Jennifer Rudd

Communications

Parkinson’s disease

What do Michael J. Fox and Mohammad Ali have in common?  Well besides being rich and famous, they both have Parkinson’s disease.  Parkinson’s disease is a neurological disease that affects many people in America today and it is what I am going to talk to you about.

Parkinson’s disease is one of the most baffling and complex of the neurological disorders.  Its cause is unknown, but there are many theories as to what causes this disease.  Parkinson’s was first described in 1817 by James Parkinson, who the disease is named for.  At first, he called this disease, the “shaking palsy.”  He is known for finding what the symptoms were for this disease.  There are many forms of Parkinsonism, but I am only going to talk to you about Parkinson’s disease or primary Parkinsonism.  I am going to inform you of the symptoms and signs of the disease, treatments, and causes of Parkinson’s disease.

Parkinson’s disease occurs when certain nerve cells, or neurons, in the area of the brain called the substantia nigra die or become impaired.  These neurons produce a chemical known as dopamine which is a chemical messenger responsible for transmitting signals between the substantia nigra and the next “relay station” of the brain to produce muscle activity.  The loss of dopamine causes nerve cells to fire out of control, leaving the person unable to control movement.  Studies show that Parkinson’s patients lose 80% of dopamine-producing cells in the substantia nigra.  There are many theories as to why this happens.  One theory holds that free radicals –unstable damaging molecules-generated by chemical reactions may contribute to cell death in the brain causes Parkinson’s disease.  Another theory explores the role of genetic factors in the development of this disease.  15-20% of Parkinson’s patients have a close relative who experience tremors, which is one of the symptoms of Parkinson’s disease.  This does not necessarily mean that you have the disease because studies have shown that you can have tremors but not have Parkinson’s.

Parkinson’s disease doesn’t affect everyone in the same way.  The disease progresses quicker in some that it does in others.  There are many symptoms to the disease, but I am only going to talk about the four major ones. They are:

a)      Tremors- uncontrollable shaking of a hand or arm on one side of the body.  They can occur in legs, feet, and the chin.  The tremor has a characteristic appearance.  It takes the form of a rhythmic back and forth motion of the thumb and forefinger at 3 beats a minute.  This is called “pill rolling” and it usually disappears during sleep and voluntary movement.

b)      Muscle stiffness- Muscles become tight and rigid as they fail to receive messages from the brain to relax.  This can cause muscle aches, a stooped posture, and slow movement.  Many people can become frozen-unable to move at all.  When this happens, the patient needs help and you need to put your foot in front of them and tell them to step over it.

c)      Bradykinesia-slowing down and loss of spontaneous and automatic movement.  This is very frustrating because on minute they can move easily and the next minute they need help.  This is the most disabling and distressing symptoms of the disease. 

d)      Postural instability-impaired balance and coordination.  This causes the patient to develop a forward or backward lean and to fall easily.  The person either has to use a walker to walk or be in a wheelchair and wheel themselves around or have someone else wheel them around.  This can also cause the patient to have a stooped posture in which the head is bowed and the shoulders are drooped

Other symptoms are difficulty swallowing, speech changes, urinary problems, depression, and sleep problems, and memory loss.  They can also suffer from dementia or intellectual loss.

There is no known cure for Parkinson’s disease but it can be managed with medications prescribed by your physician or a neurologist.  The physician determines how much the symptoms disrupt your life and then picks the right medications for you.  No two patients are alike and it takes time to find the right medications for you.  There are a number of medications that are used to treat the disease and here of four of the main ones:

                                        I.      Sinemet CR or L-dopa- this medication is used to relieve the muscle stiffness, tremor, and weakness caused by the disease. 

                                     II.      Levsin or Levbid- helps to reduce muscle stiffness and tremors and controls drooling caused by the disease.

                                   III.      Mirapex- mimics dopamine’s role in the brain allowing patients to regain muscle control lost by the disease.

                                  IV.      Tasmar- helps relieve muscle stiffness, tremor and weakness and can also help the patient with talking, walking and dressing

   50,000 Americans are diagnosed with Parkinson’s each year with ½ a million Americans affected at one time.  The disease strikes men and women in almost equal numbers.  It seems to occur more often in men than women though, with a 3:2 ratio.  Studies have shown that African-Americans and Asians are less likely than whites to get the disease. 

Here are some statistics:

4 in every 1,000 people have Parkinson’s.

1 in 100 people over the age of 60 have the disease. 

1 in 10 people over the age of 80 have the disease.

In 5 to 10% of cases, Parkinson’s develops during a person’s 20s and 30s.