Complications For Parkinson’s Disease

Parkinsons Tremor: Causes Treatments And More

Parkinsons disease is a neurological disease that disrupts balance and movement. It occurs when the brain cells responsible for producing dopamine, a chemical in the body that regulates mood and movement deteriorate. According to research, the most common symptom of Parkinsons disease is tremor. This article discusses the type of …

What Are The Surgical Treatments For Parkinsons Disease

Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.

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Clinical Management Of Motor Complications

In early PD, treatment with CD-LD IR 25100 mg administered TID typically provides relatively sustained relief of motor symptoms through the day with benefit lasting from dose to dose. Once the duration of symptomatic benefit shortens and patients begin to experience OFF episodes, treatment strategies are available to mitigate the impact of these motor fluctuations.

If a patient is experiencing wearing off motor fluctuations on CD-LD IR, a common strategy is to increase the frequency of administration. Many patients will experience resolution of mild wearing off when going from CD-LD IR TID to QID . If wearing off fluctuations are still present on a QID regimen, further shortening of the interdose interval can be attempted, but such regimens are a challenge for patients and adherence decreases . Therefore, to reduce motor fluctuations in patients who are on CD-LD IR QID, adding an adjunctive medication or switching to CD-LD ER may be advantageous. In our practice, we commonly add one or possibly two adjunctive therapies first, and if that is insufficient, we then favor converting the levodopa regimen to CD-LD ER.

Available adjunctive medications include MAO-B inhibitors , mixed selective MAO-B inhibitors and ion channel inhibitors , COMT inhibitors , an adenosine 2A receptor antagonist , and dopamine agonists . The choice of adjunctive medication typically depends on a combination of patient factors and medication characteristics .

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Being Prepared & Anticipating Problems

Because of the concerns that we will discuss below, it is prudent to have your neurologist speak to your surgeon and anesthesiologist prior to the surgery so he/she can discuss the potential issues that may arise during and after the surgery. It is also very useful to have your neurologist write a letter with all the necessary information so it can be dispersed to other members of the medical team who will be responsible for your day-to-day care after the surgery.

Depending on the type of surgery, there may be more than one option for anesthesia. General anesthesia may not be the only option, and a more localized form of anesthesia may be possible. Local anesthesia typically causes fewer side effects. Discuss what anesthesia options you have with the surgeon and anesthesiologist prior to the surgery.

In addition, if the surgery requires you to stay in the hospital overnight, consider having a family member or friend stay with you. This person can provide a calming presence, helping to prevent agitation or distress. He or she can keep an eye on whether you are taking your own medications correctly and what additional medications you are bring given.

What Are The Symptoms Of Parkinsons Disease

Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:

Other symptoms include:

• Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
• Handwriting changes: You handwriting may become smaller and more difficult to read.
• Depression and anxiety.

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How Does This Condition Affect My Body

Parkinsons disease causes a specific area of your brain, the basal ganglia, to deteriorate. As this area deteriorates, you lose the abilities those areas once controlled. Researchers have uncovered that Parkinsons disease causes a major shift in your brain chemistry.

Under normal circumstances, your brain uses chemicals known as neurotransmitters to control how your brain cells communicate with each other. When you have Parkinsons disease, you dont have enough dopamine, one of the most important neurotransmitters.

When your brain sends activation signals that tell your muscles to move, it fine-tunes your movements using cells that require dopamine. Thats why lack of dopamine causes the slowed movements and tremors symptoms of Parkinson’s disease.

As Parkinson’s disease progresses, the symptoms expand and intensify. Later stages of the disease often affect how your brain functions, causing dementia-like symptoms and depression.

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Gut Microbiome Of Patients Favors Inflammation Study Suggests

Here, an international team of scientists conducted analyses of data collected from 55 Parkinsons patients and 55 people without the disease . The collected data included evaluations of stool and blood samples, as well as clinical data.

In line with prior findings, this analysis found that Parkinsons patients had reduced levels of fecal butyrate, and lower abundances of butyrate-producing bacteria in their guts.

Statistical analyses also showed that, among those with Parkinsons, lower levels of butyrate were associated significantly with more severe depression, as measured by the Geriatric Depression Scale .

The scientists then conducted a series of analyses to look for epigenetic changes associated with altered butyrate levels. Epigenetics refers to chemical alterations made to DNA molecules that do not alter the genetic sequence, but can change how the DNA is read for instance, increasing or decreasing the activity of individual genes.

This study is the first to examine the possible role of epigenetic changes as a link between gut microbiota, its metabolites, and the pathophysiology of neural and immune cells in Parkinsons, the researchers wrote.

Our results suggest that butyrate may impact through epigenetic effects on innate immune cells, the researchers wrote.

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What Is Parkinsons Disease

Parkinsons disease is the second most common neurodegenerative disorder and the most common movement disorder. Characteristics of Parkinsons disease are progressive loss of muscle control, which leads to trembling of the limbs and head while at rest, stiffness, slowness, and impaired balance. As symptoms worsen, it may become difficult to walk, talk, and complete simple tasks.

The progression of Parkinsons disease and the degree of impairment vary from person to person. Many people with Parkinsons disease live long productive lives, whereas others become disabled much more quickly. Complications of Parkinsons such as falling-related injuries or pneumonia. However, studies of patent populations with and without Parkinsons Disease suggest the life expectancy for people with the disease is about the same as the general population.

Most people who develop Parkinsons disease are 60 years of age or older. Since overall life expectancy is rising, the number of individuals with Parkinsons disease will increase in the future. Adult-onset Parkinsons disease is most common, but early-onset Parkinsons disease , and juvenile-onset Parkinsons disease can occur.

