Parkinsons Disease - Well known Causes and Symptoms - Diseases Treatment - Symptoms, Causes and Cure for Diseases on A to Z

What do doctors call this condition?

Parkinsonism, paralysis agitans, shaking palsy

What is this condition?

Named for James Parkinson, the English doctor who wrote the first accurate description of the disease in 1817, Parkinson's disease is a slowly progressive movement disorder that characteristically produces muscle rigidity, loss or absence of voluntary motion (akinesia), and involuntary tremors.

One of the most common crippling diseases in the United States, Parkinson's disease affects men more often than women, and strikes 1 in every 100 people over age 60. Because of increased longevity, this amounts to roughly 60,000 new cases diagnosed annually in the United States alone.

What causes it?

Although the cause of Parkinson's disease in unknown, studies of the brain have established that a deficiency of a neurotransmitter, dopamine, prevents brain cells from performing their normal function within the central nervous system.

Parkinsons Disease symptoms?

The cardinal symptoms of Parkinson's disease are muscle rigidity and akinesia and an insidious tremor that begins in the fingers (unilateral "pill-roll" tremor), increases during stress or anxiety, and decreases with purposeful movement and sleep. Muscle rigidity results in resistance to passive muscle stretching, which may be uniform or jerky.

Akinesia causes the person with Parkinson's disease to walk with difficulty, either bent backward or falling forward.

Akinesia also produces a high-pitched, monotone voice; drooling; a masklike facial expression; loss of posture control; and difficulty swallowing or speaking (or both). Occasionally, the person's eyes are fixed upward, with involuntary tonic movements, or the eyelids are completely closed. Parkinson's disease itself doesn't impair the intellect, but a coexisting disorder, such as arteriosclerosis, may do so.

How is it diagnosed?

Lab tests are not usually helpful in identifYing Parkinson's disease, so the diagnosis is based on the person's age and history, and the characteristic clinical picture of the disease. However, a urinalysis may support the diagnosis by revealing decreased dopamine levels. A conclusive diagnosis is possible only after ruling out involutional depression, cerebral arteriosclerosis, other causes of tremor and, in people under age 30, intracranial tumors, Wilson's disease, or toxicity from phenothiazine or other drugs.

How is it treated?

Because there's no cure for Parkinson's disease, the primary aim of treatment is to relieve symptoms and keep the person functional as long as possible. Treatment consists of drugs, physical therapy and, in severe cases unresponsive to drugs, neurosurgery.

Drug therapy usually includes Larodopa, a dopamine replacement that's most effective during early stages of the disease. It's given in increasing doses until symptoms are relieved or side effects appear. Because side effects can be serious, a combination drug­Sinemet-is frequently given. When Larodopa proves unsuitable, alternative drug therapy includes anticholinergics, such as Artane; antihistamines, such as Benadryl; and Symmetrel, an antiviral agent. Eldepryl, an enzyme-inhibiting agent, allows conservation of dopamine and enhances the therapeutic effect of Larodopa.

When drug therapy fails, stereotactic neurosurgery may be an alternative. In this procedure, electrical coagulation, freezing, radioactivity, or ultrasound is used to inactivate a small, specific portion of the brain to prevent involuntary movement. This is most effective in young, otherwise healthy people with unilateral tremor or muscle rigidity. However, neurosurgery can only relieve symptoms.

Individually planned physical therapy complements drug treatment and neurosurgery to maintain normal muscle tone and function

What can a person with Parkinson's disease do?

If you have difficulty eating, eat frequent small meals to increase your caloric intake.

To help establish a regular bowel elimination routine, drink plenty of fluids and eat high-fiber foods.

If you have trouble moving from a standing to a sitting position, consider installing an elevated toilet seat.

If you have excessive tremors, you may achieve partial control of your body by sitting on a chair and using its arms to steady yourself.

Remember that fatigue may cause you to depend more on others.

As instructed by your doctor, use proper positioning to help prevent bed sores and contractures .

If you're taking Larodopa, follow your doctor's instructions on which foods to avoid (such as multivitamin preparations and fortified cereals) .

Take household safety measures to prevent accidents.

For more information, contact the National Parkinson Foundation or the United Parkinson Foundation.