Understanding Parkinson’s Disease
What is Parkinson’s Disease?
Parkinson’s Disease is a chronic progressive neurological disorder, resulting from degeneration in certain part of the brain called “substantia nigra”. This leads to the insufficient production of “dopamine” which is a chemical substance responsible for transmitting neuro signals in the human body.
The decrease in the quantity of “dopamine” can directly affect the motor functions hence significantly inhibits the patient’s ability to move. This disease is often found in elderly people of 60 years old or above, however some patients can be diagnosed with the disease as young as 30 to 40 years of age
What Causes Parkinson’s Disease?
Most cases are idiopathic and primary in nature (i.e. cause unknown). Yet a few cases are due to family inheritance.
However, secondary Parkinsonism may be related to the following situations:-
- encephalitis
- brain injury
- tumor
- calcification of the brain
- carbon monoxide poisoning
- heavy metal chemical poisoning
Major Symptoms of Parkinson’s Disease
Tremor
The patient will continue to have uncontrollable tremor of his limbs, especially obvious when at rest and not in motion. The tremor usually starts with one hand, then gradually extended to the lower limb of the same side. Eventually the other side of the body may also be affected.
Rigidity (stiffness)
The patient’s limb muscles will become stiff. He would experience great resistance when stretching or bending the affected part of the body, while his movement would be as difficult as turning the machine gear.
Bradykinesia (slow movement)
This includes a range of phenomena such as: difficulty in writing with the patient’s handwriting getting smaller and more squiggy; sitting for a long time without changing the posture; feeling difficult to start or stop walking; lacking in facial expression etc.
Postural Instability (poor balance)
Due to problem in maintaining balance, the patient will often tend to shuffle forward in small and quick steps once he starts to walk, while his body would dash forward in order to keep balance.
Non-Motor Symptoms of Parkinson’s Disease
- insomnia and sleep problem
- emotional illness
- disorder of the involuntary nervous system
- cognitive impairment
- constipation
Treatment Available
There is currently no cure to Parkinson’s disease. Yet relief of symptoms and slowing down of deterioration may be achieved through the following methods:
Drug Therapy
Through regular medication, the symptoms can be controlled by:
- increasing the dosage of dopamine
- slowing down the decomposition or metabolism of dopamine in the brain
- suppressing the action of acetylcholine
Taking supplements replenishing/mimicking dopamine may also help to alleviate symptoms.
Speech Therapy
This would aim to address the speech and swallowing problems of patients.
Physiotherapy
Suitable amount of physical exercises, such as tai chi, yoga, ping pong and brisk walking, can help to enhance the patient’s mobility.
Occupational Therapy
This is mainly to train up the patient’s self-care ability with the help of suitable rehabilitation equipment, including rollator, wheelchair, installation of handrail at home.
Surgical Treatment - Deep Brain Stimulation (DBS)
When patients with Parkinson's disease fail to achieve satisfactory results through medication, such as signs of involuntary movements or drugs are not effective, surgery may be considered as an option to improve mobility.
DBS involves minimally invasive brain surgery to implant a probe or electrode into a specifically defined area of the brain, with wire connection to a stimulator for regulating the flow of current to facilitate body motion.
The stimulator is usually implanted under the skin of the chest, similar to a pacemaker.
Chinese Medicine
During the early phase of Parkinson's disease when symptoms are mild, it may not be necessary to take western medicine. At this stage, Chinese medicine can be considered for treatment.
Some universities in Hong Kong are conducting research on treatment of the disease using traditional Chinese medicine. Currently, taking Chinese herbal medicine, massage and acupuncture is not a cure, but rather an alternative for relieving Parkinson's disease.
Managing Parkinson’s Disease
The key is to slow down the deterioration of the disease taking into account the following:
- the rate of degeneration varies from person to person
- a correct and well-informed understanding of the disease
- proper medication
- suitable exercises
- positive mindset
- stay optimistic
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