Parkinson’s DiseaseNidhi G. VekariaBrookdale Community Collage
HESC-105 Medical Terminology
In medical world, there are many diseases out there but most of them do have proper treatment, medications, and procedures but some of them do not have reliable treatment. One of them is Parkinson’s disease has not proper treatment to get ride off. The purpose of choose this topic is that, one of the common disease in older people which my elder aunt is suffering from last five years. I often talk to her to know about her condition and I came to know more about Parkinson’s and its symptoms.
“Parkinson’s disease (PD) is a type of neurological disorder that targets brain cells that can affect the ability to perform common daily activities also a chronic and progressive disease, meaning that the symptoms become increase over time” (Bradley, 2009, p.129). Mandybur and Gartner (2018) describe PD as: involve degeneration of a small group of nerve cells in the midbrain of the skull that call neurons. Parkinson’s affects neurons is in area of the midbrain. Dopamine is the chemical that sends messages to part of the brain to control some of the neurons of basal ganglia. The loss of these connections and this neurotransmitter cause symptoms of Parkinson’s. As PD progresses, some neurons in the basal ganglia stimulate other neurons, that cause person cannot control movement normally. Symptoms can be seen differently in person to person (Mandybur ; Gartner, 2018). Primary motor signs of Parkinson’s disease include tremor of the hands, foot, arms, and legs. Other sings are slowness of movement, rigidity or stiffness of the muscles and postural instability (Bradley, 2009, p.130).
In Massano and Bhatia (2012) summary article reviewing is the incidence increases dramatically with increasing age. More than two percent of the population in the United States have PD. Parkinson’s is more common in older people. Parkinson’s disease symptoms can see at any age, mostly in age after sixty.
Parkinsonism is related to slow physical movement, which involving one of the following features: tremor, rigidity and postural instability. All patients have Parkinsonism who has Parkinson’s disease but not necessary that patients have a Parkinson’s disease. Also Parkinsonism has secondary symptoms related to a number of different condition or different identifiable causes such as including toxins, drugs, tumors, and many more. Parkinson’s disease is common that affects to 78 percent of patients. Parkinsonism-plus syndrome are degenerative disorder that cause by additional neurodegenerative disorder. But they have similar to PD symptoms (O’Sullivan & Schmitz, 2007, p. 853).
According to Massano, and Bhatia (2012), symptoms that patients feel, and a sign is individuals see, such as physician. For instance, might be laziness is a symptom while an expanded pupil is a sign. PD does not look the same in every patient. The clinical sings be different significantly. Some patients have no tremor and are just rigid and slow movements. Other have only tremor, with little or no slowness. Also, progression of the disease might be varies such as some patients have disability reach an advanced stage, while some patients have affected very mildly in starting phase (Mathew & Aggarwal, 2012, p. 297). The primary motor symptom is that patients perform physically movements and non-motor symptoms are related to brain and body functions (Mathew & Aggarwal, 2012, p.297).
In O’Sullivan and Schmitz (2007, p. 856-857) summary of the primary motor symptoms related with Parkinson’s disease are: Rigidity that refers to a tightness or muscle stiffness. It typically affects week muscles first, especially the shoulders and neck. Rigidity may affect after the left or right side, eventually spreading to whole part of body. Over the time as disease progress it becomes more sever. In starting phase of PD, its might be decreases able to move easily and painful. Also, Bradykinesia (slow physical movements) involve in difficulty to maintaining movement and lack or slowness of movements. Movements are typically reduced in speed, range, and distance. Usually, patients cannot easily perform any movement and coordination by self. For example, patients have difficulty in daily basic activity such as getting up to the chair or bad, and walking, etc. Rigidity and depression can also affect bradykinesia. Furthermore, Tremor is usually seen while patient in supine and standing position. This is may also be seen in the forearm, jaw, tongue and lower part of the body when patient is supine position. When patients do walk become slower and shuffling. Patients have very slow movement with little facial expression and blink eyes less than normal. Tremor tends to be less severe when the patient is relaxing position. Moreover, Patient with PD demonstrates abnormalities of posture and balance. These changes are rare in the early years of PD. Patient also experience increasing difficulty during activities such as self-initiated movements and increasing risk to fall down (O’Sullivan ; Schmitz, 2007, p. 856-857).
In constant, Mathew and Aggarwal (2012, p. 298) refers that Parkinson’s disease is a type of movement disorder; the related to non-motor symptoms can be overlooked. There are several common symptoms of PD but those are not primarily involved such as depression, anxiety and psychosis etc. Non-motor symptoms include sensory problems such as sleep disorder, speech difficulties, and reduce smell etc. Sleep problems are commonly seen in PD patients and it’s affected by medications for PD. However, sleep problems are core sing of PD. Also, patients with PD experience by decreased voice volume, and uncontrolled speech level. There may be repeated words or slurring and hesitate before talking.
