in PD are:

• Small, cramped handwriting (micrographia)
• Dementia and confusion
• Fear or anxiety
• Slow thinking & memory problems
• Sexual dysfunction
• Fatigue and body aches
• Compulsive behaviors
• Loss of energy
• Sleep disturbances: excessive daytime sleepiness; insomnia; vivid, disturbing dreams.

These symptoms certainly vary in intensities in different persons. They are seen as the disease progresses and everyone do not suffer from all of them.

Pathogenesis:

We now know that many of the signs and symptoms of Parkinson’s disease develop when certain nerve cells (neurons) in an area of the brain called the substantia nigra are damaged or destroyed. Normally, these nerve cells release dopamine — a chemical that transmits signals between the substantia nigra and another part of the brain, the corpus striatum. These signals cause your muscles to make smooth, controlled movements.

As a normal part of aging everyone loses some dopamine-producing neurons.

People with Parkinson’s disease lose half or more of neurons in the substantia nigra. Although other brain cells also degenerate, the dopamine-containing cells are critical for movement and so their damage takes center stage.

Causes of Parkinson’s disease:

Why Parkinson’s Disease occurs, no one knows. These are some factors that scientists believe predisposes individuals to PD.

• Genetic factors: About 15 to 25 percent of people with Parkinson’s report having a relative with the disease. This means that if your parent has Parkinson’s, your chances of developing the disease are slightly higher than the risk in the general population.
• Studies have revealed that there may be more of a genetic basis to young-onset PD (that is, the 10 percent or so of people with Parkinson’s for whom onset occurs at or before age 50) than to later-onset PD.
• The vast majority of Parkinson’s cases are not directly inherited, but researchers have discovered several genes that can cause the disease in a small number of families. Genetic diseases occur when important genes contain mutations, which result in abnormal proteins that in turn cause disease.
• Environmental factors: Scientists have suggested that Parkinson’s disease may result from exposure to an environmental toxin or injury. Research has identified several factors that may be linked to PD, including rural living, well water, herbicide use and exposure to pesticides. Pesticides are thought to adversely affect the brain by inhibiting energy production resulting in brain cell death.
  Studies have also shown that smoking and caffeine use appear to protect against the development of PD. However, it is universally agreed that the health risks associated with smoking are worse than any incidental benefits that might be gained by this habit.
  Also, a synthetic narcotic agent called MPTP can cause immediate and permanent Parkinsonism if injected.
• Head trauma: Past episodes of head trauma are reported more frequently by sufferers than by others in the population.
• Drug induced: Antipsychotics, which are used to treat schizophrenia and psychosis, can induce the symptoms of Parkinson’s disease (or parkinsonism) by lowering dopaminergic activity.

Diagnosis:

Currently, no blood or laboratory tests that have been proven to help in diagnosing PD. It is difficult to diagnose PD accurately. Thus, medical history and a neurological examination alone guide the physician in diagnosing.

Treatment options for Parkinsons Disease

Conventional treatment

There is no permanent cure for PD. Though many patients show dramatic response to medications initially, with gradual progress, the benefits of drugs diminish.

Treatment usually comprises of: –

• Medications
• Counseling
• Physical therapy

Counseling

Certain changes in diet and life style can go a long way in improving a persons coping skills with PD.

Healthy eating

Eat more of fruits, vegetables and whole grains.

These foods are high in fiber, which is important for helping prevent constipation. Also, drink plenty of water and increase fibre intake through supplements.

Healthy Exercise

Regular exercise is extremely important if you have Parkinson’s disease. It helps improve mobility, balance, range of motion and even emotional well-being. Your doctor or physical therapist may recommend a formal exercise program, but any physical activity, including walking, swimming or gardening, is beneficial. Weight-bearing exercises, such as walking, jogging and dancing, may be helpful.

Keep in mind that your energy level may go up and down, and you’ll sometimes need to pace yourself. If you’re tired, try doing one part of your routine at one time of day and adding another segment later. Choose a time to exercise when your medicines are working well and you feel strong.

Be sure to stretch before and after you exercise. Stretching warms up your muscles, helps prevent stiffness, and improves your flexibility and balance.

Walking with care

Parkinson’s disease can disturb your sense of balance, making it difficult to walk with a normal gait. These suggestions may help:

• If you notice yourself shuffling, slow down and check your posture. It’s best to stand up straight with your head over your hips and your feet eight to 10 inches apart.
• Buy a good pair of walking shoes. Avoid running shoes.
• Practice taking long steps and exaggerate lifting your legs and swinging your arms.
• If you become stuck in place — known as freezing ¾ rock gently from side to side or pretend you’re stepping over an object on the floor.

homeopathic treatment-

homeopathy have wonderful results to arrest further progress of illness.