In Parkinson’s disease, cells in the brain die. These are cells that produce the substance dopamine, which is essential for maintaining control over movements. The deficiency of dopamine causes poorer muscle control. Parkinson’s disease mainly occurs in men over the age of fifty.
Symptoms
Parkinson’s disease can progress gradually. Symptoms often build up gradually over months or even years. The disease can also occur suddenly. The most well-known symptoms of Parkinson’s disease are:
- Trembling of body parts, such as hand, arm or leg
- Stiffness of the muscles
- Slow movements
- Walking becomes shuffling
- Face becomes emotionless
- Hunched posture
- Difficulty swallowing
- Talk more slowly
Parkinson’s progresses gradually. In the first phase, the symptoms start mildly and only occur on one side of the body. In the second stage, the patient experiences complaints on both sides of the body. Balance disorders occur in phase three. The patient notices that he can no longer perform all the actions himself. In the fourth phase, the complaints become increasingly worse and the Parkinson’s patient needs support with many actions. In the final stage there is dependence on a wheelchair or bed.
Diagnosis
Parkinson’s disease is often only discovered at a late stage. This is because the complaints gradually get worse. If Parkinson’s is suspected, the GP refers the patient to a neurologist. The diagnosis is made based on the symptoms of Parkinson’s and the physical examination. Sometimes a scan of the brain is made. A PET scan can show a deficiency of dopamine in the brain. In some cases, Parkinson’s is only diagnosed when the medication prescribed for Parkinson’s works.
Therapy
Medication
Parkinson’s disease cannot be cured. Medication treatment focuses on improving the balance of dopamine and acetylcholine in the brain. If a patient is severely limited in his independence, medication that resembles dopamine can be prescribed. This concerns, for example, pergolide or bromocriptine. The strongest drug to treat Parkinson’s is levopoda, but this drug has serious side effects, such as nausea and visual illusions. In the longer term, the side effects become less severe.
Physiotherapy and speech therapy
Physical therapy can help if patients have difficulty performing movements, such as getting up from a chair or walking. The physiotherapist can help you to keep moving. This is extremely important for a Parkinson’s patient and ensures that problems with, among other things, weak bones are prevented. Physiotherapy can help make daily movements such as getting out of bed easier, so that independence can be maintained for as long as possible. An occupational therapist can help with adjustments in and around the home. If you have speech problems, a speech therapist can be called in. Research has shown that Parkinson’s patients benefit from speech therapy to reduce speech and swallowing problems.
Surgery
Surgery is only used if medication does not suppress the shaking. Surgery usually never completely cures Parkinson’s. The most commonly used form of surgery is Deep Brain Stimulation (DBS). Electrodes are placed in the brain. Electrical impulses are sent via these electrodes from a stimulator that is placed in the chest. In the past, it was more common to switch off a specific area of the brain. Nowadays, Deep Brain Stimulation is more often chosen.
Cause
Parkinson’s disease is caused by dying brain cells responsible for the production of dopamine. People with secondary parkinsonism have the same symptoms as people with Parkinson’s, but are dealing with causes other than the death of brain cells. This could, for example, be a brain haemorrhage or a side effect of a certain medication.
Outlook
Patients with Parkinson’s have the same life expectancy as healthy people thanks to the latest treatment options. However, fatal complications can occur in Parkinson’s patients who are seriously ill, such as lung disease or poorly functioning kidneys.
Parkinson’s dementia
Forty percent of people with Parkinson’s will develop dementia. This is also called Parkinson’s dementia. Dementia begins about ten to fifteen years after the first symptoms of Parkinson’s and is more common in men.