Progressive brain damage (Parkinson’s disease) : Symptoms, Causes, Diagnosis & Treatment

Progressive brain damage (Parkinson's disease) : Symptoms, Causes, Diagnosis & Treatment

Parkinson’s disease (PD) is a progressive disorder that affects nerve cells in the brain responsible for body movement. When dopamine-producing neurons die, symptoms such as tremor, slowness, stiffness, and balance problems occur.

It’s thought around 1 in 500 people are affected by Parkinson’s disease, which means there are an estimated 127,000 people in the UK with the condition.

Most people with Parkinson’s start to develop symptoms when they’re over 50, although around 1 in 20 people with the condition first experience symptoms when they’re under 40.

Men are slightly more likely to get Parkinson’s disease than women.

Parkinson’s often starts with a tremor in one hand. Other symptoms are slow movement, stiffness and loss of balance.

How does Parkinson’s disease affect your body?

Parkinson’s disease is a condition in which parts of the brain become progressively damaged over many years. The central nervous system is made up of the brain and spine. When a person gets Parkinson’s disease, the cells that make dopamine in a part of the brain die. Dopamine cells send information to other cells which makes us do the actions we do. Because of this, Parkinson’s disease mainly affects the body’s motor system

What are the Causes of Parkinson’s disease?

Common causes include –

  • Genetics – 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. However, it’s rare for the disease to be inherited this way.
  • Environmental factors – 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. However, the evidence linking environmental factors to Parkinson’s disease is inconclusive.
  • Medication (drug-induced parkinsonism)  – Where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped.
  • Other progressive brain conditions – Such as progressive supranuclear palsy, multiple systems atrophy, and corticobasal degeneration
  • Cerebrovascular disease – Where a series of small strokes cause several parts of the brain to die.
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What are the Risk Factors of Parkinson’s disease?

Common risk factors include :

  • Gender – Many studies have identified that the incidence of PD is more common in men than women. The reasons for the differences in men and women with PD are unclear, although one suggested explanation is the protective effect of estrogen in women. Other theories to explain the difference between PD in men and women include the higher rate of minor head trauma and exposure to occupational toxins in men and genetic susceptibility genes on the sex chromosomes.
  • Age -Increasing age is a risk factor for PD, as the incidence of PD increases with age. PD affects 1% of the population over the age of 60, and this increases to 5% of the population over the age of 85. Only about 5% of all people with PD are diagnosed before the age of 60, which is considered early onset PD.
  • Ethnicity – Several studies have found that PD is more common in Whites than in Blacks or Asians. It is estimated that the prevalence of PD is 50% lower in Blacks and Asians than in Whites. However, the highest incidence of PD is found in Hispanics, followed by non-Hispanic Whites, Asians, and Blacks. According to one analysis, the incidence of PD in Hispanics is 16.6 per 100,000 persons, compared to 13.6 per 100,000 in non-Hispanic Whites, 11.3 per 100,000 in Asians, and 10.2 per 100,000 in Blacks.
  • Family history and genetics – Approximately 15% of people with PD have a relative with the disease. While some cases of PD occur in families, 85% of cases are sporadic, meaning they occur without an identified inherited genetic predisposition A number of genetic mutations have been identified that are associated with PD. Some of these appear to be more causal, while others simply increase a person’s risk for the disease.
  • Head Trauma – Trauma to the head, neck, or upper cervical spine seems to increase a person’s risk of developing PD. While the research is not conclusive, several studies have shown a link between head trauma and an increase in a person’s risk of developing the disease.
  • Environmental pesticides – While there have been theories that rural living may be a risk factor for PD, urban areas have a higher prevalence and incidence of PD.7A number of studies have looked at the relationship between exposure to environmental factors, like pesticides, and the development of neurological conditions, including PD and Alzheimer’s disease. Several studies have found associations between PD and exposure to pesticides, but there are also studies that have shown no association. At this time, the evidence is inconclusive.
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What are the symptoms of Parkinson’s disease?

The three main symptoms of Parkinson’s disease are:

  • Involuntary shaking of particular parts of the body (tremor)
  • Slow movement
  • Stiff and inflexible muscles
  • Other common symptoms include :
  • Depression and anxiety
  • Balance problems – this may increase the chance of a fall
  • Loss of sense of smell (anosmia)
  • Insomnia
  • Memory retardation
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How is Parkinson’s disease diagnosed?

No tests can conclusively show that you have Parkinson’s disease. Your doctor will base a diagnosis on your symptoms, medical history and a detailed physical examination.

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How to prevent & control Parkinson’s disease?

As such, there is no method to prevent Parkinson’s disease but reducing stress can reduce the risk of development. Drinking green tea, eating organic, local vegetables, and regular aerobic exercise all significantly reduce the long-term cumulative damage done by stress.

Treatment of Parkinson’s disease Allopathic Treatment

Common medications are :

  • Levodopa – Most people with Parkinson’s disease eventually need a medication called levodopa. Levodopa is absorbed by the nerve cells in your brain and turned into the chemical dopamine, which is used to transmit messages between the parts of the brain and nerves that control movement. Increasing the levels of dopamine using levodopa usually improves movement problems.
  • Dopamine agonists – 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. They are often taken as a tablet, but are also available as a skin patch (rotigotine). Sometimes dopamine agonists are taken at the same time as levodopa, as this allows lower doses of levodopa to be used.
  • 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. Both selegiline and rasagiline can improve the symptoms of Parkinson’s disease, although their effects are small compared with levodopa. They can be used alongside levodopa or dopamine agonists.
  • Catechol-O-methyltransferase inhibitors – Catechol-O-methyltransferase (COMT) inhibitors are prescribed for people in later stages of Parkinson’s disease. They prevent levodopa from being broken down by the enzyme COMT.

