Parkinsons Disease Is A Progressive Disorder
Parkinsons Disease is a progressive neurodegenerative disorder that primarily affects movement and, in some cases, cognition. Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinsons Research, patients usually begin developing Parkinsons symptoms around age 60 and many live between 10 and 20 years after being diagnosed. However, a patients age and general health status at onset factor into the accuracy of this estimate. Age is the greatest risk factor for this condition, but young-onset Parkinsons disease, which affects people before age 50, accounts for between 10 and 20 percent of PD cases.
While there is no cure for Parkinsons disease, many patients are only mildly affected and need no treatment for several years after their initial diagnosis. However, PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. This progression occurs more quickly in some people than in others.
Pharmaceuticals and surgical interventions can help manage some of the symptoms, like bradykinesia , rigidity or tremor , but not much can be done to slow the overall progression of the disease. Over time, shaking, which affects most PD patients, may begin to interfere with activities of daily living and ones quality of life.
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in the basal ganglia, an area of the brain that controls movement, become impaired and/or die. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems of Parkinsons. Scientists still do not know what causes cells that produce dopamine to die.
People with Parkinsons also lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinsons, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.
Many brain cells of people with Parkinsons contain Lewy bodies, unusual clumps of the protein alpha-synuclein. Scientists are trying to better understand the normal and abnormal functions of alpha-synuclein and its relationship to genetic mutations that impact Parkinsons disease and Lewy body dementia.
How Is Tremor Treated
Although there is no cure for most forms of tremor, treatment options are available to help manage symptoms. In some cases, a persons symptoms may be mild enough that they do not require treatment.
Finding an appropriate treatment depends on an accurate diagnosis of the cause. Tremor caused by underlying health problems can sometimes be improved or eliminated entirely with treatment. For example, tremor due to thyroid hyperactivity will improve or even resolve with treatment of thyroid malfunction. Also, if tremor is caused by medication, discontinuing the tremor-causing drug may reduce or eliminate this tremor.
If there is no underlying cause for tremor that can be modified, available treatment options include:
Medication
Focused Ultrasound
A new treatment for essential tremor uses magnetic resonance images to deliver focused ultrasound to create a lesion in tiny areas of the brains thalamus thought to be responsible for causing the tremors. The treatment is approved only for those individuals with essential tremor who do not respond well to anticonvulsant or beta-blocking drugs.
Surgery
When people do not respond to drug therapies or have a severe tremor that significantly impacts their daily life, a doctor may recommend surgical interventions such as deep brain stimulation or very rarely, thalamotomy. While DBS is usually well tolerated, the most common side effects of tremor surgery include dysarthria and balance problems.
Lifestyle changes
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How Similar Is Canine Parkinsons Disease To The Human Condition
Parkinsons disease in dogs is very similar to how it affects humans.
Firstly, both unpredictably affect your movement. Both dogs and humans with this disease can expect to have sudden moments of stiffness. This could be any limb but also the face.
Equally, both can expect surprise tremors and shakes. This is often one of the first things owners notice in their dogs a Parkinson like tremor in dogs or the dog shaking his head like Parkinsons
The core of the disease is the same in both dogs and humans.
However, it is important to recognize the different ways Parkinsons presents in dogs and humans.
A huge reason why Parkinsons disease is difficult to spot in dogs in the early stages is because they dont speak. Their faces also dont express the same ways that ours do.
The first signs of Parkinsons in humans are mostly not being able to move the face in the same way or slurred speech.
Unless you have a real-life Scooby-Doo in your life that is linguistically gifted, its most likely you wont spot the signs of Parkinsons in your dog until their limbs are affected with those Parkinsons tremors I mentioned a moment ago.
Another critical difference is with the age groups that Parkinsons most affects. As I said in the intro, it is usually the over 50s that are affected by this pervasive disease in the human world.
Types Of Parkinsons Tremors
Quivering in these parts of the body can be signs of Parkinsons:
- Finger Twitching Commonly seen among patients in the early stages of the disease, this symptom is also called a pill-rolling tremor because the fingers and hand appear to be rolling a pill-sized object.
- Jaw Tremors This movement in the jaw may resemble a slow shivering and disappear while eating or talking. In some cases, the teeth chatter. Patients may chew gum to stop the trembling.
- Foot Tremors This shakiness may appear while resting, lying down, or dangling the feet. It stops when standing and walking. It can also extend beyond the feet and cause the whole leg to vibrate.
- Tongue Tremors Although far less reported than other types of tremor, quivering in tongue can be a revealing manifestation of Parkinsons, according to an article published in December 2015 in the journal Movement Disorders Clinical Practice. The shaking can also appear in the chin, lips, and face.
While these types of tremors can help doctor identify Parkinsons, about 30 percent of patients do not have these movements, per prior research. Those people who do not have a resting tremor may not get a diagnosis immediately, says Gilbert. If doctors dont see it, they wont necessarily think a person has Parkinsons.
