Disorder of Movements: Parkinson’s Disease

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Table of Contents

Abstract
Introduction
Symptoms and Diagnosis
Therapy
Disease Management
Research Directions
Conclusion
Reference List

Abstract

The Research Paper deals with Parkinson’s disease as the second most common neurodegenerative disease; its symptoms, diagnosis, and therapy. It tackles the ways of disease management and research directions in this field.

Introduction

Parkinson’s disease (also called Paralysis agitans, Shaking palsy) deserves special attention as it is very commonly encountered in medical practice and it is the second most common neurodegenerative disease (Factor and Weiner, 2002, p.xiii). There is no denying the fact that the life of a person who has been diagnosed with such a chronic progressive disease like Parkinson’s disease is dramatically changed at once. The influence and special importance of this disease for clinical neurology may be explained by the fact that the population of the industrialized world ages. E. Ronken and G. J. M. van Scharrenburg (2002) state: “Most cases are diagnosed between the ages of 50 and 60 years and less than 10% is diagnosed below the age of 40”(p.3) According to the research conducted in 1996, about 3.5 million cases were registered in the world. Still, a very optimistic fact must be mentioned: incredible advances and success in the sphere of Parkinson’s disease (PD) treatment can be observed during several last decades. That is why the disease, its symptoms, ways of treatment, and disease management deserve special attention and they are going to be analyzed in this paper.

Symptoms and Diagnosis

The term “parkinsonism” denotes not a particular disease, but a condition that has a certain number of peculiar symptoms, like the following: trembling of the limbs, jaw, and face, stiffness of muscles, slowness of movements (bradykinesia), short steps, soft and even manner of speech.

Parkinson’s disease is the most commonly encountered type of Parkinsonism today. It may be also called idiopathic parkinsonism, where the word idiopathic means the unknown cause of the disease. In fact, PD is the disorder of nerve cells (they are called neurons) of the part of the brain that is responsible for the movements of muscles. A chemical called dopamine that is made by these neurons should send special signals to our muscles for the movements, but it does not cope with its task properly in case of PD, because neurons die or are damaged and, unfortunately, nowadays the thing that damages neurons remains undiscovered in spite of all the researches. Still, C. Duvoisin and J. Sage (2001) state:

Under the microscope, however, pathologists can see an abnormal structure within the affected nerve cells. This structure was first described by Dr. Frederic Lewy in 1908 and so it is known as the Lewy body. These bodies are the hallmark of Parkinson’s disease. They are not found in other forms of parkinsonism. This selective involvement of certain systems of nerve cells scattered through the brain and spinal cord suggests that an unknown toxin or a deficiency of some undiscovered nutrient may be responsible. Some think that there is merely a premature aging process that affects the cells of substantia nigra (p.3).

Speaking about the symptoms of PD, it should be mentioned, the onset of the disease is so gradual and lingering, that patients can seldom say when it really started. Moreover, it is usually noticed not by the patient himself, but by someone close to him, like a colleague or relative. C. Duvoisin and J. Sage (2001) describe a medical case when a man came to consult a doctor because of his “mumbling speech” that interfered with his profession – a salesman. It took the doctor a year to diagnose a disease, only when tremor appeared (p.15).

Doctors define three groups of symptoms that are peculiar for PD: primary motor symptoms, secondary motor symptoms, and nonmotor symptoms. The first group includes resting tremors, which is typical of 70% of patients. It is called so because it appears when the muscles are in a relaxed state. Bradykinesia and rigidity also belong to this group of symptoms. The last symptom is postural instability that together with bradykinesia may cause the falling of a person. These symptoms may also make a person “freeze” when he wants to walk but cannot. Among secondary motor symptoms, such complications as fatigue, dystonia, akathisia, impaired motor coordination, “masking”, difficulties in swallowing and chewing, impotence should be mentioned. Finally, PD may be shown by such nonmotor symptoms as loss of energy, depression, pain, cramping, and urinary problems (Duvoisin and Sage, 2001).

Therapy

Unfortunately, contemporary medicine has not yet answered the question: how to cure Parkinson’s disease; but doctors have found ways of relieving the symptoms of the disease. Besides, many patients do not suffer greatly during the first several years after the diagnosis, but when the symptoms become severe and painful, doctors usually prescribe levadopa (L-dopa), which helps to replace the brain’s dopamine. This medicine was found about 30 years ago and it was like e real revolution in the PD’s treatment. There are cases when some other drugs that also affect the level of dopamine are prescribed, such as, for instance, amantadine, anticholinergic medications, selegiline (Mittel, 2002). For those patients who do not properly respond to drugs, surgery may be used. There is a procedure, called “cryothalamotomy”, that “requires the surgical insertion of a supercooled metal tip of a probe into the thalamus (a relay station deep in the brain) to destroy the brain area that produces tremors” (Mittel, 2002, p.15). This procedure may be applied to those patients who suffer severe tremors. One more surgical treatment, pallidotomy, has claimed the scientists’ interest. The mechanism of the procedure is the following: “a portion of the brain called the globus pallidus is lesioned” (Mittel, 2002, p.15). As a result of this treatment, such symptoms as bradykinesia, tremor, and rigidity may be eased. Nowadays, restorative surgery, where nerve cells transplantants are used, is developing very fast and it is showing great promise as for the sphere of Parkinson’s disease treatment. This sphere of investigation should get better financial support from the government, because it may save many lives, relieve pain and cure people.

