Parkinson’s disease

          Parkinson’s disease

Alok Srivastava

 

                                     Chapter 1

     Introduction:

Parkinson’s disease is the most common movement disorder. It is neurodegenerative disorder. It is a progressive disease, it gets worse over time. In which, we can observe loss of muscle control, which leads to trembling of the limbs and head while at rest, stiffness, slowness, and impaired balance. As symptoms worsen, it may difficult to walk, talk and Parkinson is a progressive brain disorder that affects mobility and mental ability. Parkinson’s disease affects the nerve cells in the brain that produce   They develop slowly and often go unnoticed by family, friends ,and even the person who has them. Parkinson’s disease is a progressive disorder of the nervous system tha affects movement. It develops gradually, sometimes starting with barely noticeable tremor in just one hand. But while a tremor may be the most well known  sign of Parkinson disease, the disorder also commonly causes stiffness or slowing of movement.

In early stages of Parkinson’s disease , your face may show little or no expression, or your arms may not swing when you walk. Your speech may  may become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over time. Although Parkinson’s disease can’t be cured, medications may markedly improve your symptoms.  Parkinson’s disease symptoms and signs may vary differ from person to person. They also change as the  disease progresses Symptoms that one person gets in the early stages of the disease, another person may not get until later-or not at all. Parkinson’s disease was named after the British doctor James Parkinson who in 1817 first described disorder in great detail as “ shaking  palsy.” Parkinson’s disease can affect when you move. Actually, our nerve cells make an important chemical called dopamine.

Dopamine sends signals to the part of your brain that controls your movement.

 

Chapter 2 

Parkinson’s signs and symptoms : 

Tremor : A tremor, or shaking , usually begins in a limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill- rolling tremor. One characteristic of Parkinson’s disease is a tremor of your hand when it is relaxed at rest.

Slowed movement : Over time, Parkinson’s disease may reduce your ability to move and slow your movement, making simple tasks difficult and time consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.

Rigid muscles: Muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause your pain.

Impaired posture and balance : Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.

Loss of  automatic movements : In Parkinson’s disease, you  may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.

Speech changes :  You may have speech problems as a result of  Parkinson’s disease . You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.

Writing changes: It may become hard to write, and your writing may appear small.

Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to signs of Parkinson’s disease.

The cause of Parkinson’s disease is unknown, but several factors appear to play a role, including:

  • Your genes.Researchers have identified specific genetic mutations that can cause Parkinson’s disease, but these are uncommon except in rare cases with many family members affected by Parkinson’s disease.

However, certain gene variations appear to increase the risk of Parkinson’s disease but with a relatively small risk of Parkinson’s disease for each of these genetic markers.

  • Environmental triggers.Exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s disease, but the risk is relatively small.

Researchers have also noted that many changes occur in the brains of people with Parkinson’s disease, although it’s not clear why these changes occur. These changes include:

  • The presence of Lewy bodies.Clumps of specific substances within brain cells are microscopic markers of Parkinson’s disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson’s disease.
  • Alpha-synuclein is found within Lewy bodies.Although many substances are found within Lewy bodies, scientists believe an important one is the natural and widespread protein called alpha-synuclein (A-synuclein). It’s found in all Lewy bodies in a clumped form that cells can’t break down. This is currently an important focus among Parkinson’s disease researchers.

Risk factors

Risk factors for Parkinson’s disease include:

  • Young adults rarely experience Parkinson’s disease. It ordinarily begins in middle or late life, and the risk increases with age. People usually develop the disease around age 60 or older.
  • Having a close relative with Parkinson’s disease increases the chances that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson’s disease.
  • Men are more likely to develop Parkinson’s disease than are women.
  • Exposure to toxins.Ongoing exposure to herbicides and pesticides may put you at a slightly increased risk of Parkinson’s disease.

Complications

Parkinson’s disease is often accompanied by these additional problems, which may be treatable:

  • Thinking difficulties.You may experience cognitive problems (dementia) and thinking difficulties, which usually occur in the later stages of Parkinson’s disease. Such cognitive problems aren’t very responsive to medications.
  • Depression and emotional changes.People with Parkinson’s disease may experience depression. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson’s disease.

You may also experience other emotional changes, such as fear, anxiety or loss of motivation. Doctors may give you medications to treat these symptoms.

  • Swallowing problems.You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
  • Sleep problems and sleep disorders.People with Parkinson’s disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day.

People may also experience rapid eye movement sleep behavior disorder, which involves acting out your dreams. Medications may help your sleep problems.

  • Bladder problems.Parkinson’s disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
  • Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.

