Thursday, December 4, 2008



Here is a video of a local newstation running a segment about Parkinson's Disease and its symptoms. It shares celebrities who have been diagnosed with this disease as well as the effect of medicine on patients.

Parkinson’s Disease is a progressive degenerative disease that destroys a part of the brain, in particular the midbrain’s basal ganglia, and it helps to control movement. Millions of people have it now. Rare before the age of 40, 1% over the age of 65, and 2.5% of people over the age of 80. Parkinson's Disease peaks between 70-79 years of age and is twice a common in men compared to women. The basal ganglia release dopamine, a chemical to help control movement in the body. In Parkinson's Disease, there is a lack of dopamine release from the basal ganglia to the key movement center of the brain. Symptoms: Falling down, change in walking, worsening of handwriting, slowing down in movement, resting tremor that goes away with movement. Fatigue, dementia, even psychosis. Signs: 1) A resting tremor. Pill rolling tremor is seen so the thumb and index finger look like they are rolling a small marble. 2) Rigidity. On exam, while extending the arm it looks like a cogwheel movement – an unsmooth mechanical motion. 3) Akinesia, meaning lack of movement. Even the face is blank, called a masked face. 4) Gait disturbance, so turning around can call a fall. Shuffling the feet occurs. Treatment: no cure unfortunately. Medications don’t slow down this progressive disease. But researchers are working on drugs to slow it down. For symptom treatment, levodopa (such as Sinemet) is used to replete the lack of dopamine in the brain. MAO B inhibitor, such as selegiline, is used – and you hear all the pharmaceutical commercials say, “Don’t use our drug if you take an MAOi.” Dopamine receptor agonists include Mirapex, Requip, Parlodel, and Permax. Also anticholinergics can be helpful in Parkinson's Disease, such as amantadine and Cogentin. COMT inhibitors (Tasmar, Comtan) are used to assist levodopa drugs, because levodopa tends to “wear off” between dosings and after 5 years usually aren’t as effective as once before. In postmenopausal women, estrogen might be helpful – but then there is increased risk of heart attack, blood clot, and breast cancer. Surgical procedures are still being investigated

Wednesday, December 3, 2008

Hope

http://www.theindychannel.com/health/17947888/detail.html?rss=ind&psp=health

This breakthrough in a cure for Parkinson's diease by Cornell University brings hope to all those who are diagnosed. They tried an "experimental gene therapy procedure in which doctors injected enzymes depleted by the disease back into their brains." These recent findings will have to be legitimized, but after treating many lab animals, this process is destined for success for both doctors and patients.

Symptoms

Various other symptoms accompany Parkinson's disease; some are minor, others are more bothersome. Many can be treated with appropriate medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person. None of these symptoms is fatal, although swallowing problems can cause choking.

Depression: This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Depression may not be severe, but it may be intensified by the drugs used to treat other symptoms of Parkinson's disease. Fortunately, depression can be successfully treated with antidepressant medications.
Emotional changes: Some people with Parkinson's disease become fearful and insecure. Perhaps they fear they cannot cope with new situations. They may not want to travel, go to parties, or socialize with friends. Some lose their motivation and become dependent on family members. Others may become irritable or uncharacteristically pessimistic. Memory loss and slow thinking may occur, although the ability to reason remains intact. Whether people actually suffer intellectual loss (also known as dementia) from Parkinson's disease is a controversial area still being studied.
Difficulty in swallowing and chewing: Muscles used in swallowing may work less efficiently in later stages of the disease. In these cases, food and saliva may collect in the mouth and back of the throat, which can result in choking or drooling. Medications can often alleviate these problems.
Speech changes: About half of all parkinsonian patients have problems with speech. They may speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. A speech therapist may be able to help patients reduce some of these problems.
Urinary problems or constipation: In some patients bladder and bowel problems can occur due to the improper functioning of the autonomic nervous system, which is responsible for regulating smooth muscle activity. Some people may become incontinent while others have trouble urinating. In others, constipation may occur because the intestinal tract operates more slowly. Constipation can also be caused by inactivity, eating a poor diet, or drinking too little fluid. It can be a persistent problem and, in rare cases, can be serious enough to require hospitalization. Patients should not let constipation last for more than several days before taking steps to alleviate it.
Skin problems: In Parkinson's disease, it is common for the skin on the face to become very oily, particularly on the forehead and at the sides of the nose. The scalp may become oily too, resulting in dandruff. In other cases, the skin can become very dry. These problems are also the result of an improperly functioning autonomic nervous system. Standard treatments for skin problems help. Excessive sweating, another common symptom, is usually controllable with medications used for Parkinson's disease.
Sleep problems: These include difficulty staying asleep at night, restless sleep, nightmares and emotional dreams, and drowsiness during the day. It is unclear if these symptoms are related to the disease or to the medications used to treat Parkinson's disease. Patients should never take over-the-counter sleep aids without consulting their physicians.

www.athealth.com/Consumer/disorders/parkinsons.html
How do Doctors Diagnose Parkinson's Disease?
Even for an experienced neurologist, making an accurate diagnosis in the early stages of Parkinson's disease can be difficult. There are, as yet, no sophisticated blood or laboratory tests available to diagnose the disease. The physician may need to observe the patient for some time until it is apparent that the tremor is consistently present and is joined by one or more of the other classic symptoms. Since other forms of parkinsonism have similar features but require different treatments, making a precise diagnosis as soon as possible is essential for starting a patient on proper medication.

http://www.parkinsons.org.pk/whatisparkinsons/what.html