Progressive Parkinson's Disease

Parkinson’s Disease

Parkinson's disease is a progressive disorder characterized primarily by uncontrollable tremors in the limbs, a shuffling gait, and generalized muscular rigidity. It most often strikes people over the age of 60. Parkinson's disease is usually not fatal, but it leads to changes in the entire body, making the patient more susceptible to other diseases. It can be present in a mild form for 20 or 30 years, but a severe form can lead to serious disability within five to ten years.

Cause

The cause of Parkinson's disease is unknown. No inherited, physiological, or environmental factors have been identified as causes of the disease. It is known, however, that Parkinson's disease is a reflection of a chemical imbalance in the brain. Those with the disease have been shown to have low levels of a neurotransmitter called dopamine. (Neurotransmitters are chemicals in the brain that transmit impulses across junctions between neurons; the delicate balance of neurotransmitters in the brain is responsible for brain function and muscular control.) To date, no cause for this chemical deficiency has been found.

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Symptoms of Progressive Parkinson

The symptoms of Parkinson's disease are uncontrollable shaking of the limbs, stiff muscles, drooling, reduced blinking, an expressionless face, stooping posture, and a shuffling walk. Tremors may worsen during rest periods and times of increased anxiety, but they may decrease when the patient makes a conscious effort to perform an action.

As the disease progresses, speech slurs and sentences trail off into unintelligible muttering. Small muscle movements become increasingly difficult—reducing the ability to write, eat, chew, and swallow—and all movements seem overly stiff and slow. The term "cogwheel rigidity" is often used to describe the typical arm motion these patients display; when the arm is pulled straight from a flexed position, it seems to jerk up and down as if controlled by a ratchet in a cogwheel.

Progressive Parkinson's Disease - Parkinson's disease is a progressive disorder characterized primarily by uncontrollable tremors in the limbs, a shuffling gait, and generalized muscular rigidity.

Excitement and tension can cause these symptoms to worsen, as can depression. Depression is common among Parkinson's disease victims, who are understandably upset by their loss of muscle control.

Diagnosis

Diagnostic evaluation involves a history, physical examination, and observation of the symptoms. If tremors are the only symptom displayed, tests may be done to rule out the possibility that other disorders are causing the tremors, such as liver disease, multiple sclerosis, chronic alcoholism, or overactivity of the thyroid gland.

Progressive Parkinson's Treatment

Treatment of Parkinson's disease consists of correcting the dopamine deficiency. Dopamine itself cannot be absorbed directly into the brain from the bloodstream, so a substance called levodopa is prescribed to help the brain manufacture more of its own dopamine.

Levodopa has several undesirable side effects, among them nausea (which is decreased if the drug is taken with meals), an uneven "on-off" effect (causing symptoms to disappear and then reappear), and a loss of effectiveness over time. Levodopa preparations are often given in combination with anticholinergic drugs, which decrease nerve-to muscle transmission, thereby reducing tremor and rigidity, and also decrease drooling. Levodopa is most often prescribed in combination with carbidopa, a substance that prevents destruction of levodopa in the body before it reaches the brain, thus allowing the use of smaller amounts of levodopa. Bromocriptine, a drug that enhances the effects of dopamine, has also been successful, as have other drugs.

Surgery to halt the tremor of Parkinson's has been helpful in select groups of patients. Physical therapy and exercise are important in a treatment program for patients with Parkinson's disease. Emotional support and understanding are also critical.