Parkinson Disease

Parkinson disease involves the nervous system specifically, movement and control of muscles. Parkinson disease affects more than 1 million individuals in the United States.

It is one of the most common neurological disorders with a prevalence estimated between 150 and 200 per 100 000. It is more prevalent in older persons, affecting 1% of those older than 65 years and 2% of those older than 85 years.

Because it is more common in older persons, the incidence that is number of new cases of Parkinson disease is increasing as the population grows older.

Parkinson disease was first described in 1817 and was originally called "shaking palsy." Medical researchers later discovered that parkinsonian symptoms were due to degeneration of nerve cells in an area of the brain called the substantia nigra.

These cells supply dopamine, a chemical that modulates movement, to other areas of the brain called the basal ganglia. Parkinson disease is progressive and leads to severe limitations in activity and quality of life if the disorder is not treated.

Neurologists (doctors who specialize in treating diseases of the nervous system) and neurosurgeons (doctors who specialize in surgery of the nervous system) individualize each person's treatment to manage the symptoms and slow the progress of Parkinson disease.

Various symptoms of Parkinson’s disease include rigidity, tremors, clumsy movements and abnormal gait. Rigidity occurs as a stiffness of arms, legs, face, and posture so that it becomes difficult for a person to carry out smooth movements.

Tremors are shaking of the head, face, arms, legs, and hands. Not everyone who has Parkinson disease has a tremor; patients with Parkinson’s disease find it difficult to carry out minor tasks like buttoning their shirts.

This is often considered an aid to diagnosis of this disease. Bradykinesia that is slowness of movement occurs. Patient is unable to maintain proper balance and have unstable gait. Neuropsychological aspects of Parkinson disease also are better understood and managed.

Dementia, depression, hallucination, and psychosis associated with Parkinson disease have been studied and new therapeutic strategies have emerged. Advances in medical and surgical therapies have provided substantial improvement in the quality of life of patients with Parkinson disease Nevertheless; these approaches are largely directed toward symptom management and eventually must give way to identification of environmental hazards that can be eliminated and raising the level of public health.

Regarding treatment various drugs are available. These include Levodopa which is a synthetic medication.

Its mechanism of action is that it makes up for the deficiency of chemical substance that is, it replaces dopamine for patients with Parkinson disease. As a result symptoms of tremor and rigidity are improved.

Another medication is Carbidopa which helps reduce adverse effects of levodopa and increases the amount of dopamine in the brain and not in the rest of the body. This is especially important so that dopamine can exert its actions where required without having unwanted effects in other parts of the body.

Several other medications are available to decrease symptoms or slow the progression of Parkinson disease. Antidepressants may be prescribed if depression occurs.

Certain surgical procedures are also done to relieve person from the effects of this disease. These include pallidotomy, thalamotomy and deep brain stimulation. Pallidotomy is a procedure in which a probe delivering electrical current is used to create a permanent lesion or a scar in a specific area of the brain, the globus pallidus to lessen rigidity, tremor, and abnormal movements called dyskinesias.

Thalamotomy constitutes a procedure in which an electrical current creates a small, permanent lesion in the area of the brain called the thalamus. This also helps reduce tremor and rigidity. Another useful method is deep brain stimulation in which an electrode is placed into a specific deep brain structure. Electrical current is delivered continuously to control tremor, rigidity, or bradykinesia.

This requires a small generator (like a heart pacemaker) to be placed under the collarbone. An operation may help persons with Parkinson disease, especially if medical therapy has failed to slow the disease process or if intolerable adverse effects occur from medications.

Because these operations involve the brain, there are significant risks involved. The risks and benefits of surgical therapy should be discussed with a neurologist and neurosurgeon. This type of surgery does not replace medical therapy, but it may lessen the amount and types of medications a patient takes.

Parkinsonism is sometimes also a feature of Alzheimer disease. However, Alzheimer disease is easy to distinguish from Parkinson’s disease because other features are much more prominent. Furthermore, unlike in Parkinson’s disease, cognitive impairment is present at the onset of Alzheimer disease.