Parkinson's Disease: Causes, Prevention and Treatment

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Introduction

Parkinson’s disease is a progressive nervous system disorder that affects movement. 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.

In the early stages of Parkinson’s disease, your face may show little or no expression. 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.

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Although Parkinson’s disease can’t be cured, medications might significantly improve your symptoms. Occasionally, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms. Parkinsonism is caused by idiopathic Parkinson’s disease in 80% of cases. In the rest the cause is usually linked to conditions such as: cerebrovascular disease, hydrocephalus, neurodegenerative disorders, inherited degenerative disease (such as Huntington’s disease) or it could be drug-induced

James Parkinson

Parkinson turned away from his tumultuous political career, and between 1799 and 1807 published several medical works, including a work on gout in 1805.[7][8] He was also responsible for early writings on ruptured appendix.

Parkinson was interested in improving the general health and well-being of the population. He wrote several medical doctrines that revealed a zeal for the health and welfare of the people similar to that expressed in his political activism. He was a crusader for legal protection for the mentally ill, as well as their doctors and families.

In 1812, Parkinson assisted his son with the first described case of appendicitis in English, and the first instance in which perforation was shown to be the cause of death.[9]

He believed that any worthwhile surgeon should know shorthand, at which he was adept.

Parkinson’s disease

Parkinson was the first person to systematically describe six individuals with symptoms of the disease that bears his name. In An Essay on the Shaking Palsy[2] (1817), he reported on three of his own patients and three persons whom he saw in the street.[10] He referred to the disease that would later bear his name as paralysis agitans, or shaking palsy.[11] He distinguished between resting tremors and the tremors with motion.[12] Jean-Martin Charcot coined the term ‘Parkinson’s disease’ some 60 years later.

Parkinson erroneously suggested that the tremors in these patients were due to lesions in the cervical spinal cord.

Causes of Parkinson

In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to symptoms of Parkinson’s disease.

The cause of Parkinson’s disease is unknown, but several factors appear to play a role, including:

Your 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.

Prevention of Parkinson

Because the cause of Parkinson’s is unknown, proven ways to prevent the disease also remain a mystery.

Some research has shown that regular aerobic exercise might reduce the risk of Parkinson’s disease.

Some other research has shown that people who drink caffeine — which is found in coffee, tea and cola — get Parkinson’s disease less often than those who don’t drink it. However, it is still not known whether caffeine actually protects against getting Parkinson’s, or is related in some other way. Currently there is not enough evidence to suggest drinking caffeinated beverages to protect against Parkinson’s. Green tea is also related to a reduced risk of developing Parkinson’s disease.

Treatment of Parkinson

So far, there is no cure for Parkinson’s disease but certain medications can help control the symptoms. They can help manage problems with walking, movement and tremor by increasing the brain’s supply of dopa. Depending on the stage of Parkinson’s Disease and the age of the patient different medications are indicated. Certain medications have only a limited effect for a few years. If the effect is not sufficient anymore the medication needs to be augmented or changed.

The main focus of the treatment will be on adequate medication and physiotherapy. Physical exercises are useful therapeutic means. In severe cases neurosurgical intervention might be necessary which is known as deep-brain-stimulation. The surgeons implant electrodes into a specific part of the brain and connect them to a generator implanted in the chest near the collarbone that sends electrical pulses to the brain. Deep-brain-stimulation may reduce Parkinson’s disease symptoms.

Living with Parkinson’s disease

It is necessary that the patient works closely with the Neurologist to find the right treatment. Certain lifestyle changes such as a healthy diet and physical exercises may help make living with Parkinson’s disease easier. Walking, swimming, dancing, water aerobics or stretching is recommended in order to improve the balance which could be disturbed by the disease. Moreover, some types of alternative medicine such as meditation, yoga, massage, tai chi and acupuncture could be useful tool

Conclusion

Parkinson’s disease comes with its own set of management dilemmas such as when to start treatment and with what? What to do when it all starts going wrong? Also, healthcare professionals need to look at non-motor symptoms and cognition.

In conclusion, Parkinsonism and Parkinson’s disease are a clinical diagnosis with motor and nonmotor symptoms. The non-motor symptoms precede the diagnosis by many years. Bradykinesia is the absolute requirement for diagnosis and diagnostic tests are rarely necessary. Follow up is key part of management as is response to treatment.

References

  1. O’Sullivan SS, Williams DR, Gallagher DA, et al. Nonmotor symptoms as presenting complaints in Parkinson’s disease: a clinicopathological study. Mov Disord 2008; 23(1): 101-6
  2. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. Journal of Neurology, Neurosurgery, and Psychiatry 1992; 55:181–84
  3. https://www.gncdubai.com/disease/neurological-parkinsons-disease/?gclid=CjwKCAiA1rPyBRAREiwA1UIy8DGP53m8roeQnHcWd3o2o5VSiOm-0_ZPwMssfTshi4uKHQf_HM4grhoCybMQAvD_BwE
  4. https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055

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