Wockhardt Guide on Parkinson

What is Parkinson's disease?
 

Parkinson's disease is a degenerative neurological disease which primarily attacks specifi c part of the brain (Substantia Nigra) which produces the neurotransmitter, dopamine. It is a chronic (persists over a long period of time), progressive (symptoms worsen with time) disease aff ecting the nervous system.

It is neither contagious nor inherited, although genetic factors may play a role in its development. Other factors may include accelerated or early aging and drug (or toxin) induced interactions.

What is synapse?
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The entire nervous system is made up of individual units called nerve cells. Nerve cells serve as a "communication network" within your body. To communicate with each other, nerve cells use a variety of chemical messengers called neurotransmitters. Neurotransmitters carry messages between nerve cells by crossing the space between cells, called the synapse.

Neurotransmitters also allow the nervous system to communicate with the body's muscles and translate thought into motion. One especially important messenger is dopamine, which is manufactured in the substantia nigra. Dopamine is crucial to human movement and is the neurotransmitter that helps transmit messages to the striatum that both initiate and control your movement and balance. These dopamine messages make sure that muscles work smoothly, under precise control, and without unwanted movement.

What causes Parkinsonism?
 

The cause of Parkinson's diseases is not known. Some researchers believe that it may result from toxins, head traumas or strokes. Parkinson's disease may also have a genetic link. Nerve cells in the part of the brain that produces dopamine, the substantial nigra (an area of the brain that controls movement and balance), begin to decrease in number.

In a normal brain, dopamine allows messages to travel across nerve endings.

In Parkinson's disease, dopamine is missing and the message fails to travel across the nerve connection. The intended body movement is slow or does not happen at all.

What are the symptoms of Parkinson's disease?
 

Onset of Parkinson's disease is subtle and will occur gradually. These may include tiredness, and general slowness of movement and speech. In time, the symptoms become more apparent and can include trembling (tremor), stooped posture, muscular stiffness (rigidity), and short shuffling steps, speaking softly in a rapid tone, poor balance, poor handwriting, and slowness of body movements (Bradykinesia).

Tremors or shaking

A common symptom is incontrollable shaking of a hand or arm on one or both sides of the body. Tremors can also occur in the legs, feet, or chin. Shaking lessens completely during sleep as the aff ected area is used and stops.

Muscle stiffness

Muscles can become tight and rigid as they fail to receive messages from the brain to relax. This can cause muscle ache a stooped posture, and slow movement. Walking may be limited to short, shuffl ing steps, and climbing stairs, getting out of chairs and bed, take extra effort. Often, people with Parkinson's disease become frozen-unable to continue movement at all. In this case, help may be need to resume movement by 'putting a foot in front of the patient to step over' or suggesting that they are 'stepping over lines'

Loss of balance

Parkinson's disease can lead to problems with balance causing the individual to fall over.

Other problems

Other symptoms may include speaking softly in a monotone voice, difficulty with swallowing and writing. Constipation is also a common problem.

Depression, feelings of insecurity and fear often bring distress to the patient and can make it difficult to cope with the illness both for the patient and for relatives.

In addition, up to one third of the patients suffering with Parkinson's disease may develop difficulties with memory, concentration and intellectual ability.

Can Parkinson's disease be cured?
 

While there is presently no cure for Parkinson's disease, available medications control the slow decline in function and manage Parkinson's disease symptoms quite effectively. The types of brain cells that are damaged as a result of the disease have a very limited ability to be repaired. However, drug treatment aims to restore the transfer of electrical information, which helps to alleviate the symptoms of Parkinsonism.

How is Parkinson's disease diagnosed?
 

Making an accurate diagnosis in the early stages of the illness can be difficult. Observation over a period of the time to assess the severity of the symptoms will help to make a distinction between Parkinson's disease and other similar illness.

What is the treatment?

The medication is usually prescribed to ease the symptoms. Treatment is very specific and requires individualization. Treatment selection will depend on age, the stage of disease, and the severity of symptoms.

Medication

The list below includes all the diff erent types of drug approved for use in the treatment of this condition, at the time of publication. Always consult your doctor if you have any questions or concern about the prescribed medication.

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Drug TypeEffect
Anticholinergics (Antimuscarinics)Block Cholinergic receptors to relieve rigidity and tremor
COMT inhibitors body (Catechol-O-methyl tranferase)Block an enzyme in the body which breaks down levodopa.
Dopamine precursor(L-Dopa)Converts to dopamine within the brain cells,replacing the missing neurotransmitters
Dopamine receptor agonists'Stimulate the production of dopamine neurotransmitters or act similarly to them.
MAO-B-Inhibitors (Monoamine oxidase inhibitors)Help to prevent the breakdown of dopamine neurotransmitters.
Other DrugsEffects
Peripheral decarboxylaseUsually given in combination with dopamine.
InhibitorsPrecursor to increase the amount of active medication reaching the brain.
Other Treatment
 

Surgery

In rare cases, if the symptoms are severe and medication given is only of limited help, surgery on the area of the brain that causes the condition may be suggested. Surgery is not a cure, but may help to relieve some of the symptoms of the disease.

Daily exercise and movement

  • Regular activity makes muscles stronger and more flexible.
  • Walking is one of the best methods of exercise and this, combined with medication, will help your general mobility.

Walking and turning

To help you keep your balance, keep your feet apart; take long steps while swinging your arms. Imagine you are stepping over a series of lines, walk in an arc to turn.

Back stretch

Stand or sit with back straight and arms in front, hands and elbows together. Move arms apart as far as possible, pushing shoulder blades together, and then return hands. (Repeat 10 times.)

Body twist

Sit in a chair with hands on shoulders and turn the upper body from side to side as far as possible. (Repeat 10 times).

Seated 'March'

Sitting in a chair slowly lift each knee in turn as if marching, (Repeat 10 times.)

Getting up and sitting down

Choose chairs with arms and fi rm seats. Lean forward, slide to the edge and push up with your arms. To sit down, back up to the chair, lean forward and lower into the seat supported by your arms.

Getting in and out of the bed

Turn on your side bending the knees. Move your feet off the bed and use your arms to push yourself up.

Dietary advice

Eat foods that are high in fi ber (vegetables, whole grain bread and cereals) and drink plenty of fluids to help with constipation problems.

 

At Wockhardt, we care for your well being. We strongly recommend practicing prevention and securing health. In a world where lifestyle evolves by the day, it is essential to stay in the pink of health. Wishing you and your family good health and happiness always. The information in the booklet is not intended as a substitute for medical advice but is to be used as an aid in understanding ailment. Always consult your doctor about your medical condition.

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