Parkinson’s disease (PD) is a chronic, degenerative neurological disorder that affects both voluntary and involuntary movement. Tremor, rigidity and freezing in place, pain, muscle cramps, swallowing difficulty, balance problems and dementia are only some of the symptoms of Parkinson’s which can cause severe debilitation. There is no cure at present; however, various treatment options can offer Parkinson’s patients temporary relief from symptoms.
In Parkinson’s disease (and so begins my modest knowledge of this condition), certain nerve cells located in the basal nuclei (or basal ganglia – the masses of gray matter in each of the two cerebral hemispheres, which ensure the smooth progress of movement) may have ceased functioning normally. Ordinarily, these nerve cells produce dopamine, a chemical that acts as a neurotransmitter in the brain (this chemical allows nerve cells to transmit signals to one another as well as to muscle fibers). Lack of supply of dopamine can lead to a state of chaos in the signals between nerve cells and muscle fibers. If such confusion occurs, the arm and leg shaking and other symptoms characteristic of Parkinson’s disease are likely to take place.
In the later stages of Parkinson’s disease the affected person loses the ability to control their movements, making everyday activities hard to manage, and the intellect begins to be affected by the disease. About one-third of Parkinson’s Disease sufferers eventually show signs of dementia. The disease runs an average ten year course and ultimately results in death usually by an infection or aspiration pneumonia.
Complications of Parkinson’s disease include dementia, aspiration, and injury from falls.
When drugs such as levodopa (L-Dopa) are taken orally, many of the worst symptoms are lessened. New drugs such as pramipexole (Mirapex) and ropinirole (Requip) can delay the need for levodopa. Apomorphine (Apokyn) is used treat episodes of reduced mobility in patients with advanced Parkinson’s that responds less effectively to levodopa. Future approaches to treatment include a focus on early detection and slowing progression of the disease. Encouraging results have been reported from surgical insertion of a pacemakerlike device deep in the brain to suppress uncontrolled movements, but surgical transplantation of fetal dopamine-producing cells failed to show significant benefits in a controlled study. Traditional surgery can alleviate some tremors, and physical therapy may help mobility.
