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Parkinson's Disease

What is Parkinson's Disease ?

Named for the English doctor who first accurately described the disease in 1817, Parkinson's disease characteristically produces progressive muscle rigidity, akinesia, and involuntary tremors. Deterioration often progresses, culminating in death, which usually results from aspiration pneumonia or some other infection.

Parkinson's disease is also called parkinsonism, paralysis agitans, or shaking palsy. It's one of the most common crippling diseases in the United States. It affects men more often than women and usually occurs in middle age or later. Due to advances in treatment of complications, increased patient longevity is more common.

Causes of Parkinson's Disease

The cause of Parkinson's disease is unknown in most cases. Studies of the extrapyramidal brain nuclei (corpus striatum, globus pallidus, and substantia nigra) have established that a dopamine deficiency prevents affected brain cells from performing their normal inhibitory function within the central nervous system.

Some cases of Parkinson's disease are caused by exposure to toxins, such as manganese dust and carbon monoxide, that destroy cells in the substantia nigra.

Signs & Symptoms of Parkinson's Disease

People with Parkinson's disease experience tremors (shakiness) as a result of the damage to their nerve cells. The tremor of Parkinson's disease gets worse when the person is at rest and better when the person moves. The tremor may affect one side of the body more than the other, and can affect the lower jaw, arms and legs. Handwriting may also look "shaky" and smaller than usual. Other symptoms of Parkinson's disease include nightmares, depression, excess saliva, difficulty turning over in bed and buttoning clothes or cutting food, and problems with walking.

The symptoms of Parkinson's disease appear gradually and get worse over time. But because the disease usually develops slowly, most people with Parkinson's can live a long and relatively healthy life.

Diagnostic Tests

Although urinalysis may reveal decreased dopamine levels, laboratory test results usually have little value in identifying Parkinson's disease.

Computed tomography scanning or magnetic resonance imaging may be performed to rule out other disorders such as intracranial tumors. A conclusive diagnosis is possible only after ruling out other causes of tremor, involutional depression, cerebral arteriosclerosis and, in patients under age 30, intracranial tremors, Wilson's disease, or phenothiazine or other drug toxicity.

Treatment

No cure exists for Parkinson's disease, so the goal of treatment is to relieve symptoms and keep the patient functional as long as possible. Treatment consists of drugs, physical therapy and, in severe disease unresponsive to drugs, stereotaxic neurosurgery.



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