Parkinson’s disease is a progressive nervous system disorder that affects body movement. It is caused by degeneration of nerve cells in brain’s part called substantia nigra. These nerve cells die, loses the ability to produce dopamine. Dopamine operates in a delicate balance with other neurotransmitters to coordinate the millions of nerve and muscle cells involved in movement. Due to decrease of dopamine, this balance is interrupted which results in tremor i.e. trembling of arms, legs, hands and jaws; stiffness of limbs; slowness of movement and impaired coordination.
Causes of Parkinson’s disease
The cause of Parkinson’s disease is not known but several factors play a role which includes-
- Genes – Many researchers recognized specific genetic mutations can cause Parkinson’s disease. It is not so common factor except with cases where other family members affected by this disease.
- Environmental effect – Exposure to some toxins may lead to Parkinson’s disease but it has less evidence.
- Low norepinephrine level – Norepinephrine, a neurotransmitter, is important for controlling many automatic body function like blood circulation. In Parkinson’s disease, the nerve endings that produce this neurotransmitter die. This leads to the person experiencing fatigue, constipation and orthostatic hypotension.
- Lewy bodies – In Parkinson’s disease, person may have clumps of protein in their brain termed as Lewy bodies. This also finally causes Parkinson’s disease.
Symptoms of Parkinson’s disease
Some of the common symptoms of Parkinson’s disease are-
- Tremor or rhythmic movement of hands, arms, legs and jaw
- Loss of spontaneous movement which decreases mental skill, reaction time, no facial expression etc.
- Loss of automatic movements like decrease in blinking, low frequency of swallowing and drooling.
- Flexed posture with bending at elbows, knees and hips
- Depression or dementia.
- Unsteady walk
- Person may speak softly, quickly, slur or hesitate before talking.
- It may become tough to write, and writing may appear small.
- Reduced sense of coordination and balance can cause people to drop items which they are holding.
Treatment of Parkinson’s disease
People suffering from Parkinson’s disease have lot of choices for treatment. Though there is no cure but medicines and surgery have helped many a times. Medicine keep your symptoms in check for many years. Doctors mostly prescribe medicines like:
- Levodopa – Commonly termed as L-dopa, is a drug that most of the doctors prescribe for Parkinson’s disease. Levodopa may improve this disease as it causes your body to make more dopamine. To cut down the side effect of this medicine i.e. nausea, doctor suggest you to take carbidopa with this.Some other side effects include vomiting, dry mouth and dizziness. It may also cause confusion, hallucinations or psychosis.
- Dopamine agonists – These drug imitates the action of dopamine in the brain. Few examples of such drugs are pramipexole, Neupro and Requip. It can be taken with or without L-dopa to treat the symptoms of Parkinson’s disease. It has more side effects than levodopa like drowsiness, nausea, dizziness, feeling faint upon standing etc.
- COMT Inhibitors – COMT is an enzyme that metabolizes levodopa in bloodstream. By blocking COMT, more levodopa can reach the brain which ultimately increase the effectiveness of treatment. Entacapone and tolcapone are used to treat fluctuations. Patients who takes tolcapone should have their blood drawn regularly to monitor the function of liver.Its side effects include diarrhea and dyskinesia.
- Selegiline – This drug minimizes the activity of MAO-B (enzyme monoamine oxidase). It metabolizes dopamine in brain, delays the breakdown of naturally occurring dopamine and dopamine which are formed from levodopa. When taken with levodopa, it may enhance the effectiveness of levodopa. Its side effects include heartburn, nausea, confusion, nightmares, headache etc.
- Surgery – Though medicines are effective in maintaining good quality life but disorder progresses, many patients develop variability in its response. Based on the symptoms, surgery is the next prescribed by doctors.
Neurosurgeons in this surgery need to fix a metal frame to the skull. Surgeon with diagnostic imaging, locates the desired area of brain and drills a small hole. Later, surgeon creates small lesions using high frequency radio waves in these structures or may implant a deep brain stimulating electrode. This technique has proved to relieve the symptoms associated with Parkinson’s disease.