Non-oral therapies can also be done when Parkinson’s symptoms become difficult to control with tablets alone. These include :

  • Apomorphine – A dopamine agonist called apomorphine can be injected under the skin (subcutaneously) either by a single injection, when required or a continuous infusion using a small pump carried around on your belt, under your clothing, or in a bag.
  • Duodopa – If you have severe on-off fluctuations, a type of levodopa called duodopa may be used. This medication comes as a gel that’s continuously pumped into your gut through a tube inserted through your abdominal wall. There’s an external pump attached to the end of the tube, which you carry around with you.
  • Surgery – Most people with Parkinson’s disease are treated with medication, although a type of surgery called deep brain stimulation is used in some cases.
  • 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 one or two 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.

Treatment of Parkinson’s disease Homeopathic Treatment –

  • Causticum: For Parkinson’s Disease with excessive rigidity
  • Gelsemium Sempervirens: For Parkinson’s Disease with shaking of hands
  • Plumbum Metallicum: For Parkinson’s Disease with slowness in movement
  • Mercurius Solubilis: For Parkinson’s Disease with vigorous trembling of hands
  • Zincum Metallicum:  For Parkinson’s Disease with trembling of hands, constant shaking of feet
  • Argentum Nitricum:  For lack of control and trembling of hands in Parkinson’s Disease
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Parkinson’s disease – Lifestyle Tips

  • Get Adequate Rest – Try to sleep approximately 8 hours per night. Consider taking 1-2 naps during the day to stay refreshed. Consult your doctor if symptoms, such as restless leg syndrome, rapid eye movement (REM)-behavior disorder, tremor, or difficulty turning in bed at night, are interfering with your ability to sleep.
  • Eat a Balanced Diet – Consider consulting a dietitian to learn about a healthful diet. Eating well can give you more energy and help you manage the symptoms of Parkinson’s disease. Later in the disease, changes may have to be made to your diet because of swallowing difficulties. This may include a diet of soft or chopped foods, or thickened liquids. It is important to keep an eye on your weight, especially weight loss. Malnutrition can worsen the symptoms of Parkinson’s disease.
  • Exercise Regularly – An exercise program can offer many benefits, such as:
  • Increasing strength
  • Improving stamina
  • Optimizing coordination
  • Decreasing rigidity
  • Improving flexibility
  • Delaying progression of disease
  • Participate in a Speech Therapy Program – Speech therapy can be useful in some people who have verbal communication impairment. Impairment may include an inability to speak loud enough.
  • Manage Your Stress – Stress is known to worsen the symptoms of Parkinson’s disease. Learning stress management can help control your symptoms.
  • Modify the Home to Enhance Safety and Access – Many individuals require access to safety equipment that can assist in improving quality of life. Occupational and physical therapists can assist in determining when equipment such as tub rails, raised toilet seats or other home modifications may be useful.

What are Recommended Exercises for Person with Parkinson’s disease?

  • Physiotherapy helps to restore movement and function when someone is affected by injury, illness or disability. It can also help to reduce your risk of injury or illness in the future.
  • Regular exercise is particularly important in helping relieve muscle stiffness, improving your mood, and relieving stress.
  • There are many activities you can do to help keep yourself fit, ranging from more active sports like tennis and cycling, to less strenuous activities such as walking, gardening and yoga.
  • Your doctor can recommend a physical therapist for you to work with. You may also want to try Tai Chi, a type of martial art that is used to promote health. This form of exercise has shown benefits in improving balance in those with Parkinson’s disease.
  • Your doctor can give you information about fall prevention if balance and coordination are a problem. If needed, you can also use a cane or walker for further support.

Parkinson’s disease & Pregnancy – Things to know

Pregnancy does not often occur in the setting of Parkinson’s disease (PD) as the most common age of onset is beyond the childbearing years, yet management of these two conditions is crucial for the health of both mother and child.

Levodopa has the best safety data for use in pregnancy and amantadine should be avoided in women who are pregnant or trying to become pregnant. The data for other pharmacological and surgical treatments is less clear. There is no evidence that women with PD have higher rates of birth or fetal complications.

Common Complications Related to Parkinson’s disease

Common complications include :

  • Thinking difficulties – You may experience cognitive problems (dementia) and thinking difficulties. These usually occur in the later stages of Parkinson’s disease. Such cognitive problems aren’t very responsive to medications.
  • Depression and emotional changes – You may experience depression, sometimes in the very early stages. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson’s disease. You may also experience other emotional changes, such as fear, anxiety or loss of motivation. Doctors may give you medications to treat these symptoms.
  • Swallowing problems – You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
  • Chewing and eating problems – Late-stage Parkinson’s disease affects the muscles in your mouth, making chewing difficult. This can lead to choking and poor nutrition.
  • Sleep problems and sleep disorders – People with Parkinson’s disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day. People may also experience rapid eye movement sleep behavior disorder, which involves acting out your dreams. Medications may help your sleep problems.
  • Bladder problems – Parkinson’s disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
  • Constipation – Many people with Parkinson’s disease develop constipation, mainly due to a slower digestive tract.

Other FAQs about Parkinson’s disease

Q. Does Parkinson’s run in families?

A. 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.

Q. Do you have pain with Parkinson’s disease?

A. Pain is a common, but perhaps unexpected, non-motor symptom of Parkinson’s disease (PD). Up to 75 percent of people can experience some form of discomfort during the course of their disease. Unfortunately, this symptom is often under-recognized and therefore undertreated.

Q. Do Parkinson’s patients sleep a lot?

A. Parkinson’s patients experience difficulties with their sleep due to the disease itself and the medications that treat it. Difficulties sleeping during the night can cause daytime sleepiness, and the medications can also cause drowsiness.


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