Introduction: Parkinson’s disease can be classified as a motor system disorder. It is a slowly progressive degenerative disorder of the nervous system characterized by tremors when muscles are at rest, slowness of voluntary movements, and increased muscle tone (rigidity) (Beers et al 546). It commonly begins between the ages of 50 and 79 and is twice as common with white people as the blacks (Beers et al 546). Background information: Parkinson’s disease dates back to about 5000 years ago to Indian alternative medicine, Ayurveda which diagnosed and treated people for Parkinsonism (Harris1).
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Early in the19th century, a British physician Doctor James Parkinson wrote an essay about the disease and named it ‘the shaking palsy. He published his paper after observing six of his patients suffer from the shaking disease and recommended the scientists come up with a cure (Harris 2). Sixty years after the publication of the paper, a French neurologist in his research for the cure of the shaking disease renamed the disease Parkinson’s after recognizing the critical contribution by Dr. Parkinson (Harris 3).
“In 1960, researchers discovered that patients who suffered from Parkinson’s had a lack of the chemical dopamine in the brain and they started to prescribe levodopa, a drug which helped in minimizing uncontrollable muscle movement, rigidity, and slurred speech among patients” (Harris 4). “The reality of the disease was realized when Popular television and movie star Michael J. Fox became perhaps the highest-profile celebrity to suffer from the disease” (Harris 5).
Symptoms: Usually, Parkinson’s disease begins subtly and progresses gradually. It begins with a coarse, rhythmic tremor in the hand while the hand is at rest. The tremor decrease when the hand is moving purposefully and disappears completely during sleep (Beers et al 547). Emotional stress or fatigue may increase the tremor (Beers et al 547). The tremor may then progress to other parts of the body like the legs the jaws and eyelids. Other early symptoms may include a reduced sense of smell due to difficulty in sniffing (deliberately breathing in large amounts of air) and the degeneration of brain cells connected with the sense of smell. Muscles become rigid and impair various body movements.
The patient suffers a lack of facial expressions with infrequent blinking (Beers et al 547). Gradually, the movement becomes slow and difficult to initiate. Decreased mobility contributes to muscle ache and fatigue (Beers et al 547). Due to the impairment on the muscle, small tasks such as buttoning a shirt and tying shoe races become harder (Beers et al 547). The handwriting becomes shaky and tiny because initiating and sustaining each stroke of a pen is difficult (Beers et al 547).
Later, the patients have difficulty in walking and especially taking the first step (Beers et al 547). “Once started, they often shuffle, taking short steps without swinging their body as they walk. Posture becomes stooped and balance is difficult to maintain. The face becomes less expressive because the facial muscles that control expression do not move” (Beers et al 547). Diagnosis: Diagnosis is based on symptoms. Mild early disease may be difficult for doctors to diagnosis because it begins subtly (Beers et al 547).
Diagnosis is especially very difficult in old people because, aging can cause some of the same problems caused by Parkinson’s disease like loss of balance, slow movements, muscle stiffness, and stooped posture (Beers et al 547). No tests or imaging procedures can directly confirm the diagnosis(Beers et al 548). However, computed tomography (CT) and magnetic resonance imaging (MRI) may be performed to look for a structural disorder that may be the cause of the symptoms (Beers et al 548). Treatment: Continuing to perform as many activities as possible can help people with Parkinson’s disease maintain mobility (Beers et al 548).
Physical and occupational therapy can help them maintain or regain muscle tone, maintain range of motion and learn the adaptive strategy (Beers et al 550). No drugs can cure Parkinson’s disease or stop its progression but many drugs can make movement easier and enable people to function well (Beers et al 548). Levodopa is can effectively be used to reduce tremors, muscle rigidity and to improve the movement of a patient.
It is mainly given with carbidopa to prevent converting into dopamine before it reaches the brain (Beers et al 550). There can also be a surgical procedure performed in the basal ganglia to destroy a tiny area around it (Beers et al 551). This procedure can be done mostly at the later stages of the disease especially when a patient has developed levodopa tolerance (Beers et al 551). Prognosis: Parkinson’s disease is progressive and therefore, patients eventually need help especially in day-to-day activities. They become severely disabled and immobile. They may be unable to eat even with assistance (Beers et al 552). Dementia develops in about half the people who suffer from this disease.
The patients suffer swallowing difficulties and therefore, they are likely to die due to aspiration pneumonia. The disease is known to cause depression in patients as it causes changes in the chemical composition of the brain that is in charge of emotional well-being. In later stages of the disease, it may cause lowered thinking capabilities, memory loss, and problems in solving the simplest problems. Patients at this stage require support from the members of the family or they can be taken to a nursing home of which the latter is the best option.
Beers, Fletcher, et al. the Merck manual of medical information. 2nd. NJ. Merck Research laboratories. 2003. Print.
Harris, C. B. “What Year Was Parkinson’s disease Discovered?” e how 2009: n. Pag. Web.