Causes and risk factors
In Parkinson’s disease certain nerve cells [neurons] get damaged or die. These neurons are responsible for secreting a chemical [neurotransmitter] dopamine. Due to damaged neurons there is lack of dopamine secretion causing altered brain activity leading to Parkinson’s disease. Exposures to certain chemicals or toxins, genetic predisposition to Parkinson’s disease are some contributing factors. Increased age [Above 60 years] is an important risk factor. Men are commonly affected than women.
Clinical presentation
Symptoms of Parkinson’s disease vary with every individual and the stage of disease. It is initially unilateral followed by bilateral affection. The most common symptoms are tremors or shaking, bradykinesia (slow, limited movements), and muscle stiffness or rigidity. Disease begins with aching in limbs, mental slowness, depression, small handwriting. Resting tremor in upper limb is commonly seen. Tremors affect lower limbs, tongue. Bradykinesia develops slowly. Rapid fine movements are affected. Difficulty in putting buttons, shaving, and writing is experienced by the patient. Gait is disturbed. Patient walks with rapid small steps [festination]. Rigidity causes stiffness of muscles and flexed posture. Muscles become weak. ‘Cogwheel rigidity’ seen in upper limb or ‘lead pipe rigidity’ is a marked feature seen in lower limbs. As the disease progresses speech becomes indistinct and soft. Lack of facial expressions, loss of blinking of eyelids is observed due to poor muscle coordination.
Investigation
There is no test for diagnosis of disease and early diagnosis is a real challenge. Diagnosis depends on neurologic examination and medical history by the patient. Symptoms like tremors, slow movements, stiffness, gait disturbance etc help to diagnose. CT scan, MRI may be done to rule out other possible diseases. Patients presenting before the age of 50 are tested for Wilson’s disease.
Treatment
There is no treatment to cure Parkinson’s disease. There are some therapies to delay the onset of motor (muscle-related) symptoms by mimicking dopamine or replacing dopamine. Surgery- stereotactic thalamotomy may be an option to treat tremors. Deep brain stimulation [DBS] is being aggressively practised where electrodes are placed in the brain to send signals or for stimulation and muscle coordination. Supportive care is given to manage the patient of Parkinson’s disease. Physiotherapy and speech therapy contribute further to the treatment.
Other Modes of treatment
The other modes of treatment can also be effective in treating Parkinson’s disease.
Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Parkinson’s disease.
Recent updates
Stem cell therapy is being studied and proved useful to create new dopamine cells when transplanted in the brain of Parkinson’s patient.
Facts and figures
Statistics shows worldwide 4 to 6 million suffer from this disease.
