 Parkinson’s disease is a progressive disorder of the central nervous system that can have devastating effects upon both the patient and their family members. The main features of Parkinson’s disease are slowness of movements, difficulty maintaining balance, muscle rigidity, and tremor. The disease is thought to be caused by low levels of a chemical called dopamine, which activates cells in our brains that let us move. While there is currently no cure for Parkinson’s disease, there are a variety of treatments available that can help to improve symptoms. Symptoms of Parkinson’s diseaseMost of the symptoms of the disease involve disruption of motor functions (muscle and movement). However, lack of energy, mood and memory changes, and pain can also occur as part of the disease. Primary symptoms of Parkinson’s disease
Slow movement (Bradykinesia) –
slowness in voluntary movement such as standing up, walking, and
sitting down. This happens because of delayed transmission signals from
the brain to the muscles. This may lead to difficulty initiating
walking, but in more severe cases can cause “freezing episodes” once
walking has begun.
Tremors – often occur in the hands, fingers, forearms, foot, mouth, or chin. Typically, tremors take place when the limbs are at rest as opposed to when there is movement. Rigidity – otherwise known as stiff muscles, often produces muscle pain that is increased during movement. Poor balance –happens because of the loss of reflexes that help posture. This causes unsteady balance, which can often lead to falls. Diagnosing Parkinson’s disease
There
are no lab tests that can definitively diagnose Parkinson’s disease. A
systematic neurological exam will include testing your reflexes and
observing things like muscle strength throughout your body,
coordination, balance, and other details of movement. These tests are
also necessary to rule out other conditions, such as nerve dysfunction,
narrowing of the spinal canal, or other types of tremor. Your doctor may
also order tests, such as blood or urine tests or CT or MRI scans, to
exclude the possibility of these other disorders.
Treatment of Parkinson’s disease
There
is no cure for Parkinson’s disease; however, there are several
medications and other types of treatment available to address the
symptoms of the disease.
Commonly used medications for Parkinson’s disease
Levodopa/Carbidopa (Sinemet) -
This is a combination of Levodopa (the chemical that patients with
Parkinson’s disease lack) and Carbidopa (a chemical that helps the
levodopa reach the brain). It works very well for controlling symptoms
for most patients but can cause some side effects, especially after
several years. Its effectiveness tends to decrease after several years.
Entacapone (Comtan) -
This is a medication that helps Sinemet work better when it starts to
lose its effectiveness. It is also available together with levodopa and
carbidopa in a combined product called Stalevo.
Dopamine agonists -
These include ropinorole (Requip) and pramipaxole (Mirapex),
medications designed to enhance your body’s natural production of
dopamine by stimulating your brain to produce more. They do not have as
much risk of long-term side effects as levodopa, and they have less
chance of losing effectiveness over time. However, they can cause
dizziness and hallucinations, especially in the elderly or in patients
with dementia. These factors make the agonists more suitable medications
for younger patients. There is some theoretical evidence that the
agonists may slow the progression of Parkinson’s disease, but scientists
have not proven this definitively.
Monoamine oxidase inhibitors -
These include selegiline (Eldepryl and Zelapar) and rasagaline
(Azilect). These are less commonly used types of medication that
increase the amount of dopamine available in the brain. They can be very
helpful in a small number of patients with Parkinson’s disease. These
medications often have fewer side-effects than the dopamine agonists but
can be harmful when used together with certain other medications,
especially some types of antidepressants. Patients can also develop
critically elevated blood pressure when combining these medications with
certain types of foods.
Surgical treatment for Parkinson’s disease
There
are some surgical options for patients with Parkinson’s disease, the
most common of which is known as Deep Brain Stimulation (DBS). This form
of surgery is sometimes used to help reduce the severity of muscle
rigidity and slowness of movements. DBS involves placing a wire into the
brain connected to a pacemaker-type device implanted just below the
skin in the chest.
Other helpful treatments for Parkinson’s disease
If
you have been diagnosed with Parkinson’s disease, you can help keep
yourself as healthy and safe as possible by taking certain precautions.
Physical therapy is often recommended and almost always beneficial.
Group wellness programs and other support groups for patients with Parkinson’s disease unite you with other people facing the same challenges. This can greatly help with feelings of isolation and depression that affect many Parkinson’s patients.
Exercise can also ease symptoms.
Research shows that patients with Parkinson’s disease who exercise
regularly do better than those who don’t. Any type of physical activity
that raises your heart rate can be beneficial.
1. Before starting an exercise regime, you should always check with your doctor.Exercise tips for people with Parkinson’s disease:2. Pursue physical and occupational therapy. 3. Exercise your face and jaw whenever possible. 4. Practice bending, stretching, and breathing exercises. 5. Try exercising in bed; it may be easier than on the floor. 6. Build your walking skills, even if that means having to hold onto something. 7. Try exercising in the water; it is easier on the joints. Tips for diet and eating:
Cut foods into smaller portions to avoid choking and to encourage digestion.
Remain upright for 30 minutes after eating. For upset stomachs linked to medication, try eating a small amount of non-protein based food before taking medication. Protein may block your body’s ability to absorb levodopa (Sinemet), so you may need to avoid taking this medication within 30 minutes before to 1 hour after eating meat or other high-protein foods. |
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