What is Parkinson’s Disease?
Parkinson’s Disease (PD) is a progressive neurological condition. Degeneration of the central nervous system causes the sufferer to experience problems in their motor skills, speech and other functions. One person in every 500 has PD in the UK which amounts to approximately 120,000 people. Most people who have PD are over 50 years of age however, there are also younger sufferers. Approximately one in 20 is under the age of 40.
PD is caused when cells in the basal ganglia (a region of the brain) die. This causes a reduction in the production of dopamine within the body. Without dopamine, people suffer from stiffness and rigidity, tremor, postural abnormalities, gait abnormalities and slowing of physical movement (bradykinesia).
As of yet we do not know what the cause of this disease is and there is no known cure.
Symptoms
Symptoms most associated with Parkinson’s Disease are tremor, rigidity and slowness of movement. However there are other symptoms not all of which affect movement.
Symptoms can be divided into two different categories; motor symptoms and non-motor symptoms.
Motor symptoms include a tremor, which affects 70% of sufferers, rigidity, which often causes pain, spasms in muscles, numbness and slowness of movement, which is often associated with taking short shuffling steps when walking. Slowness of movement and rigidity can also affect a person’s facial muscles causing a loss of facial expression. As well as these more common symptoms a person can also experience constipation and incontinence, swallowing and saliva control problems, falls and dizziness, difficulties with speech and communication, weight loss and dietary problems and pain.
Non-motor symptoms – in some cases people will suffer from mental health problems including mild memory problems, dementia, depression, anxiety and hallucination. Other non-motor symptoms include sleep and sexual problems.
Diagnosis
Typically the diagnosis is based on medical history and a neurological examination. Response to Levodopa is also a good indicator of PD. As of yet there is no definitive test to indentify PD and therefore diagnosis is given by an experienced neurologist.
Treatment
Drugs are predominantly used to treat the symptoms of Parkinson’s Disease whilst research continues into finding a cure. Due to the reduction of dopamine producing cells in the brain, most drug treatments are aimed at increasing the levels of dopamine. There are many different drugs prescribed and none of them are perfect, however, they can relieve symptoms.
Therapists are also important to help with the symptoms of Parkinson’s and can aid significantly in rehabilitation. Physiotherapy for Parkinson’s Disease can help both patient and carer to develop an appropriate exercise programme to work on muscle and joint stiffness and postural problems. As well as giving tactics and equipment, which help with walking problems, Occupational Therapists (OT’s) can offer advice and equipment to help with functional daily activities. Speech and Language Therapists can help with communication and/or swallowing difficulties that may occur and a Dietician can help with maintaining good nutrition and constipation.
Sometimes treatment may involve surgery. This is only used in people who have had symptoms for some time and who are not being controlled well by medication. Surgical options include deep brain stimulation, lesioning techniques, infusion of chemical cells into the basal ganglia, implantation of foetal brain tissue and gamma knife surgery. However all surgery carries risks and must be very carefully discussed with the consultant and GP.
Further support and information can be found through the
Parkinson’s Disease Society who organise both local support groups and an online community.
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