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Parkinson's Disease: A Degenerative Illness That Complicates Life’s Journey

Experts fear that India may see a massive 200 to 300 % rise in Parkinson’s Disease (PD) cases within 20-30 years.

Parkinson’s Disease is a progressive neurological disorder, predominant in the Western world. The numbers are staggeringly high in the USA with more than 200,000 cases every year.

Though still more common among Whites, as per the latest trends, the global prevalence of PD is on the rise. And India is very much in the mix. Reports show that in the past 20 years, it affected around 300-400 lives per lakh population.


This however is just the beginning of the worries. That’s because the age profile of Parkinson’s Disease is also changing. The typical onset time was around 60 years. But according to specialists, those under 40 are growing increasingly susceptible to it. This is without a doubt a matter of serious concern and one that needs immediate scrutiny.


So, let's deepen our knowledge of the health condition and create awareness in the process. From Parkinson's Disease causes to potential remedies, here is all you need to know.



What Is Parkinson's Disease?

Parkinson's Disease is a chronic illness that affects the central nervous system. It is named after James Parkinson. He was an English physician, who first described the disorder in 1817 as a "shaking palsy".


The health condition leads to cell loss in a specific part of the brain known as the substantia nigra. These are dark neurons that produce Dopamine, essential to regulate movement. When Dopamine levels drop, the person experiences irregular brain activities. This causes movement troubles as well as other Parkinson's Disease symptoms.



The disease is different from Parkinsonism. The latter impacts both sides of the body and does not usually involve a tremor. Whereas PD mostly affects one side more than the other. Many people also question whether Parkinson's Disease and Alzheimer's Disease are related. Well, both of them are neurodegenerative diseases and have similarities. For example, they impact your thinking, movement, and communication. And can thus be categorized under the umbrella term Dementia. But they are distinct disease entities and should not be confused with one another.


Parkinson's Disease Causes

The exact reason behind the occurrence of Parkinson's Disease is unknown. But the list of possible catalysts is long.

  • Genes (A close kin with PD manifolds the chances)

  • Lewy bodies (Unusual presence of a protein named alpha-synuclein, in the brain)

  • Age (Individuals 60 years and above are more prone to Parkinson's Disease)

  • Gender (Men are more vulnerable to developing the condition than women)

  • Toxin exposures (Herbicides and pesticides can increase the risk)

  • Extreme stress

  • Poor quality of life


Parkinson's Disease Symptoms

Parkinson's Disease signs and symptoms can vary from one individual to another.



But the most common forms of manifestation include:

  • Tremors (in the head, arms, hands, or legs)

  • Slowness of movement

  • Stiffness in muscles

  • Impaired posture

  • Lack of balance and coordination

  • Reduced ability of automatic movements like blinking, smiling, etc.

  • Changes in speech and writing

Other complications that can accompany the condition cover:

  • Depression

  • Difficulty in thinking

  • Chewing, swallowing issues

  • Sleep irregularities

  • Bladder-related concerns

  • Constipation

  • Fatigue

  • Blood pressure fluctuations


Stages of Parkinson's Disease

Being a progressive disorder, the symptoms worsen with time. The patient goes through 5 recognized Parkinson's Disease stages before being dependent.

Stage 1

Tremors, and changes in posture, movement, and facial expressions can occur. But the signs are so mild that they won’t disrupt your daily way of life.

Stages 2

Symptoms begin to worsen. There will be increased shaking in the body, and rigidity in movement. Although the patient can handle the usual chores on their own, the level of difficulty is more.

Stage 3

It is the mid-stage where the individual will experience a loss in balance. They will be forced to restrict daily tasks but are still capable of staying independent.

Stage 4

Disability will move to an advanced phase. They can walk or stand without help. But constant monitoring is important to avoid accidents. At this stage, living alone is not possible.

Stage 5

This is the most exhausting stage. The patient won't be able to stand or walk and will face severe muscle stiffness. They mostly have to stay bedridden or wheelchair-bound. 24*7 care is required.


Parkinson's Disease Treatment - Can the Disease Be Cured?

Unfortunately, as of now, the neurodegenerative disorder Parkinson's Disease has no cure.



But thankfully, there are medicines to reduce or delay the suffering.

  • Carbidopa-Levodopa - It is a natural chemical that goes to the brain and converts to Dopamine.

  • Inhaled Carbidopa-Levodopa - It is given when pills taken by mouth stop functioning.

  • Carbidopa-Levodopa Infusion- The medicine is introduced directly to the small intestine. It is done in a gel form via a feeding tube in advanced-stage patients.

  • Dopamine Agonists - These imitate the effects of Dopamine in the brain. They are not as efficient as Levodopa but last longer.

  • Monoamine Oxidase B (MAO B) Inhibitors- They stop the breakdown of brain Dopamine.

  • Catechol O-methyltransferase (COMT) Inhibitors - They extend the effects of Levodopa.

  • Anticholinergics - They are often used to control tremors.

  • Anticholinergics - They provide short-term relief and are effective in the early stages.

  • Adenosine Receptor Antagonists - They help release more Dopamine. This is done by targeting brain areas regulating the response. Istradefylline (Nourianz) is an important medicine in this regard.

  • Nuplazid (Pimavanserin) - It is given to patients who experience hallucinations and delusions.

The above-mentioned medicines work wonders for many patients. But if they are in one of the advanced Parkinson's Disease stages, surgery may be recommended.


Deep Brain Stimulation (DBS) can benefit individuals who are not able to enjoy the stable results of Levodopa. The process involves the surgeons implanting electrodes into a particular brain section. They do it by sending electrical pulses to the brain with the help of a generator implanted in the chest. This therapy however involves risks of stroke, brain hemorrhage, and infection. Also, DBS won’t work on controlling symptoms for patients who are not responding to Levodopa at all. The only exception is the treatment of tremors.


Another advanced Parkinson's disease treatment includes MRI-guided focused ultrasound. It is effective in managing the tremors associated with the disorder.


Final Thoughts - How To Lead A Better Life With Parkinson's Disease?

Getting diagnosed with Parkinson's Disease does not mean the end of life. Besides prompt Parkinson's disease treatment, lifestyle changes can also improve your condition. So,

  1. Get involved in aerobic exercises

  2. Incorporate balancing and stretching tasks in your physical therapy sessions.

  3. Consult a speed-language pathologist to reduce speech difficulties.

  4. Take measures to combat your stress issues.

  5. Lead a healthy life in general.

Also, diligently follow the guidance of your Parkinson's Disease specialist. These measures won’t bring drastic upgrades. But, it will certainly help you gain better control of your life.

 


The Author : Dr. Sunil Khattri

sunilkhattri@gmail.com

+91 9811618704


Dr. Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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