Parkinson's Disease

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About

Parkinson's disease is a progressive disorder of the central nervous system affecting more than 1.5 million people in the United States. Clinically, the disease is characterized by a decrease in spontaneous movements, gait difficulty, postural instability, rigidity and tremor.

Parkinson's disease is caused by the degeneration of the pigmented neurons in the substantia nigra of the brain, resulting in decreased dopamine availability. The major symptoms of the disease were originally described in 1817 by an English physician, Dr. James Parkinson, who called it "Shaking Palsy." It was not until the 1960's, however, that pathological and biochemical changes in the brain of patients were identified, opening the way to the first effective medication for controlling the symptoms of the disease.

Men and women alike are affected. The frequency of the disease is considerably higher in the over-60 age group, even though there is an alarming increase of patients of younger age. In consideration of the increased life expectancy in this country and worldwide, an increasing number of people will be victims of Parkinson's disease.

Symptoms

The symptoms of Parkinson's disease may begin so gradually that patients may not even be aware they have the disease. While some may feel they have symptoms, they often do not get checked by a physician until the symptoms become very pronounced. For everyone especially over the age of 50 it is strongly recommended to have regular medical check ups. It is especially important to see a neurologist who can determine early on if a patient exhibits symptoms, even if the patient is unable to notice these symptoms.

A diagnosis of Parkinson's disease is made when a person shows at least 2 of the primary symptoms of the disease, which include:

  • Rigidity
  • Tremor
  • Slow Movement (bradykinesia)
  • Loss of Movement (akinesia)
  • Difficulty with balance and walking
  • Fixed facial expression
  • Gradual loss of spontaneous movement
  • Changed handwriting
  • Decrease in voice volume
  • Disturbances in gait
  • Constipation
  • Decreased sense of smell
  • Depression
  • Inability to initiate bodily movement
  • A tendency to "freeze" in bodily movement

Treatments

Follow Up Care

Medications for Parkinson's Disease
Administration of the drug levodopa has been the standard treatment for Parkinson's disease. Once it reaches the brain, levodopa is converted to dopamine, which replaces the same substance not present in sufficient amounts in Parkinson's patients. However, treatment with levodopa does not prevent the progressive changes of the brain typical of Parkinson's disease. The drug may also produce side effects in some people, due to its change to dopamine before reaching the brain. The simultaneous administration with levodopa of substances inhibiting this change allows a higher concentration of levodopa to reach the brain and considerably decreases the side effects. Some new drugs have recently been approved offering a wider choice of medications for the patient, while others are under investigation in this country and overseas in an effort to obtain better therapeutic results with fewer side effects.