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Parkison's Disease

January 02 2017 at 10:37 PM by Sonali Panda


 

Parkinson’s disease is a progressive neurodegeneration disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson’s disease, the disorder also commonly causes stiffness or slowing of movement.

 In the 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 become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over time.

Causes:

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

  1. Genetics:

Some studies suggest that genes play a role in develpoment of parkinsonsons. An estimated 15 percent og people with parkinsons have a family history of the condition.

2. Environment:

Ther’s also some evideance that one’s enviornment can play a role. Exposure to certain  chemicals has been suggested as a possible link to parkinson’s disease. These include pesticides such as insecticides, hericides and fungicides. It also possible that agent orange exposure may be linked to parkinson’s.

Parkinson’s has also been potentially linked to drinking well water & consuming manganeese.

3. Loss of Dopamine: 

Dopamine is a neuro transmitter chemicals that aids in passing messages between different sections of the brain. The cells that produce dopamine are damaged in people with parkinson’s disease. Without an adequate supply of dopamine the brain is unable to properly send and receive messages. This disruption affects body’s ability to co-ordinate movement. It can cause problems with walking and balance.

4. Age & Gender:

Aging also plays a role in parkinson’s disease. Advanced age is the most significant risk factor for developing parkinson’s disease. Scientists believe that brain and dopamine function begin to decline as the body ages. This makes a person more susceptiple to parkinson’s. It is more common in men than in women.

Symptoms:

Parkinson’s disease symptoms and signs may vary from person to person. Early signs may be mild and may go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides.

Symptoms begin gradually, often on one side of the body. Later they affect both sides. They include

  • 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).15781359_10154593828409667_3849480347110178564_n
  • Slowed movement (bradykinesia): 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 you 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.

As symptoms get worse, people with the disease may have trouble walking, talking, or doing simple tasks. They may also have problems such as depression, sleep problems, or trouble chewing, swallowing, or speaking.

PD usually begins around age 60, but it can start earlier.  There is no cure for PD. A variety of medicines sometimes help symptoms dramatically. Surgery and deep brain stimulation (DBS) can help severe cases. With DBS, electrodes are surgically implanted in the brain. They send electrical pulses to stimulate the parts of the brain that control movement.

When to see a doctor

See your doctor if you have any of the symptoms associated with Parkinson’s disease — not only to diagnose your condition but also to rule out other causes for your symptoms.

Diagnosis:

No specific test exists to diagnose Parkinson’s disease. Doctors(Neurologist) diagnose based on medical history, a review of your signs and symptoms, and a neurological and physical examination.

Your doctor may order tests, such as blood tests, to rule out other conditions that may be causing your symptoms.

 Imaging tests — such as MRI, ultrasound of the brain, SPECT and PET scans — may also be used to help rule out other disorders. Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.

Sometimes it takes time to diagnose Parkinson’s disease. Doctors may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate your condition and symptoms over time and diagnose Parkinson’s disease.

Treatment :

Parkinson’s disease can’t be cured, but medications can help control your symptoms, often dramatically. In some later cases, surgery may be advised.

Doctors may also recommend lifestyle changes, especially ongoing aerobic exercise. In some cases, physical therapy that focuses on balance and stretching also is important. A speech-language pathologist may help improve your speech problems.

  • Rehabilitation: Exercise programs are recommended in people with Parkinson’s disease.There is some evidence that speech or mobility problems can improve with rehabilitation, although studies are scarce and of low quality. Regular physical exercise with or without physical therapy can be beneficial to maintain and improve mobility, flexibility, strength, gait speed, and quality of life. When an exercise program is performed under the supervision of a physiotherapist, there are more improvements in motor symptoms, mental and emotional functions, daily living activities, and quality of life compared to a self-supervised exercise program at home. In terms of improving flexibility and range of motion for people experiencing rigidity, generalized relaxation techniques such as gentle rocking have been found to decrease excessive muscle tension. Other effective techniques to promote relaxation include slow rotational movements of the extremities and trunk, rhythmic initiation, diaphragmatic breathing, and meditation techniques.As for gait and addressing the challenges associated with the disease such as hypokinesia (slowness of movement), shuffling and decreased arm swing; physiotherapists have a variety of strategies to improve functional mobility and safety. Areas of interest with respect to gait during rehabilitation programs focus on, but are not limited to improving gait speed, the base of support, stride length, trunk and arm swing movement. Strategies include utilizing assistive equipment (pole walking and treadmill walking), verbal cueing (manual, visual and auditory), exercises (marching and PNF patterns) and altering environments (surfaces, inputs, open vs. closed). General cardiovascular fitnessexercise,aerobic conditioning- walking and swimming.Strengthening exercises have shown improvements in strength and motor function for people with primary muscular weakness and weakness related to inactivity with mild to moderate Parkinson’s disease. However, reports show a significant interaction between strength and the time the medications were taken.

Therefore, it is recommended that people with PD should perform exercises 45 minutes to one hour after medications when they are at their best. Also, due to the forward flexed posture, and respiratory dysfunctions in advanced Parkinson’s disease, deep diaphragmatic breathing exercises are beneficial in improving chest wall mobility and vital capacity. Exercise may improve constipation.

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