Parkinson’s Disease

Parkinson’s Disease

Introduction

Parkinson’s disease (PD) is a neurological movement syndrome that is progressive in nature and worsens after some time. Statistics done by the National Institute of Health found that the disease affects nearly five hundred thousand people in the United States (NIH). The symptoms of the disease start gradually, but not all people suffering from it experience all the symptoms since the severity differs among various patients. The research shows the progression of the disease occurs at different speeds between different people. However, the disease progresses in five stages commonly known as Hoehn and Yahr Scale, widely used by physicians to categorize patients with the disease (Manfredsson, et al., 2018). In stage one of the disease, the signs of PD are mild and are only observed in one part of the patient’s body. During the second stage, symptoms can be seen on both sides of the body or at the midline. The third stage has characterized the loss of sense of balance as well as the slowness of movement. At the fourth stage, the symptoms of PD are severely disabling, while in the fifth stage, the symptoms are severe which prevents the patient from rising.

Signs and Symptoms of Parkinson Disease

Patients with PD usually experience sudden changes in their handwriting. The disease makes it difficult for the patient to control movements due to changes that occur in the brain. Fine motor skills such as the ability to right are greatly affected which makes writing more difficult. However, this results in Micrographia (small handwriting). The handwriting also appears cramped in nature whereby the letters appear smaller than usual with short spacing between them. Similarly, PD causes rest tremor which is generally the most known sign of PD whereby fingers can shake or twitch when they are supported by a surface. The tremors are also experienced just a few seconds after the arms have been stretched. The tremor can only be noticed by the patient alone during the earlier stages of the disease. However, as the condition worsens, the shaking will be easily seen by other people.

Conversely, people with PD experience sleeping disorders.  This is characterized by restless legs syndrome that leads to uncontrolled movements such as kicking or flailing their arms regularly. Insomnia is another sleeping problem that prevents one from sleeping due to a lack of sleep. Also, the periodic movement of limbs is a sleeping disorder that prevents PD patients’ from sleeping comfortably. Equally, the rigidity of the muscles and bradykinesia are some of the early symptoms of PD. However, bradykinesia is a symptom that causes slowness when individuals perform rapid alternating movements of a particular part of the body. Rigidity increases muscle tone which normally felt when examining the affected muscle segment.

Similarly, patients with PD experience gait and postural impairment. This is characterized by the tendency of a patient to observe a stooped posture due to the absence of postural reflexes. As a result, patients with PD are always associated with falls. When the gait is affected the patient tends to have short shuffling of steps. Additionally, PD is associated with sensory dysfunction. This is characterized by a loss of sense of smell (hyposmia) and a decrease in the perception of visual motion. Sensory dysfunction is also associated with a decrease in discrimination of color as well as a visual contrast. Paresthesia is also an abnormal sensation that is associated with sensory dysfunction.

Consequently, dysautonomia is another symptom associated with PD that is usually characterized by orthostatic dysfunction. Dysautonomia is linked to constipation among patients and excessive sweating. The symptom causes the patient to have decreased swallowing movements (sialorrhea) and sexual dysfunction. Notably, patients with PD are generally getting tired very first after performing a simple task. They also complain of pain regularly which cannot be linked which cannot be linked to any recent activity.

Body Organs Affected PD

PD majorly affects the nerve cells in the substantia nigra as well as basal ganglia.  However, dopamine is always produced by the nerve cells of substania nigra. Similarly, the level of dopamine in the brain is being released is reduced if the nerve cells of the substantia nigra die as a result of PD. The loss of dopamine triggers the onset of PD symptoms like the rigidity of muscles and slowness of movement. Equally, PD affects the Autonomic Nervous System (ANS) as well as the heart (Faivre, Joshi, Bezard & Barrot, 2019). The presence of Lewy bodies that have undergone neurodegeneration in parts of the brain that regulate ANS processes prevents the normal functioning of the system. Accumulation and neurodegeneration of Lewy bodies directly affect the ANS. In this case, the blood pressure drops as a result, or cause Neurogenic Orthostatic Hypotension due to dysfunction of the ANS.

Diagnosis of Parkinson Disease

Currently, there is no test to diagnose PD except when the person has died. During the early phase, the patient may be misdiagnosed due to similarities of symptoms to other diseases having Parkinson like symptoms. The neurologist can perform the first assessment of the disease based on the neurological exam, medical history, and symptoms present. Since PD is hereditary, it is essential to check if any other family member is suffering from PD. Hoehn and Yahr scale is usually used when diagnosing PD. Similarly, Unified Parkinson’s Disease Rating Scale is another guideline that has been developed to assist in the diagnosis of PD. These two guidelines are vital in ruling out other disorders that might be related to PD.

Treatment of Parkinson Disease

Presently, the treatment to cure PD has not been discovered. However, there are several therapies that have been recommended to slow the beginning motor symptoms or enhance them. The recommended therapies are made in such a way that they raise the level of dopamine by either imitating dopamine, slowing its breakdown, or replacing it (Alessi & Sammler, 2018). Conversely, levodopa has been found to be the most effective therapy for PD as it is transformed into dopamine once in the brain. Nevertheless, the use of levodopa (Sinemet) for a long time can result in reduced or shortened response to the drug, involuntary movements may occur, and painful cramps. Additionally, levodopa use is usually delayed up to the time when motor impairment worsens. Carbidopa is usually prescribed alongside levodopa to prevent the breakdown of levodopa prior to reaching the brain.

Equally, monoamine oxidase type B inhibitors, as well as dopamine agonists, have also shown some effectiveness in relieving PD. However, this option comes with unfriendly effects such as nausea, constipation, drowsiness, hallucinations, and swelling. Similarly, another way of treating PD is through surgery (pallidotomy and thalamotomy), whereby deep brain stimulation can be done or destroying certain areas within the brain, causing the disease. However, exercising and resting can be important in preventing the onset of the symptoms or reducing them. Occupational, speech, and physical therapy are also beneficia