About Parkinson's Disease


What is Parkinson's Disease

What causes Parkinson's Disease?

What are the major symptoms?

What treatments are available?

 

 

‘PD’ Tomorrow is hopeful - Medical Episode



 

 

 

 

 

 

 

 

 

 

 



 

 

 

What is Parkinson’s Disease?

Parkinson’s Disease is a chronic progressive neurological disorder resulting from degeneration in part of the brain called “substantia nigra”. This leads to the insufficient production of “dopamine” which is a chemical responsible for transmitting neuro signals in the human body. The decrease in the amount of “dopamine” can directly affect the motor functions hence greatly inhibits the patient’s ability to move.

This disease is often found in elderly people of 60 years old or above, but some patients can be diagnosed having the disease as young as 30 to 40 years of age.

Dopamine is responsible for transmitting neuro signals in the human body.

 

The decrease in the amount of dopamine can directly affect the motor functions hence greatly inhibits the patient’s ability to move.

 

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What causes Parkinson's Disease?

Most Parkinson’s disease cases are idiopathic (i.e. cause unknown). However, there is parkinsonism related to the following situations:-

- drug induced
- encephalitis
- small strokes
- skull or brain injury/brain tumor
- carbon monoxide poisoning/other chemical poisoning

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What are the major symptoms?

 

Tremor

The patient continues to have uncontrollable tremor at limbs, which is particularly obvious when not otherwise at motions. The tremor is usually first found at one hand, then gradually extended to the lower limb of the same side. Finally the other side of the body may also be affected.

 

Rigidity

The patient’s muscle at limbs are becoming stiff. There is major resistance when stretching or bending the affected body part and the motion is as difficult as cog wheel movement.

 

Bradykinesia (slow movement)

This include a series of phenomena such as: difficulty in writing - the patient’s handwriting gets progressively smaller and squiggly; long time sitting without postural change; feeling difficulty to start and stop walking; lacking facial expression etc.

 

Postural Instability (poor balance)

The patient does not have corresponding swing of the upper limbs when walking. The body can lose balance easily. Due to the balancing problem, the patient often shuffles forward in short steps once starts walking, and the body is leaned forward in order to maintain balance.

 

Other Symptoms

- freezing (feet immobilized suddenly)

- stooped posture

- blank facial expression (masked face)

- swallowing and speech problem

- drooling

- bladder control problems

- constipation

- sexual dysfunction

- mood changes

 

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What treatments are available?

There is no cure to Parkinson’s disease at the moment, but relief of symptoms may be achieved through the following methods:-

 

Drugs Therapy

Through regular dosage of medication, the symptoms can be controlled through:

- increasing the amount of dopamine (temporarily replenishing or mimicking dopamine)
- slowing down the metabolism of dopamine in the brain
- blocking the action of acetylcholine in the brain

Drugs replenish/mimicking dopamine help alleviate symptoms

 

Physiotherapy

Suitable amount of physical exercise can help improve the patient’s mobility.

 

Occupational Therapy

Mainly to train the patient’s self care ability and use of suitable rehabilitation equipment.

 

Speech Therapy

To help improve the patient’s speech and swallowing problem.

 

Surgery

Deep Brain Stimulation (DBS) - refers to implanting a probe or electrode, a stimulator into a clearly defined, abnormal discharging brain region, a region generating "static." By generating a blocking or inhibiting counter-current, the effects of the static are lessened or negated. This new technology has already been introduced in Hong Kong and a few major hospitals have acquired successful clinical experience in using this treatment method.

For PD patients at their late stage who do not respond well to drugs and whose condition is severe, the doctors may consider using surgical treatment to improve their condition. However, the patients and their families should bear in mind that one stimulator costs about HK$80,000, and each patient needs two stimulators. Besides, they should also consider the risks involved even though the success rate of this surgery has reached 98%.

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