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Parkinson's Disease

Understanding Parkinson’s disease.

Parkinson's disease is a complex neurological disorder and one of a larger group of neurological conditions called motor system disorders. In the normal brain, some nerve cells produce the chemical dopamine, which transmits signals within the brain to produce smooth movement of muscles. In Parkinson's patients, 80% or more of these dopamine-producing cells are damaged, dead, or otherwise degenerated. This causes the nerve cells to fire wildly, leaving patients unable to control their movements. 

Though full-blown Parkinson's can be crippling or disabling, experts say early symptoms of the disease may be so subtle and gradual that patients sometimes ignore them or attribute them to the effects of aging. At first, patients may feel overly tired, "down in the dumps," or a little shaky. Their speech may become soft and they may become irritable for no reason. Movements may be stiff, unsteady or unusually slow.

Symptoms usually show up in one or more of the following ways:
  • Tremors or trembling in hands, arms, legs, jaw, and face
  • Rigidity or stiffness of limbs and trunk
  • Slowness of movement (Bradykinesia)
  • Impaired balance and coordination (postural instability)

These symptoms are both chronic―persisting over a long period of time―and progressive―getting more severe over time. Other symptoms of Parkinson's appear in varying degrees, such as: depression, low blood pressure, temperature sensitivity, leg discomfort, emotional changes, difficulty swallowing and chewing, speech changes, urinary problems or constipation, skin problems and sleep abnormalities. 

Over time, Parkinson's sufferers exhibit similar external characteristics: continual tremor, stooped posture, slow shuffle and blank stares. Presently, there is no cure and it is not completely understood as to what causes the disease. However, it is manageable through medication and lifestyle, especially when identified in the early stages.

In 1957, the Parkinson's Disease Foundation was established in America to fund research and assist Parkinson’s sufferers. Other foundations have since been formed, including the notable Michael J Fox Foundation, named after the much loved actor. The foundation has been very public about its goal of developing a cure for the disease within this decade.

While the root causes of Parkinson's disease are not known, scientists have found several causes of the symptoms. Since the 1960s, research has continued to progress at a rapid rate. Even though Parkinson’s cannot yet be cured, the symptoms can be effectively controlled. The work toward a cure, however, continues.

Who Gets Parkinson's disease?

Parkinson’s is the second most common degenerative disease after Alzheimer’s. About 50,000 Americans are diagnosed with Parkinson's disease each year, with more than half a million Americans affected at any one time. Getting an accurate count of the number of cases may be impossible however, because many people in the early stages of the disease assume their symptoms are the result of normal aging and do not seek help from a physician. Also, diagnosis is sometimes difficult and uncertain because other conditions may produce some of the symptoms of Parkinson's disease. 

Parkinson's Disease is a rare phenomenon, affecting approximately 1 in 300 people. Most individuals will have one or more of the risk factors above and never experience any of the symptoms. 

Risk factors include:
  • Advancing age
  • Sex – Some studies suggest males are more likely to get Parkinson's than females
  • Family history
  • Declining estrogen levels
  • Agricultural work history with exposure to an environmental toxins
  • Genetic factors
  • Low levels of B vitamin folate
  • Head trauma

How is Parkinson's diagnosed?

There are no specific tests that can be performed for Parkinson's disease. Instead, the physician may need to observe the patient for some time until it is apparent that the tremor is consistently present and is joined by one or more of the other classic symptoms.

How is the disease treated?

There are several drugs that have been found to provide relief from the symptoms of Parkinson's disease. Unfortunately, many of them have mild to severe side effects. In addition, the results vary by patient and often treat some symptoms while leaving others.

Levodopa – The most commonly prescribed drug. Levodopa is a chemical that crosses the blood-brain barrier and is converted to dopamine in the brain. It is technically known as a 'precursor to dopamine.'

Segeline – This is a MAO-B inhibitor. MAO-B is an enzyme that degrades dopamine, therefore inhibiting this enzyme causes dopamine to have a longer lasting effect on the brain.

Anticholigernic Medications – They block nerve impulses that control muscle movement. They also block acetylecholine, a neurotransmitter that helps to regulate muscle movement. Anticholigernics work best in patients who are over 70, where their main symptoms are tremors and drooling.

Surgery - Surgery can be used to treat Parkinson's disease. In general, it is currently regarded as a backup treatment to drugs. There are several procedures for varying intended results. Further research is still being done on the value of these techniques as well as new procedures being explored.

Exercise and Therapy – Simple exercise or more advanced therapies like speech or physical therapy are often used to treat Parkinson's. The disease progression is not interrupted but exercise and specialized therapies can help improve mobility, body strength and range of motion, and target certain muscles to improve speech or eating.

Support Groups - Because of the drastic changes in their life, support groups are often encouraged to help patients adjust to their new lifestyle. For information about support groups in your area, go to the National Parkinson’s Association website at http://www.parkinson.org/Search-Pages/Chapter-Locator.

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