It must be mentioned that rather popular are alternative methods of treatment PD, such as keeping to a diet of fruits, vegetables, monounsaturated fats (e.g. olive oil), fish; ayurvedic medicine; yoga; traditional Chinese medicine; Tai Chi; acupuncture and herbal medicine. Yet, some scientists believe that for preventing or curing Parkinson’s disease there is no specific vitamin, mineral or some other nutrient. Still, people should remember that well-balanced diet is beneficial for everybody (Mittel, 2002, p.15).

To conclude, it must be said that the fact remains that Parkinson’s disease can be neither cured nor prevented, but medicine helps the patients to control symptoms and lead active life. Scientists are confident that in few years researches will find out new information about the mechanism of PD and will find out methods of slowing, cure and prevention of the disease.

Disease Management

It is always very difficult for any person to accept that he is ill. It is especially difficult with PD patients, because, as it was mentioned above, the disease is characterized by slow process. Patients usually deny their being ill, they often keep the diagnosis in secret even from the members of their families; they refuse to follow medical prescriptions. The main task is to cope with psychological problem of chronic disease. S. Peterman Schwarz (2006) gives advice to patients who have recently been informed about their state. She says that the first step should be the following: to learn more about your illness. They say, warned – means armed. Patients should remember that the disease affects different people in different ways, and their reaction to treatment is also different. That is why a person should read medical journals, specialized books, use the Internet in order to get more information that will empower him to make smart and reasonable actions.

Patients should be careful and should be “self-centered” on their health in the positive meaning of this word. They should understand that they really need this attention. At the same time they should not be self-centered on the visible symptoms of their disease, they should not deprive you of pleasure of communication with your relatives and friends (Peterman Schwarz, 2006, p.3).

It is also recommended for patients with PD to tell people about their illness, though it may appear to be difficult, but people may be interested in finding information about the illness. Patients should keep positive attitude and in case, if they have noticed such symptoms as loss of appetite, sadness, insomnia, they should consult their doctor, because there is danger of depression. There also exist special PD support groups, where people with the same problems can share their feelings and get necessary help (Peterman Schwarz, 2006, p.7).

Research Directions

“Scientists, physicians, and patients hope that today’s progress means tomorrow’s cure and prevention” (Mittel, 2002, p.17). Scientists try to find the cause of PD, studying possible environmental factors, toxins and genetic factors. There exists a possibility that some people are genetically more predisposed to PD. Besides, laboratory experiments at animals are in progress, they make great contribution into the process of development of treatment.

New researches of human brain are very promising. They include studying other areas of brain, not only substantia nigra. Maybe the secret of Parkinson’s disease is hidden there.

Morover, nowadays scientists are working at new promising approach, the aim of which is to use genetically engineered skin cells that will help to struggle against the disease.

The importance of the NINDS must be also mentioned. The NINDS is a world leader in research on neurological disorders; it supports and organizes a lot of laboratory experiments and clinical trials. Besides, this organization supports 11 Parkinson’s Disease Research Centers of Excellence throughout the country (Mittel, 2002, p.18).

Conclusion

In this paper such important problem of humanity as Parkinson’s disease was analyzed. The work emphasized basic ideas connected with the cause, symptoms and therapy of the disease. It also contains some advice for patients and the analysis of present researches in this sphere.

Drawing a conclusion, it must be mentioned that though Parkinson’s disease still remains unconquered, there are a lot of prospects of the victory of humanity over this terrible disease. People should unite their efforts in the struggle and the results are sure to appear, they should just remember that once such diseases as scurvy and tuberculosis were also considered to be incurable, but today these diseases are cured successfully.

Reference List

Duvoisin, R.C. & Sage, J. (2001). Parkinson’s disease: a guide for patient and family. NY:Lippincott Williams & Wilkins.

Factor, S.A. & Weiner, W.J. (2002). Parkinson’s disease: diagnosis and clinical management. NY: Demos Medical Publishing.

Mittel, C.S. (2002). Parkinson’s Disease: Overview and Current Abstracts. NY:Nova Publishers.

Peterman Schwarz, S. (2006). Parkinson’s Disease: 300 Tips for Making Life Easier. NY: Demos Medical Publishing.

Ronken, E. & van Scharrenburg G. J. M. (2002). Parkinson’s Disease. Amsterdam: IOS Press.

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