The degeneration of cells of substantia nigra, a section of the brain results into Parkinson’s disease. These cells project into the basal ganglia, which ensures smooth muscle movements. The cells in the substantia nigra produce a neuro-transmitter or a chemical that transmits nerve impulses, which is known as dopamine. Dopamine acts with acetylcholine – another neuro-transmitter that fine-tunes muscle control. In this disease, the level of dopamine is reduced as compared to levels of acetylcholinem, and this results into impairment of the control of muscles.
Parkinson’s disease usually occurs after the age of 60, and is more common in men than in women. The exact cause of Parkinson’s disease is not yet known, but there are chances that it may run in the family and genetic factors may be involved in some cases.
The term parkinsonism is used for symptoms of Parkinson’s disease when they are due to an underlying disorder or certain drugs. Repeated head injuries or some anti-psychotic drugs used to treat severe psychiatric illnesses, increase the chance of occurrence of parkinsonism.
Parkinsonism may show a gradual or sudden onset depending upon the cause. Moreover, the main symptoms of Parkinson’s disease or parkinsonism may develop either gradually over the years or it may take just a few months.
- Your hand becomes shaky or you feel tremors in one hand, arm or leg usually while resting. This may later occur on both the sides.
- Muscles may become stiff, making the movements difficult.
- There is decrease in movements or the movements become slow.
- Shuffling walk without arm swing.
- An expressionless or mask-like face.
- Stooped posture.
As time passes and the disease progresses, the problem of stiffness, immobility and constant trembling of hand may increase. Due to this you may find it difficult to perform daily tasks. It may affect other functions like speech may become slow and hesitant, and swallowing may become difficult. There are chances that the person may go into depression due to restricted movements. Around 30% of the people with Parkinson’s disease may eventually develop dementia.
Parkinson’s disease is difficult to diagnose at first due to the slow development of its symptoms or parkinsonism. For parkinsonism, the doctor may ask you to go for CT scanning or MRI to exclude other possible causes. If a specific underlying disorder is found, you will be diagnosed as having parkinsonism rather than Parkinson’s disease.
Drug treatment: During the early stages of Parkinson’s disease, when the disease is mild, it may be difficult to give any treatment, as drugs cannot change the progression of the disease. Later on, the drugs are used to relieve symptoms and reduce disability by correcting chemical imbalances in the brain. This can be done either by boosting the dopamine levels or by blocking some of the effects of acetylcholine or a combination of both.
An anti-cholinergic drug that can be effective for several years can be given to reduce shaking and stiffness. But, it may cause side-effects such as dry mouth, blurred vision and difficulty in passing urine. These drugs may also cause confusion and thus should be rarely used by elderly people.
Although, Parkinson’s disease can be treated with several drugs available in the market, none of the drugs are effective enough to reverse its progress. However, it may provide some relief from the major symptoms.
Physical treatment: The patient may take physiotherapy to manage the mobility problems or speech therapy for speech and swallowing problems. It’s important to take support of a stick or a person to walk and move around.
Surgical treatment: If the symptoms are not controlled by drugs, the patient may go for a surgery if health permits. In surgery, the doctors may destroy the affected part of the brain tissue that is responsible for the tremors. Therapies still being assessed include replacement of damaged brain cells with transplanted tissue and deep brain stimulation with electrical impulses.
What can be done?
- Take good care of your health in general.
- Simple exercises or regular walks will help you keep your body flexible.
- Emotional and practical help and support from the family and friends can work wonders.
- Update yourself about parkinsonism and Parkinson’s disease.
Prognosis of parkinsonism:
The course of Parkinson’s disease varies, but parkinsonism can be treated with the help of drugs, which can improve the quality of life, though it cannot cure the disease. The patient can live an active life even years after the diagnosis.