PARKINSON'S DISEASE

Definition

Parkinson's disease is a neurological disease of unknown aetiology. Parkinson's patients often exhibit a "shuffling" gait, tremor of the limbs when they are at rest, increased resistance to passive movement, stooped posture, and stiffness. Some individuals also experience cognitive impairment/dementia. A deficiency of dopamine, an important chemical transmitter in certain brain cells governing movement, balance and walking, is considered responsible for the primary disease symptoms.

Facts

It is estimated that Parkinson's disease affects one million people in the United States. Most commonly striking people over the age of 50, Parkinson's disease now occurs in about 200 people per 100,000 population.

Symptoms

Primary symptoms include rigidity, tremor, slow movement (bradykinesia) or loss of movement (akinesia) and difficulty with balance and walking. There are always two primary symptoms present when a diagnosis of Parkinson's disease is made.

Secondary symptoms: Parkinson's disease patients may also experience some secondary symptoms such as depression, constipation, weight loss, sleep disturbances, cognitive impairment, forced eye-lid closure, drooling, difficulty with speech, swallowing, voiding and problems with sexual performance.

Diagnosis

Although there are no specific tests for Parkinson's disease, there are several ways of making a diagnosis. Usually a diagnosis is based on a neurological exam which covers evaluation of the symptoms and their severity. If symptoms are serious enough, a trial test of anti-Parkinson's drugs may be indicated. Also when indicated, brain scans may be made to rule out other diseases whose symptoms resemble Parkinson's disease.

Treatment

There is no cure for Parkinson's disease at this time. If the disease progresses beyond minor symptoms, drug treatment may be indicated. The most commonly prescribed medication is L-DOPA (levodopa) which helps replenish some of the lost dopamine. Other drugs, designed to stimulate the dopamine system or mimic its controlling effect on other nerve cells, are used, such as bromocriptine, pergolide, selegilene and trihexyphemidye.

Levodopa is considered the most effective drug at this time. Sinemet, a combination of levodopa and carbidopa, is usually the drug most doctors use to treat Parkinson's disease patients.

Care for Parkinson's patients includes a well-balanced diet and regular exercise. Physical therapy or surgery may also be indicated for some patients.