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Parkinsons disease

Parkinsons disease



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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
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Parkinson's Disease

Parkinson's disease develops gradually, often starting with a barely noticeable tremor
in just one hand. But while tremor may be the most well-known sign of Parkinson's
disease, the disorder also commonly causes a slowing or freezing of movement.

Friends and family may notice that your face shows little or no expression and your
arms don't swing when you walk. Speech often becomes soft and mumbling.
Parkinson's symptoms tend to worsen as the disease progresses.

While there is no cure for Parkinson's disease, many different types of medicines can
treat its symptoms. In some cases, your doctor may suggest surgery.

The symptoms of Parkinson's disease vary from person to person. Early signs may be
subtle and can go unnoticed for months or years. Symptoms typically begin on one
side of the body and usually remain worse on that side. Parkinson's signs and
symptoms may include:

Tremor. The characteristic shaking associated with Parkinson's disease often

begins in a hand. A back-and-forth rubbing of your thumb and forefinger, known as pill-rolling, is common. However, many people with Parkinson's disease do not experience substantial tremor.

Slowed motion (bradykinesia). Over time, Parkinson's disease may reduce

your ability to initiate voluntary movement. This may make even the simplest
tasks difficult and time-consuming. When you walk, your steps may become
short and shuffling. Or your feet may freeze to the floor, making it hard to take
the first step.

Rigid muscles. Muscle stiffness often occurs in your limbs and neck.
Sometimes the stiffness can be so severe that it limits the range of your
movements and causes pain.
Impaired posture and balance. Your posture may become stooped as a result
of Parkinson's disease. Imbalance also is common, although this is usually
mild until the later stages of the disease.
Loss of automatic movements. Blinking, smiling and swinging your arms

when you walk are all unconscious acts that are a normal part of being human.
In Parkinson's disease, these acts tend to be diminished and even lost. Some
people may develop a fixed staring expression and unblinking eyes. Others
may no longer gesture or seem animated when they speak.

Speech changes. Many people with Parkinson's disease have problems with
speech. You may speak more softly, rapidly or in a monotone, sometimes
slurring or repeating words, or hesitating before speaking.
Dementia. In the later stages of Parkinson's disease, some people develop
problems with memory and mental clarity. Alzheimer's drugs appear to
alleviate some of these symptoms to a mild degree.

Many symptoms of Parkinson's disease result from the lack of a chemical messenger, called dopamine, in the brain. This occurs when the specific brain cells that produce dopamine die or become impaired. But researchers still aren't certain about what sets this chain of events in motion. Some theorize that genetic mutations or environmental toxins may play a role in Parkinson's disease.

Risk factors
Risk factors for Parkinson's disease include:
Age. Young adults very rarely experience Parkinson's disease. It ordinarily
begins in middle or late life, and the risk continues to increase with age.
Heredity. Having one or more close relatives with Parkinson's increases the

chances that you'll also develop the disease, although your risk is still less than 5 percent. Recent evidence suggests a crucial role for small contributions from many different genes that program brain architecture.

Sex. Men are more likely to develop Parkinson's disease than women are.
Exposure to toxins. Ongoing exposure to herbicides and pesticides puts you
at slightly increased risk of Parkinson's.
When to seek medical advice

See your doctor if you have any of the symptoms associated with Parkinson's disease
\u2014 not only to diagnose the illness but also to rule out other causes for your problem.
For instance, tremor is often an early sign of Parkinson's disease, but the most
common type of tremor, known as essential tremor, isn't caused by Parkinson's.

Although Parkinson's disease can sometimes be difficult to pin down, getting an
accurate diagnosis is the key to starting appropriate treatment that may help delay or
manage symptoms for years.

Tests and diagnosis

No definitive tests exist for Parkinson's disease, so it can be difficult to diagnose, especially in the early stages. And parkinsonism \u2014 the symptoms of Parkinson's disease \u2014 can be caused by many other types of problems. Examples include:

Other neurological disorders. Essential tremor, dementia with Lewy bodies,
multiple system atrophy and progressive supranuclear palsy each feature some
symptoms common to Parkinson's disease.
Drugs. Antipsychotic medications \u2014 such as chlorpromazine (Thorazine) and
haloperidol (Haldol) \u2014 block dopamine, as do anti-nausea drugs like

prochlorperazine (Compazine) or metoclopramide (Reglan). If you take any of these drugs, you may develop parkinsonism, although it is reversible when the drug is stopped.

Toxins. Exposure to carbon monoxide, cyanide or certain other toxins can
produce symptoms similar to Parkinson's disease.
Head trauma. Both solitary head injuries and the repetitive variety of head
trauma common in boxing have been linked to parkinsonism, although risks
are small.
Structural problems. Strokes or fluid buildup in the brain (hydrocephalus)
may occasionally mimic Parkinson's disease.

A diagnosis of Parkinson's disease is based on your medical history and a
neurological examination. As part of your medical history, your doctor will want to
know about any medications you take and whether you have a family history of
Parkinson's. The neurological examination includes an evaluation of your walking and
coordination, as well as some simple hand tasks.

A diagnosis of Parkinson's is most likely if you have:
At least two of the three cardinal Parkinson's symptoms \u2014 tremor, slowing of
motion and muscle rigidity
Onset of symptoms on only one side of the body
Tremor more pronounced at rest, for example, when your hands are resting in
your lap
Strong response to levodopa, a Parkinson's drug
Parkinson's disease is often accompanied by these additional problems:
Depression. This can occur even before other Parkinson's symptoms.
Receiving treatment for depression can make it easier to handle the other
challenges of Parkinson's disease.
Sleep problems. People with Parkinson's disease often have trouble falling
asleep and may wake up frequently throughout the night. They may also
experience sudden sleep onset, called sleep attacks, during the day.
Difficulty chewing and swallowing. The muscles you use to swallow may be
affected in the later stages of the disease, making eating more difficult.
Urinary problems. Parkinson's disease may cause either urinary incontinence
or urine retention. Certain medications used to treat Parkinson's also can make
it difficult to urinate.
Constipation. Many people with Parkinson's disease develop constipation
because the digestive tract works more slowly. Constipation may also be a
side effect of medications used to treat the disease.
Sexual dysfunction. Some people with Parkinson's disease may notice a
decrease in sexual desire. This may stem from a combination of psychological
and physical factors, or it may be the result of physical factors alone.

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