"parkinsons disease #1"

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James Parkinson, a British physician, 1st discovered Parkinson’s Disease in 1817 in a paper entitled An Essay on the Shaking Palsy which described the first symptoms of the disease..


Parkinson’s disease today is the most common neurological disease of high age. It is degenerative disorder of the nervous system that usually occurs in middle or later life and has a progressive, prolonged course. Many people suffer from this disease, my grandfather for one, god rest his sole, had a bad case of PD just before his death, also pro boxer Muhammad Ali, TV star Michael J Fox, pope john Paul and Yassar Arafat also suffer from PD.


Parkinsons disease (PD) is the result of the loss of dopamine producing brain cells. Dopamine is a chemical messenger responsible for transmitting signals within the brain. Parkinsons disease occurs when certain nerve cells, or neurons, die or become impaired resulting in the loss of dopamine in the brain. This then leaves sufferers unable to direct or control their movement in a normal manner.


When the nerve cells die they no longer produce and send dopamine so the signal to move doesn’t get through to the brain. Acetylcholine, another chemical in the brain is controlled by dopamine. When the dopamine levels are low there is too much acetylcholine causing muscle stiffness and tremors which many PD sufferers experience?


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Some major Symptoms of PD are


Tremors in the hands, fingers, forearm, or foot tend to occur when the limb is at rest but not when performing tasks. Tremor may occur in the mouth and chin as well. Rigidity, or stiff muscles, may produce muscle pain and an expressionless, mask-like face. Rigidity tends to increase during movement.


Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson’s. Parkinsonian gait is the distinctive unsteady walk associated with Parkinson’s disease. There is a tendency to lean unnaturally backward or forward, and to develop a stooped, head-down, shoulders-drooped stance. Arm swing is diminished or absent and people with Parkinson’s tend to take small shuffling steps (called festination). Someone with Parkinson’s may have trouble starting to walk, appear to be falling forward as they walk, freeze in mid-stride, and have difficulty making a turn. Bradykinesia is slowness in voluntary movement. It produces difficulty initiating movement as well as difficulty completing movement once it is in progress. It occurs in 77% - 8% of those diagnosed with PD. The delayed transmission of signals from the brain to the skeletal muscles, due to reduced dopamine, produces bradykinesia.


Some other symptoms are


Depression, Memory problems mental confusion, Speech problems, swallowing difficulties, Restlessness, Eyelid Closure, Difficulty writing


· Skin problems


· Anxiety


· Urinary tract infections


· Excessive sweating


· Lack of Facial Expression


· Sexual problems


· Sleep disorders


There are 5 stages to PD


Stage I Symptoms are only on one side of the body


Stage II Symptoms are on both sides of the body


Stage III Balance is impaired


Stage IV Assistance is required to walk and other symptoms are severe


Stage V Wheelchair bound


Treatment � Chemical


Levodopa is one of the most common chemicals used in the fight against Parkinson’s disease. This chemical replenishes some of the dopamine lost in the brain. Unfortunately dramatic side effects where present including sever nausea, vomiting, and hallucinations along with many others. An improved version of Levodopa has been made with much less side effects. it is called Sinemet.


TREATMENT- physical Surgery for the treatment of Parkinsons is used when symptoms become very disabling and are not responding to drug therapy. Additionally, people that undergo surgery must be in good health overall, younger than 70, and mentally capable. Different symptoms are improved depending on the area of the brain that is targeted. There are three types of surgery for PD, of them are lesioning ,and deep brain stimulation (DBS).


Thalamotomy is a type of Lesioning surgery in which a small portion of the thalamus in the brain is destroyed.


Improves Tremor.


Somewhat Improves Rigidity (stiffness).


Does not Improve Bradykinesia.


Pallidotomy a type of Lesioning surgery in which a portion of the globus pallidus is destroyed in the brain. Long-term studies indicate that the improvements may last for five years or longer.


Improves Rigidity, and Tremor.


Somewhat Improves Balance, Freezing, Walking, Soft speech


Deep brain stimulation of the subthalamus nucleus in the brain. May be the most promising surgery. But is not yet approved by FDA.


Improves Slowness, Rigidity, Tremor, , On-Off problems, Increases On time, Reduction in levodopa needed.


There is no reported cause of PD. But a common theory is that it results from a mixture of the genetics within a person and an anonymous environmental set off. In some cases, Parkinson’s disease may result from an earlier brain infection, caused by a virus.


But for now we must live with this disease that engulfs over 1 &1/ million people in the world today and wait until that special day comes when that special someone finds the ultimate cure for this unkind disease.





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