Parkinson's disease

Parkinson's is caused by the loss of dopamine-producing neurons.

What is Parkinson's Disease?
Parkinson's is a progressive nervous system disorder that affects movement. It develops gradually, often starting with a barely noticeable tremor in just one hand.

Key Insight: While tremors are the most well-known sign, the disorder also causes stiffness (rigidity) and slowing of movement (bradykinesia).

Symptoms

Symptoms often start on one side of the body and remain worse on that side. They are divided into motor (movement) and non-motor issues.

1. Motor Symptoms (TRAP)

• Tremor: Shaking, usually starting in a hand or fingers (often a "pill-rolling" motion). It typically happens when the hand is at rest.
• Rigidity: Muscle stiffness that can be painful and limit range of motion.
• Akinesia (Bradykinesia): Slowness of movement. Steps become shorter, and it becomes hard to get out of a chair.
• Postural Instability: Impaired balance and a stooped posture, increasing the risk of falls.

2. Non-Motor Symptoms

• Loss of Automatic Movements: Reduced blinking, smiling (masked face), or arm swinging while walking.
• Speech Changes: Speaking softly, quickly, or slurring words.
• Micrographia: Handwriting becomes small and cramped.
• Sleep Disorders: Acting out dreams (REM behavior disorder) is a common early sign.

Causes

Parkinson's occurs when neurons in the brain break down or die. These neurons produce Dopamine, a chemical messenger responsible for smooth, coordinated muscle movement.

• Lewy Bodies: Clumps of specific substances (alpha-synuclein) found in brain cells are a microscopic marker of the disease.
• Genetics & Environment: While mostly random, exposure to certain toxins (herbicides/pesticides) and specific gene mutations increase risk.

Complications

• Thinking Difficulties: Cognitive problems (dementia) can occur in later stages.
• Depression & Anxiety: Emotional changes often occur before physical symptoms.
• Swallowing Problems: Leading to drooling or choking risks.
• Sleep Issues: Insomnia or waking frequently.

Diagnosis

There is no specific test (like a blood test) for Parkinson's. Diagnosis is based on symptoms and a neurological exam.

The "Levodopa Challenge": Doctors may give you a dose of carbidopa-levodopa medication. If your symptoms improve significantly, it confirms the diagnosis.

Treatment

There is no cure, but medications can dramatically improve symptoms.

1. Medications

• Carbidopa-Levodopa (Sinemet): The most effective drug. Levodopa converts into dopamine in the brain. Carbidopa prevents nausea.
• Dopamine Agonists: Mimic dopamine effects in the brain (e.g., Mirapex, Requip).
• MAO-B Inhibitors: Prevent the breakdown of brain dopamine (e.g., Azilect).

2. Surgical Procedures

Deep Brain Stimulation (DBS): Surgeons implant electrodes into a specific part of the brain. These are connected to a generator in the chest (like a pacemaker) that sends electrical pulses to reduce tremors and rigidity. This is usually for advanced cases where meds fluctuate.

3. Lifestyle & Therapy

• Exercise: Critical for maintaining balance and flexibility. Boxing, dancing, and Tai Chi are especially helpful.
• Physical Therapy: Focuses on "big movements" (LSVT BIG) to counteract the small, shuffling movements of Parkinson's.
• Speech Therapy: Helps with soft voice and swallowing issues.

⚠️ PREVENTING FALLS

• Make a U-turn instead of pivoting on one foot.
• Focus on striking the ground with your heel first when walking.
• Avoid carrying things while walking to keep hands free for balance.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.