Introduction Parkinson’s disease is a regarded as a common neurodegenerative condition. The etiology of the disease has not completely been understood, but the condition has been associated with a confluence of factors. The first is the loss of a number of neurotransmitters, most notably dopamine that produces neurons in the pars compacta of the substantia nigra. It has also been linked to the combined effects of environmental exposures and aging that accelerate the process of nigral cell death. There is also the possibility that some people may have a predetermined genetic susceptibility to environmental insults.
For example, the disease is less common for Africans and Asians as compared to the Caucasians. Currently, there are no tests that exist to diagnose the disease. The neurologist diagnose the disease based on a review of signs and symptoms, medical history and a physical and neurological examination. Other tests may be carried out to rule out other conditions. That might be causing the symptoms. Signs and Symptoms The symptoms of the disease vary from one person to another. The symptoms that appear on one person in the early stages of the infection may not appear on another person at all or they may appear later.
The common symptoms include resting tremor in a hand, arm or leg, stiff and aching muscles, slow limited movement, weakness of face and throat muscles, difficulty with walking and balance and brief inability to move. For a small number of people, the symptoms have been observed to appear on only one side of the body and never move to the other side. Comorbidities and Progression of the Disease Due to the extensive involvement of a large number of brain structures, the disease may be associated with development of number comorbidities that challenge the diagnosis.
For example, depression occurs to the about 50% of the patients. This may be underdiagnosed because some symptoms such as insomnia and fatigue may be considered as part of aging or PD. Another troubling comorbidity of the disease is Parkinson’s Disease psychosis. The symptoms of psychosis include hallucinations, agitation, paranoia and changes of sexual behavior. The progression of the disease can take 20 years or even longer. The rate at which the disease progresses differ from one person to another. Most doctors use Hoehn and Yahr scale of the Parkinson’s disease. According to this scale, there are five stages of the disease progression.
In stage one; the disease affects only one side of the body. The symptoms start to show on stage two, affecting both sides of the body, but the balance is still there. In stage three, the balance is impaired, but the person can still function independently. At stage four, the person is severely disabled, but they can still stand or walk without help. In the final stage, the patient becomes bedridden or wheelchair bound. Treatment and Drugs The medication available can help control the symptoms, but the disease itself is incurable. In some cases, surgery may be advised.
The doctor may also recommend lifestyle changes such as ongoing aerobic exercise. The medication help manage problems with tremor and movement by increasing the supply of dopamine to the brain and other help to improve the symptoms of the disease. The commonly prescribed drugs are: (1) Carbidopa-levodopa. Levodopa is a natural chemical that passes into the brain and is converted to dopamine. It is regarded as the most effective treatment for the movement symptoms of the disease. Its side effects include lightheadedness, nausea or involuntary movements after taking high doses.
(2) Dopamine agonists can also be used for treatment. They mimic the effect of dopamine in the brain. They supplement the lost functions as the neurotransmitters die. Its side effects are nausea, involuntary movement, hallucinations, sleepiness, swelling and compulsive behaviors such as hyper-sexuality, eating and gambling. Parkinson’s Disease 3) Amantadine is also another drug that may be prescribed. It is used as a short-term relief of the symptoms during the early stages. Its side effects include purple mottling of the skin, hallucinations or swelling. 4) MAO-B inhibitors.
They inhibit the enzyme that crush levodopa, thus improving its action. Some of its side effects include; hallucination, possible interactions with antidepressants and blood pressure issues. Other medications available include anticholinergics and catechol O-methyltransferase (COMT) inhibitors.
Deep brain stimulation surgery can also be offered to people with advanced disease and have shown unstable medication responses.
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