Parkinson’s disease is diagnosed by a physician while patient perform physically movements, and explaining their medical history. It is purely clinical and there is no complete diagnostic test to conform PD. Physician can check patient’s symptoms of PD that absence or presence. Symptoms that suggest a diagnosis other than PD include visions, early postural instability, and involuntary movements than tremors. Parkinson’s disease is take time to diagnose. Physician may recommend to patients for diagnose on time so they can check increase or decrease symptoms and condition of patients (Mathew & Aggarwal, 2012, p. 299).
Bradley (2009, p. 236-238) summarized that, Parkinson’s disease cannot treat properly but some medication may help. Sometime physician suggest for surgery after many years of PD but surgery also cannot suggest to those patient who has age over the eighteen. PD patients should change their life style such as doing live on going activities and taking regular session of physical therapy so that can help in posture stabilization. PD has ways of treatment such as medication, exercise, surgery, and alternative medicine.
Levodopa (L-dopa) drug is support of symptomatic treatment for PD. L-dopa is highly effective in treating motor symptoms such as slow physical movement. It is benefited in bradykinesia and rigidity but its less effect on tremor. It has not a direct impact on postural instability. The initial function improvement is often intense. Dopamine is in the brain that converted by L-dopa. It is help to reduces stiffness and slow physical movement in patients. PD symptoms are produced by low level of dopamine in the brain. Furthermore, Dopaminergic drug has greatest benefit such as reducing rigidity and bradykinesia. This medication can also be used to reduce motor functions such as speed and postural stabilization or coordination. The contrary effect is most common to L-dopa such as nausea and light headache. Moreover, Anticholinergics agents are used in early untreated PD. These have little or no effect on bradykinesia, and postural instability but it helpful in sever tremor and rigidity. Physician should be avoided if the patient is above 65 years. PD patients may taking medicine is help in walking, movements and tremor (Mathew ; Aggarwal, 2012, p. 300).
A combination of physical therapy and medicine is a key role that managing PD patients. For most patients, physical therapy is not prescribed until the disease has progressed and patient movements are affected. There are many ways to achieve goals and outcomes, for example whiling to direct involve in activities, follow family/caregiver’s instruction, and supportive therapy such as physical therapy, psychological therapy and etc. Educate of patients family members and caregiver is the best way to get best outcomes (O’Sullivan ; Schmitz, 2007, p. 854-855). O’Sullivan and Schmitz (2007, p. 855) give suggestions that may also help such as explain patients that try not to move too quickly, and aim for put heel first on the floor when patient is walking. Author also suggests if patient notice their self is shuffling then stop and check the posture. It’s best to stand up straight, and look in front, not directly down, while walking.
Bradley (2009, p. 138-139) summarized that, Surgery is recommended to those patients who has progressive PD and respond poorly to medication. There are three main surgical approaches; ablative surgery, deep brain stimulation (DBS) and neural transplantation.
In addition, Alternative medicine such as supportive therapy can help PD patients, mainly in pain, fatigue and depression. Massage therapy is helpful in depression, stress relive, pain relive, muscle stiffness and relaxation. Also, yoga is involved increases patients flexibility, posture, and balance. Moreover, Alexander technique meaning self-development techniques that can help posture stabilize and reduce muscle stress and pain (O’Sullivan & Schmitz, 2007, p. 859-860).
In conclusion, Parkinson’s disease can be seen more frequent in older populations. It could take years that people diagnosed PD. People can affect by PD differently as disease progresses. Everybody cannot experience same symptoms and sing of PD, if some people can experience same then, they can experience differently in beginning of PD and intensity level can also be vary. There are several medicines available that help to PD patients but it’s not totally curable. Surgery is another option that patient can prefer it but it is also risky and expansive. Unfortunately, Parkinson’s disease is not proper way to curable and gets ride off it.
Bradley, W. G. (2009). Treating the Brain. Washington, DC: Dana Press.
Mandybur, G. ; Gartner, M. (2018 April). Parkinson’s disease (PD). Retrieved from https://www.mayfieldclinic.com/PE-PD.htm
Massano, J. & Bhatia, K. P. (2012). Clinical Approach to Parkinson’s Disease: Features, Diagnosis, and Principles of Management. Cold Spring Harbor Perspectives in Medicine, 2(6), a008870. http://doi.org/10.1101/cshperspect.a008870
Mathew, K. G. ; Aggarwal, P. (2013). Medicine Prep Manual for Undergraduates. New Delhi, India: Elsevier.
O’Sullivan, S. B. & Schmitz, T. J. (2007). Physical Rehabilitation. Philadelphia, PA: F.A. Davis.