PARKINSON’S DISEASE

Parkinson’s disease is one of the more common diseases of the nervous system first described in 1817 by James Parkinson. It is estimated that this year alone, 50,000 people in this country will be diagnosed with this chronic, progressive movement disorder.

Symptoms of Parkinson’s disease arise when nerve cells (neurons) in different areas of the brainstem, such as the substantia nigra, are damaged. As we age everyone loses some of these neurons, but those with Parkinson’s disease lose half or more of these neurons which result in abnormal nerve-firing patterns that affect body movement. The neurons
in the substantia nigra produce dopamine which transmits signals from the substantia nigra to another area of the brain called the striatum. When too many of the dopamine-producing neurons are lost trouble with movement begins.

The main risk factor is age. Others include a family history of Parkinson’s disease, midlife obesity, ongoing exposure to herbicides and pesticides and drinking well water. Males also have a slightly higher risk than females.

Parkinson’s begins with a faint tremor; the onset is so gradual that it is hard to recall when it began. Tremor is the outstanding sign of the disease. Other frequent signs include slow or shuffling walk, stooped posture, unsteady gait, and impaired balance. Muscle rigidity in the limbs and neck can also be experienced.

Treatment for Parkinson’s is highly individual. A healthy diet and exercise may help. Special attention should be paid to posture. Medications can help regulate movement problems, but what is appropriate depends on the symptoms and progression of the disease. Some drugs include dopamine replacers, dopamine agonists (they mimic dopamine’s role in the brain) and/or dopamine enhancers. Surgical treatment in advanced Parkinson’s disease when drug therapy is no longer effective is an option, but it is not right for everyone.

At present there is no known cure, but research is ongoing. Current research involves a study of clumps of proteins called Lewy bodies discovered in certain cells of the brain in those who have Parkinson’s disease. The other area of research is the study of genomic pathways. Researchers are looking at a large cluster of related genes and patterns within these genes that make some more likely to develop Parkinson’s. Even though there is at present no cure, great progress has been made in understanding, treating and managing the disease.

Source: Mayo Clinic Health Letter, November 2007, Parkinson’s Disease
Medical Surgical Nursing, Concepts and Clinical Practice 3rd Edition, Phipps-Long-Wood, Parkinson’s Disease (Paralysis Agitans)