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Drastic Changes In Blood Pressure

PD can cause drastic changes in blood pressure because it affects the autonomic nervous system, which controls blood flow and blood pressure. Unlike other parts of the body, we do not have control over our nervous system. When PD occurs, it takes over the nervous system creating changes in blood pressure throughout the day, says Medical News Today.

These drastic changes in blood pressure can lead to orthostatic hypertension, a drop in blood pressure that causes a person to feel dizzy or faint when they stand up, writes the source. It can also lead to falls and fainting. Another common problem is low blood pressure, also known as hypotension. High blood pressure can also be a problem for some people. Any type of wild fluctuation between the two can lead to heart problems. To help treat this complication and avoid any drastic changes, doctors can sometimes prescribe medications that will help stabilize blood pressure. Patients can also invest in a pair of compression stockings which may also be helpful.

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Overview Of Demyelinating Disorders

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Common Complications And Side

As Parkinsons disease progresses , symptoms have a knock-on effect. Deterioration and impairments in the body can lead to a variety of other health concerns that cause a person great difficulty.

As much as these potential concerns cause discomfort for a person, all are treatable with appropriate medication or therapies.

Associated complications which can arise include:

How to manage some of the more common side-effects of Parkinsons disease

The nature of Parkinsons disease progression means that the condition manifests in a variety of ways, not just in areas of mobility. Non-motor symptoms can sometimes be of more distress to a sufferer, troubling their day-to-day lives even more so than their physical ailments.

Once certain non-motor symptoms are recognised, it is easier to understand why and how they are adversely affecting quality of life, as well as gain control through appropriate treatment.

Other problems which can also be effectively managed include:

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Complications Of Parkinsons Disease

As well as the symptoms usually associated with Parkinsons disease like rigidity and tremors, those living with the condition may also experience other complications. According to the Mayo Clinic, these complications may include:

Cognitive ProblemsCognitive problems tend to occur in the later stages of the disease, where thinking and reasoning may become impaired. Currently, there is no medication available to treat this complication.

Depression and AnxietyIts common for people living with Parkinsons disease to suffer from emotional changes such as depression or anxiety. Speak to your doctor if youre finding it hard to cope emotionally as medication or counseling may help.

Difficulty in SwallowingAs Parkinsons disease progresses, some patients may find they experience swallowing difficulties. This may also lead to an excess of saliva in the mouth and drooling.

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Sleep DisordersSleep disorders are extremely common in people with Parkinsons disease. Common complaints include difficulty falling asleep, waking to go to the bathroom, restless leg syndrome, REM sleep behavior disorder and sleep apnea.

Bladder and Bowel ProblemsDifficulty in controlling urination or starting urination is a common complication of Parkinsons disease. In addition, many may find that they suffer from constipation.

Sudden Changes in Blood PressureDizziness when standing up is due to a sudden drop in blood pressure.

Diagnosis Of Parkinsons Disease

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.

A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.

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How Is Parkinsons Disease Diagnosed

Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.

To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.

If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.

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What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms

Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.

Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.

Preventing falls and maintaining balance: Falls are a frequent complication of Parkinsons. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.

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Parkinsons Disease And Preparing For Surgery

People with Parkinsons disease sometimes face procedures or surgeries due to other medical conditions not related to PD. These could be relatively simple procedures such as a colonoscopy or endoscopy, common surgeries such as cataract removal, gall bladder removal or hernia repair, or more complex surgeries such as open-heart surgery or transplant surgery. I am frequently asked about specific concerns that arise when contemplating surgery for someone with PD.

People with PD, as well as people with other brain disorders, are more prone to side effects from anesthesia as well as negative effects from the stress of the surgery itself. Its important to remember that not everyone is affected in the same way, and this doesnt mean people with PD cannot have the surgeries and procedures they need. It is however important to be educated about what potential problems may arise so that you are as prepared as you can be.

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Illustrative Case Of Acute Psychosis

An 80-year-old woman with Parkinsons disease was brought by her caregiver to the hospital emergency room because of marked agitation and paranoid ideation. She had physically attacked a staff member at the nursing home where she had been recently placed. One year earlier she developed visual hallucinations, initially well controlled with quetiapine . In the last 6 months she had developed frequent delusions with loss of insight. On admission to the Neurology ward she was taking 300mg per day of levodopa and quetiapine . Her cognitive state was normal. Other medical conditions known to cause acute psychosis were ruled out. Several treatment changes were tried. First, levodopa dose was halved without any significant motor worsening or improvement in hallucinations or delusions. In consequence, quetiapine was switched to clozapine , prompting improvement in psychiatric symptoms. In the end, levodopa was raised back to 300mg a day and clozapine was maintained. A few months later she had developed cognitive decline and rivastigmine was added.

• Learning points: Psychosis exacerbation after nursing home placement loss of insight and delusions as severity markers before adding antipsychotic therapy for psychosis consider dopaminergic drug reduction, especially in advanced disease stages after acute episode resolution check cognitive status.

What Are The Final Stages Of Parkinsons Disease

The final stages of Parkinsons disease, also called stage five, are associated with severe motor and non-motor symptoms. Advanced stiffness and freezing can make it impossible for a person to walk. Postural problems in the neck, back, and hips can cause a person in the later stages of Parkinsons disease to require a wheelchair or become bedridden. Besides mobility problems, there can be increasing swallowing and speech problems. Mental health symptoms such as depression, anxiety, delusions, hallucinations, and dementia may also worsen.

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