PARKINSONISM Overview
Parkinson’s disease is also called Parkinsonism. It is a degenerative disease of the brain which is age-related. It makes parts of the brain to deteriorate, especially the basal ganglia.
It should be noted that in this condition, there is inadequate dopamine, which is a crucial brain neurotransmitters. It is lack of sufficient dopamine that causes tremors and slowed down movements.
Signs and symptoms of Parkinsonism intensify as the condition progresses further.
Epidemiology
Globally, Parkinsonism is very common.
It is the second most common age-related degenerative brain disease.
It affecets at least 1% of elders above 60 years old.
Risk Factors
- Age. Increased age. Average age at which it starts is 60 years of age.
- Sex. It is more in men and people assigned male at birth.
- Heredity
- Exposure to toxins
Signs & Symptoms
Non-motor symptoms;
- Depression
- Anosmia/ loss of sense of smells
- Inability to think properly and focus
- Autonomic nervous system symptoms such as;
- Orthostatic hypotension
- Constipation
- Urinary incontinence
Common motor-related symptoms;
- Unstable walking gait
- Bradykinesia/slowed motion
- Stiffness of the joints
- Muscle tremors
Others;
- Drooling
- Constipation
- Mask-like facial on the face
- Dysphagia
- Hypophonia/ unusually soft speaking voice
Stages
The Movement Disorder Society- Unified Parkinson’s Disease Rating Scale(MDS-UPDRTS) classifies Parkinson’s disease into 4 different areas of how the disease can affect a person.
The stages are listed and described below;
Stage I: Non-motor aspects of experiences of daily living.
Non-motor symptoms include anxiety, depression and dementia. Pain, constipation, incontinence and fatigue are also reviewed in this first section.
Stage II: Motor aspects of experiences of daily living.
Movement-related tasks and abilities. For example the ability to talk, eat, swallow, dress up and shower.
Stage III: Motor examination
Determination of movement-related effects of the disease. For example tremors, stiffness and rigidity.
Stage IV: Motor complications
Checking the impact of symptoms of the disease on a person’s life.
Diagnosis & Tests
Proper patient history-taking. Here, presence of 2 of the 3 cardinal signs is needed to clinically diagnose parkinson’s disease;
- Rigidity
- Bradykinesia
- Resting tremor
Computer tomography scan.
Magnetic resonance imaging(MRI)
Positron emission tomography scan.
Spinal tap/ lumbar puncture
Skin biopsy
Treatment & Management
- Medications;Carbidopa-levodopa
Inhaled carbidopa-levodopa
Carbidopa-levodopa infusion
Dopamine agonists such as pramipexole and apomorphine
Monoamine oxidase B inhibitors. These include selehiline, rasagiline,, safinamide.
Catechol O-methyltransferase (COMT) inhibitors such as entacapone and opicapone. Tolcapone is rarely prescribed as it enhances risk of liver damage and liver failure.
Anticholinergic drugs such as benztropine and trihexyphenidyl
Amantadine
Adenosine (A2A)receptor antagonists. For example Istradefylline.
Nuplazid to treat hallucinations - Surgical procedures such as;
Deep brain stimulation - Home remedy
Healthy eating. Consume good nutrition . Foods rich in fibre prevent constipation, which is one of the symptoms of parkinsonism.
Prevention
- Perform exercises regularly
- Avoiding falls
Living With the Condition
- Take medicines as prescribed by the doctor
- Do not ignore any symptoms