You may also experience:

  • Blood pressure changes.You may feel dizzy or lightheaded when you stand due to a sudden drop in blood pressure (orthostatic hypotension).
  • Smell dysfunction.You may experience problems with your sense of smell. You may have difficulty identifying certain odors or the difference between odors.
  • Many people with Parkinson’s disease lose energy and experience fatigue, and the cause isn’t always known.
  • Many people with Parkinson’s disease experience pain, either in specific areas of their bodies or throughout their bodies.
  • Sexual dysfunction.Some people with Parkinson’s disease notice a decrease in sexual desire or performance.

 

                             Chapter 3

Prevention

Because the cause of Parkinson’s is unknown, proven ways to prevent the disease also remain a mystery. However, some research has shown that caffeine — which is found in coffee, tea and cola — may reduce the risk of developing Parkinson’s disease. Green tea also may reduce the risk of developing Parkinson’s disease.

Some research has shown that regular aerobic exercise may reduce the risk of Parkinson’s disease.

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Parkinson’s signs and symptoms :

  1.  .Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. …

2 .  .Slowed movement ..

  1. .Rigid muscles. …

4 .  Impaired posture and balance. …

  1. Loss of automatic movements. …
  2. Speech changes. …
  3. Writing changes
  4. .uncontrollable shaking and tremors.
  5. .slowed movement (bradykinesia)

10 .balance difficulties and eventual problems standing up.

11 .stiffness in limbs

  • Stiff muscles (rigidity) and aching muscles. One of the most common early signs of Parkinson’s is a reduced arm swing on one side when you walk. This is caused by rigid muscles. Rigidity can also affect the muscles of the legs, face, neck, or other parts of the body. It may cause muscles to feel tired and achy.
  • Slow, limited movement, especially when you try to move from a resting position. For instance, it may be hard to get out of a chair or turn over in bed.Weakness of face and throat muscles. It may get harder to talk and swallow. You may choke; cough or drool. Speech becomes softer and monotonous. Loss of movement in the muscles in the face can cause a fixed, vacant facial expression, often called the “Parkinson’s mask.”

Difficulty with walking and balance. A person with this disease is likely to take small steps and shuffle with his or her feet close together, bend forward slightly at the waist, and have trouble turning around. Balance and posture problems may cause frequent

Be careful

1.You help maintain the quality of life for person

2 .You educate yourself about symptoms, treatments, and the progression of the disease.

  1. You keep track of appointments with the doctor, medication schedules, and exercise.

No cure for Parkinson’ disease

Yes,There’s currently no cure for Parkinson’s disease, but treatments are available to help relieve the symptoms and maintain your quality of life. These treatments include: supportive therapies – such as physiotherapy. Medication

No special test for Parkinson’s disease

There is no objective test (such as a blood test, brain scan or EEG) to make a definitive diagnosis of Parkinson’s disease. Instead, a doctor takes a careful medical history and performs a thorough neurological examination, looking in particular for two or more of the cardinal signs to be present. There is no lab test for Parkinson disease. So it can be difficult to diagnose. Doctors use medical history and a neurological  examination to diagnose it.

 

Weight loss is common in Parkinson’s patients

Parkinson’s is a chronic and progressive disease marked by tremors, impaired coordination, and slowness and/or stiffness. The cause and cure are unknown. Weight loss is common in Parkinson’s patients, according to background information from the study.

                       Is stress caused  for Parkinson’s disease

All persons experience psychological stress. . Although the impact of psychological stress onParkinson’s disease  has yet to be fully defined, there is ample evidence that PD symptoms worsen during times of stress.

The best treatment for Parkinson disease

1.Carbidopa-levodopa. …

2..Carbidopa-levodopa infusion. …

3..Dopamine agonists. …

4..MAO-B inhibitors. …

5.Catechol-O-methyltransferase (COMT) inhibitors. …

6.Anticholinergics. …

7.Amantadine

 

                                       Chapter 4   

Foods are good for Parkinson Disease

  1. vegetables: artichokes, okra, kale, bell peppers, potatoes.
  2. fruits: berries, pears, apples, grapes.
  3. grains.
  4. eggs.
  5. legumes: kidney beans, edamame, lentils.
  6. nuts: pecans, walnuts, hazelnuts.
  7. dark chocolate.
  8. some beverages such as red wine, coffee and tea.

 

 Yes,  there is pain with Parkinson’s disease

The types of pain associated with Parkinson’s include: aching or burning pain from muscles or skeleton, sharp pain from a nerve or nerve root, numbness or “pins and needles” pain also radiating from a nerve or nerve root, pulsing or aching pain that results from tightness or ongoing twisting and writhing movements.

