Parkinson's Flashcards
What is Parkinson’s disease?
Parkinson’s disease is a condition in which parts of the brain become progressively damaged over many years
What are the main symptoms of Parkinson’s disease?
The 3 main symptoms of Parkinson’s disease are:
involuntary shaking of particular parts of the body (tremor)
slow movement
stiff and inflexible muscles
Most frequently, patients have gait impairments, difficulty in linking movements together smoothly and episodes of freezing.
What are other symptoms of Parkinson’s disease?
A person with Parkinson’s disease can also experience a wide range of other physical and psychological symptoms.
These include:
Facial masking depression and anxiety balance problems (this may increase the chances of a fall) loss of sense of smell (anosmia) problems sleeping (insomnia) Nerve Pain memory problems- dementia (personality change, hallucinations) Urinary problems ( incontinence) Constipation Sexual, ED in men and difficultly of arousal in women Dizziness Excessive sweating Swallowing difficulties- Dysphagia Drooling- excessive saliva production.
What are the causes of Parkinson’s disease?
Parkinson’s disease is caused by a loss of nerve cells in the part of the brain called the substantia nigra.
These cells are responsible for producing a chemical called dopamine.
Dopamine acts as a messenger between the parts of the brain and nervous system that help control and co-ordinate body movements.
The loss of these cells means the amount of dopamine in the brain is reduced.
Meaning the part of the brain controlling movement cannot work as well as normal, causing movements to become slow and abnormal.
The loss of nerve cells is a slow process. The symptoms of Parkinson’s disease usually only start to develop when around 80% of the cells have been lost.
What causes the loss of nerve cells?
It’s not known why the loss of nerve cells associated with Parkinson’s disease occurs, although research is ongoing to identify potential causes.
Currently, it’s believed a combination of genetic changes and environmental factors may be responsible for the condition.
A number of genetic factors have been shown to increase a person’s risk of developing Parkinson’s disease, although exactly how these make some people more susceptible to the condition is unclear.
Parkinson’s disease can run in families as a result of faulty genes being passed to a child by their parents. But it’s rare for the disease to be inherited this way.Some researchers also feel environmental factors may increase a person’s risk of developing Parkinson’s disease.
It’s been suggested that pesticides and herbicides used in farming and traffic or industrial pollution may contribute to the condition.
But the evidence linking environmental factors to Parkinson’s disease is inconclusive.
Diagnosis
A diagnosis of Parkinson’s disease is likely if you have at least 2 of the 3 following symptoms:
shaking or tremor in a part of your body that usually only occurs at rest
slowness of movement (bradykinesia)
muscle stiffness (rigidity)
If your symptoms improve after taking a medication called levodopa, it’s more likely you have Parkinson’s disease.
Special brain scans, such as a single photon emission computed tomography (SPECT) scan, may also be carried out in some cases to try to rule out other causes of your symptoms.
Treatment of Parkinson’s
There’s currently no cure for Parkinson’s disease, but treatments are available to help relieve the symptoms and maintain your quality of life.
These treatments include:
supportive therapies, such as physiotherapy
medication
surgery (for some people)
You may not need any treatment during the early stages of Parkinson’s disease as symptoms are usually mild.A care plan should be agreed with your healthcare team and your family or carers.
This will outline the treatments and help you need now and what you’re likely to need in the future, and should be reviewed regularly.
Supportive Therapies
A physiotherapist can work with you to relieve muscle stiffness and joint pain through movement (manipulation) and exercise.
The physiotherapist aims to make moving easier and improve your walking and flexibility.
They also try to improve your fitness levels and ability to manage things for yourself.
Occupational Therapist
An occupational therapist can identify areas of difficulty in your everyday life.They can help you work out practical solutions and ensure your home is safe and properly set up for you
Speech and Language Therapy
Many people with Parkinson’s disease have swallowing difficulties (dysphagia) and problems with their speech.
A speech and language therapist can often help you improve these problems by teaching speaking and swallowing exercises, or by providing assistive technology.
Diet Advice
Medications for Parkinson’s
Medication can be used to improve the main symptoms of Parkinson’s disease, such as shaking (tremors) and movement problems.Three main types of medication are commonly used:
levodopa
dopamine agonists
monoamine oxidase-B inhibitors
Most people with Parkinson’s disease eventually need a medication called levodopa.
Levodopa
Levodopa is absorbed by the nerve cells in your brain and turned into the chemical dopamine.
Increasing the levels of dopamine using levodopa usually improves movement problems.
Often combined with other medication, such as benserazide or carbidopa which stop the levodopa being broken down in the bloodstream before it has a chance to get to the brain.
At first, levodopa can cause a dramatic improvement in the symptoms. But its effects can be less long-lasting over the following years (as less nerve cells to absorb medicine)
– as more nerve cells in the brain are lost, there are fewer of them to absorb the medicine.Long-term use of levodopa is also linked to problems such as uncontrollable, jerky muscle movements (dyskinesias) and “on-off” effects, where the person rapidly switches between being able to move (on) and being immobile (off).
Dopamine agonist
Dopamine agonists act as a substitute for dopamine in the brain and have a similar but milder effect compared with levodopa. They can often be given less frequently than levodopa
Monoamine Oxidase-B inhibitors
Monoamine oxidase-B inhibitors
Monoamine oxidase-B (MAO-B) inhibitors, including selegiline and rasagiline, are another alternative to levodopa for treating early Parkinson’s disease.
They block the effects of an enzyme or brain substance that breaks down dopamine (monoamine oxidase-B), increasing dopamine levels.
Catechol-O-methyltransferase inhibitors
Catechol-O-methyltransferase inhibitors
Catechol-O-methyltransferase (COMT) inhibitors are prescribed for people in later stages of Parkinson’s disease.
They prevent levodopa being broken down by the enzyme COMT.
Surgical Treatment (not common)
Deep brain stimulation
Deep brain stimulation involves surgically implanting a pulse generator similar to a heart pacemaker into your chest wall.
This is connected to 1 or 2 fine wires placed under the skin, and is inserted precisely into specific areas in your brain.
A tiny electric current is produced by the pulse generator, which runs through the wire and stimulates the part of your brain affected by Parkinson’s disease.
Although surgery does not cure Parkinson’s disease, it can ease the symptoms for some people.
