Parkinson’s disease, parkinsonism: symptoms, treatment

Parkinson’s disease is a chronic disease of the nervous system characterized by tremors and stiffness of the whole body. Cells die in certain areas of the brain, causing a deficiency of dopamine. What are the symptoms of Parkinson’s disease, how can the disease be treated and what is the prognosis? What is the difference between Parkinson’s disease and parkinsonism?

Article content

  • Parkinson’s disease
  • Causes of Parkinson’s disease
  • Parkinsonism
  • Symptoms of Parkinson’s disease
  • Diagnosis of Parkinson’s disease
  • Treatment of Parkinson’s disease and parkinsonism
  • Prognosis of Parkinson’s disease
  • Research
  • World Parkinson’s Day: every year on April 11

 

Parkinson’s disease

Parkinson’s disease is a progressive disorder of the brain that causes tremors and problems with movement . Parkinson’s disease is a brain disorder that is relatively common and mainly affects the elderly. About one percent of people over fifty-five are affected by the disease.

Causes of Parkinson’s disease

Parkinson’s disease is caused by the death of cells in certain areas of the brain. In these areas of the brain, movements are finely regulated by dopamine and acetylcholine (neurotransmitters). In Parkinson’s disease there is a deficiency of dopamine , which complicates muscle control. The cause of this is not known, but it is known that hereditary factors are involved. About thirty percent of people with Parkinson’s disease have a family member with the disease. The disease is more common in men and is more common in people over the age of fifty.

Parkinsonism

This is a word for the symptoms you see with Parkinson’s disease, but the cause is another condition. It can be caused by certain medications , such as antipsychotics, but also by repeated brain damage .

Symptoms of Parkinson’s disease

The symptoms of Parkinson’s disease start slowly, it can occur over a period of months or years. Parkinsonism can occur insidiously but also acutely, depending on the cause.

  • Trembling, shaking of hand, leg or arm. First usually on one side, later on both sides and what is striking is that it almost always occurs when someone is at rest .
  • Trembling or shaking does not have to occur.
  • Stiff muscles, it is difficult to start a movement.
  • Movement is slow.
  • Someone can walk with shufflers, with small steps.
  • The face shows little emotion, expression.
  • Movements reminiscent of counting money can be made with the thumb and index finger.
  • Saliva runs out of the mouth due to disturbed motor skills of the mouth, swallowing can be difficult.
  • Speech becomes softer and others often cannot understand the person well.
  • The posture is bent.
  • Once the person is walking it is difficult to stop.
  • Many people with the disease become depressed.
  • About thirty percent of people with Parkinson’s eventually develop dementia.

 

Diagnosis of Parkinson’s disease

Because the main symptoms of the disease begin gradually, the diagnosis will often not be made immediately . The GP will examine the person and perhaps refer him or her to a neurologist. The diagnosis may be made if someone responds well to antiparkinsonian medications.

Treatment of Parkinson’s disease and parkinsonism

The symptoms can be reduced by medication, physiotherapy or surgery. If parkinsonism is caused by the use of certain medications, the symptoms may disappear within about eight weeks after adjusting the medication.
Physiotherapy, speech therapy, occupational therapy : problems with movement can be reduced. Speech therapy can help with speech and swallowing problems and an occupational therapist can indicate what changes can be made at home.

Medicines

The balance between dopamine and acetylcholine in the brain must be restored. If the symptoms are quite mild, dopamine-like medications may be recommended (such as pramipexole, ropinirole). Drugs that reduce the activity of acetylcholine (for example trihexyphenidyl) can also be prescribed. However, these drugs can cause symptoms of dementia in older people, or worsen them if they already exist. Blurred vision, urinary problems and dry mouth can also be side effects. An anti-flu drug, amantadine sometimes also works, but has a number of side effects such as: a feeling of nausea, no appetite for food and someone may start to hallucinate. Levodopa is the strongest drug, a feeling of nausea and vomiting are side effects that occur in the beginning. It can also happen that someone makes involuntary movements or hallucinates. Finally, the effectiveness of levodopa decreases.

Operation

Young people may undergo surgery if the shaking cannot be reduced with medication. The part of the brain that is responsible is then switched off. Stimulating the deeper brain with electrical impulses is a new technique to prevent trembling. In the future, brain cell implantation may be possible.

What you can do yourself

Staying in shape is very important. Make sure you get enough exercise, take a walk every day. In addition to exercise, rest is also very important. Don’t forget about mental well-being, support from family, friends and acquaintances is also very valuable.

Prognosis of Parkinson’s disease

The course of the disease is very different. Medicines can reduce the symptoms and thus improve the quality of life. Many people with Parkinson’s disease can live a good life for many years to come. However, many people with the disease ultimately need daily support because it becomes increasingly difficult to control the symptoms.

Research

  • A lot of research is being done into Parkinson’s disease. In May 2012, a message appeared about vitamin K2 . Neuroscientist Patrik Verstreeks from VIB (the Flemish Institute for Biotechnology) and KU Leuven, had managed to reverse the consequences of one of the gene defects that underlie Parkinson’s disease with vitamin K2. His discovery opens perspectives for people with Parkinson’s disease. Further research is still needed.
  • Substantial grant for Parkinson’s research (February 2013): a partnership of researchers that includes Groningen cell biologists Arjan Kortholt and Peter van Haastert has received a grant of $1,300,000 from the Michael J. Fox Foundation for Parkinson’s Research. The part of the budget that the Groningen researchers can spend is approximately $350,000. The aim of the project: to determine the three-dimensional structure and mechanism of action of the protein LRRK2. Mutations in the gene for this protein are associated with hereditary forms of Parkinson’s disease. The expectation is that more insight will be gained into the pathogenesis of Parkinson’s and that the research can contribute to the development of medicines.

 

World Parkinson’s Day: every year on April 11

Every year on April 11, it is World Parkinson’s Day. On that day, worldwide attention is drawn to Parkinson’s disease and parkinsonism. It is important that money is raised for two purposes: scientific research into the cause of the disease – to ultimately make a cure possible. And research into and application of optimal care for people with Parkinson’s disease. The day has been organized internationally since 1997. April 11 was chosen because this is the birthday of Dr. James Parkinson , the English physician who first recognized and described the symptoms of the disease as a coherent whole. In 2009, the Parkinson’s Association paid national and regional attention to World Parkinson’s Day for the first time.

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