 

The treatment options for Parkinson’s disease

 Dopaminergic medications reduce rigidity (muscle stiffness), improve speed, help with coordination, and lessen tremor (shaking).

Levodopa – the most effective Parkinson’s drug; is absorbed by the nerve cells in the brain and turned into dopamine

 

The most common drug in the treatment for Parkinson’s disease

Levodopa and carbidopa (Sinemet). Levodopa (also called L-dopa) is the most commonly prescribed medicine for Parkinson’s. It’s also the best at controlling the symptoms of the condition, particularly slow movements and stiff, rigid body parts.Levodopa works when your brain cells change it into dopamine.

 

Side effects of Parkinson’s medication

  1. mild nausea, dry mouth, loss of appetite, heartburn, diarrhea, constipation;
  2. headache, dizziness, drowsiness, blurred vision;

3.sneezing, stuffy nose, cough, or other cold symptoms;

4 .sleep problems (insomnia), strange dreams;

  1. muscle pain, numbness or tingly feeling;

 

What foods should be avoided when taking levodopa

 

Avoid taking iron supplements or eating a diet that is high in protein (protein sources include meat, eggs, and cheese). These things can make it harder for your body to digest and absorb carbidopa and levodopa.

 

How long does it take for levodopa to work?

When levodopa is taken 30-60 minutes before a meal, many people notice an improvement beginning after about 30 minutes. Most people with Parkinson’s disease note that benefit of levodopa lasts about 3-5 hours, but the duration of benefit may range from as long as a day to as short as an hour.

 

What are the long term effects of Parkinson’s disease?

  1. Problems with gait and balance, including falls.

2, Difficulty communicating (speech impairment)

3.Swallowing difficulty.

  1. Weight loss.

5  .Cognitive impairment (thinking, memory) and behavioral problems.

 

Chapter 5

Parkinson’s disease is curable.

there is no cure for Parkinson’s disease. But  in my opinion, identifying individual symptoms and determining a proper course of treatment, most people with the disease can live enjoyable, fulfilling lives.

 

I now know that I was not the only one being told early on to think twice about attending a support group. In hindsight, this was a missed opportunity for community.Going at it alone only added to the stigma attached to Parkinson’s that keeps many of us silent. With the constant worry about getting worse and thus, being found out, it wasn’t long before.

With the support of my family, in time I let go of my Parkinson’s secret and began to engage with others in the Parkinson’s community As I began to do this for other newly diagnosed people with Parkinson’s, I discovered my inbox was suddenly full of people whose stories were identical to mine: scared and alone, often keeping their diagnosis secret and knowing no one else that was with living with Parkinson’s. Many were not sure what to ask their physician. Almost everyone wanted to know what I was doing to stay well. Looking back, I see now that these conversations were the spark for my dream of opening a center to help people to live well with Parkinson’s.

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A center provides our local community of people with Parkinson’s and other movement disorders a place to turn for physical, emotional and spiritual support where the stigma of Parkinson’s is left at the door, and everyone is encouraged to take charge of their well-being. The center offers a variety of exercise classes such as dance, cycling and boxing, to name just a few of the activities that help clients strengthen their bodies. A center  also has art and music therapy, as well as a drumming circle to soothe the mind and spirit. A peer program and separate support groups for people living with Parkinson’s and their care partners complement the classes. I also hosts expert presentations to help bring the latest movement disorder research and news to light.

The wellness center provides a common ground along with fresh energy and hope, which reinvigorates entire families. Every day, many newly diagnosed people that have not even thought about exercising in years enter our circle of support, creating new friendships and building community.

We face this disease together, with grit and determination. We sweat, we sing, we laugh, and occasionally, we even have to help each other up off the floor. What makes this group so special is that we know that it is working. The impact is evident in our improved outlooks, better health and more knowledgeable and invigorated Parkinson’s community.

In my experience, the Parkinson’s community is one that knows how to roll up their sleeves to get things done. There are many things within your reach if you feel inspired to try. I have friends who started support groups where none previously existed. Groups bring many voices to the table and from there, ideas become reality. There are a growing number of specialized Parkinson’s exercise programs to choose from, some of the more widely known including: I know many people who have been given space for their Parkinson’s classes at the local , in boxing gyms and in community centers simply because they asked. It turns out that folks can be quite generous.

My best advice for how to begin making a difference in your community is this: share your story. Almost everyone knows someone that is living with Parkinson’s, many of whom are looking for someone to talk to. Be the one who starts the dialogue in your community, and that might lead to something bigger than yourself.

-packed with up-to-date information about everything Parkinson’s, plus an expanded worksheets and resources section to help you put what you’ve learned into action.

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