Parkinson’s Disease
Parkinson's disease is a progressive brain disorder that causes slow movement, muscle stiffness, and problems with balance and posture.
What is Parkinson's disease?
Parkinson's disease is a neurodegenerative disorder caused by the destruction of dopamine-producing neurons in the substantia nigra region of the brain. Dopamine is a crucial neurotransmitter that facilitates precise movement coordination in the basal ganglia. Symptoms become evident typically after 60-80% of dopamine-producing neurons are lost, and Lewy bodies are often observed in pathological examinations. It is the second most common neurodegenerative disorder after Alzheimer's disease and has a higher incidence in individuals over the age of 60.
Parkinson's disease presents with both motor and non-motor symptoms, which include:
Motor Symptoms:
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Tremor (trembling): Typically occurs at rest, known as "resting tremor."
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Rigidity: Muscles become stiff, often accompanied by pain.
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Bradykinesia: Slowed movement, reduced ability for fine motor control.
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Postural instability: Difficulty maintaining posture and balance.
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Stooped posture: Characterized by bent neck, waist, elbows, and knees.
Non-Motor Symptoms:
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Neuropsychiatric symptoms: Depression, anxiety, apathy, hallucinations.
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Cognitive impairment: Similar to dementia, with fluctuating cognitive function.
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Autonomic nervous system dysfunction: Orthostatic hypotension, constipation, urinary dysfunction, sexual dysfunction.
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Sleep disorders: Insomnia, REM sleep behavior disorder.
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Urinary dysfunction: Urinary urgency, nocturia.
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Other symptoms: Pain, sensory deficits, fatigue, loss of sense of smell.
Diagnosis of Parkinson's disease relies primarily on specialist examination, with MRI or PET scans providing supplementary assistance.
Parkinsonian syndrome and secondary Parkinsonism are often referred to as 'cousins' of Parkinson's disease. Parkinsonian syndrome presents with symptoms associated with progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration, and Lewy body dementia, which are distinct disorders.
Secondary Parkinsonism manifests as a secondary form of Parkinson's symptoms due to various causes such as drug-induced, vascular, normal pressure hydrocephalus, brain tumors, and toxic substances.
Treatment options for Parkinson's disease include:
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Medication Therapy: Using dopamine replacement therapies or medications that enhance dopamine function.
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Surgical Therapy: Procedures such as Deep Brain Stimulation (DBS), which involves stimulating specific areas of the brain.
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Physical Therapy: Exercise programs aimed at improving motor skills and balance.
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Occupational Therapy: Training to improve daily living functions.
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Speech Therapy: Improving speech and swallowing functions.
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Lifestyle Modifications: Enhancing quality of life through nutrition management, stress reduction, and ensuring adequate sleep.
These comprehensive treatments work together to improve the quality of life for patients with Parkinson's disease.