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Why Is Diagnosis Difficult
Unfortunately Parkinsons Syndrome Sufferers may present with rather confusing combinations of symptoms arising from the loss of nerve function and muscle stiffness or spasm as well as the symptoms arising from the Degenerative Disc Disease at more than one disc level.
In the light of the primary diagnosis of Parkinsons Syndrome, physicians tend to associate symptoms with the Parkinsons Syndrome rather than that of the underlying Degenerative Disc Disease. In addition the dangers of treating the Degenerative Disc Disease with open surgery for this particular group of patients makes physicians or surgeons reticent to offer the surgical solutions which would be offered to less challenged patents.
Until the advent of aware state surgical examination, the sources of Parkinsons Syndrome Sufferers were hard to define and surgeons engaged in pre-operative guesstimation based on the results of clinical examination, X-rays, MRI scans and CAT scans. The complexity of the spinal region means that a wide range of possible conditions exist to confound diagnosis. In the presence of Degenerative Disc Disease the surgeon will tend to focus upon and treat evident pathology on the scan. In our published studies the pain was found to be arising at an adjacent level in almost 20% of cases.
What Are The Five Stages Of Parkinsons Disease
Researchers may disagree on the number of stages of Parkinsons disease . However, they all agree the disease is a progressive disease with symptoms that usually occur in one stage may overlap or occur in another stage. The stage increase in number value for all stage naming systems reflect the increasing severity of the disease. The five stages used by the Parkinsons Foundation are:
- Stage 1: mild symptoms do not interfere with daily activities and occur on one side of the body.
- Stage 2: Symptoms worsen with walking problems and both sides of the body affected.
- Stage 3: Main symptoms worsen with loss of balance and slowness of movement.
- Stage 4: Severity of symptoms require help usually person cannot live alone.
- Stage 5:Caregiver needed for all activities patient may not be able to stand or walk and may be bedridden and may also experience hallucinations and delusions.
A neurologist who specializes in movement disorders will be able to make the most accurate diagnosis. An initial assessment is made based on medical history, a neurological exam, and the symptoms present. For the medical history, it is important to know whether other family members have Parkinsons disease, what types of medication have been or are being taken, and whether there was exposure to toxins or repeated head trauma previously. A neurological exam may include an evaluation of coordination, walking, and fine motor tasks involving the hands.
The diagnosis of Parkinsons disease is more likely if:
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Lewy Body Dementia Vs Parkinsons Disease Dementia
Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.
Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.
The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.
This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.
The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.
Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.
Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.
Parkinsons disease itself isnt fatal, but complications can be.
Research has shown a median survival rate of about
So What Relationship Do The Health Effects Of Parkinsons Have With Death
The adverse health effects of Parkinsons are serious, and you should work with your doctor to explore the many ways to manage your Parkinsons symptoms. However, Parkinsonian symptoms do not directly cause death, but they do increase your risk for other factors that can lead to death. For instance, one of the symptoms of Parkinsons is postural instability which leads to an increased risk of falls. Postural instability by itself will not cause death but falls can lead to serious injuries that can result in death. So, Parkinsons symptoms can increase the risk for death but will not cause death in and of itself.
This is an important distinction to make because instead of seeing Parkinsons as a death sentence we should look at it as a manageable risk factor the same way we look at dieting. A poor diet will not kill you, but it will increase your risk for developing diseases that can. We should think of Parkinsons in the same way, that if we manage our symptoms of Parkinsons through exercise, medication, etc. we decrease the likelihood of risk factors that lead to death.
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Care Of Patients With Advanced Parkinsons Disease
Presenting at the UCSF 9th Annual Conference of Parkinsons Disease for Patients and Caregivers, Dr. Maya Katz spoke for 38-minutes about caring for those with advanced Parkinsons disease, including a definition of advanced PD, medication considerations, non-motor symptoms, wellness and exercise, goals of care and taking a supportive care approach.
What Are The Results
Successful DBS is related to 1) appropriate patient selection, 2) appropriate selection of the brain area for stimulation, 3) precise positioning of the electrode during surgery, and 4) experienced programming and medication management. DBS for essential tremor may significantly reduce hand tremor in 60% to 90% of patients and may improve head and voice tremor.
Patients report other benefits of DBS. For example, better sleep, more involvement in physical activity, and improved quality of life.
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Symptoms Of Parkinsons Disease
Parkinsons disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Other symptoms may include depression and other emotional changes difficulty swallowing, chewing, and speaking urinary problems or constipationskin problems and sleep disruptions.
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinsons as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinsons disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinsons. They may see that the persons face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinsons often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
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How Do Symptoms Progress
The most common symptoms of Parkinsons are tremor, rigidity and slowness of movement.
Not everyone with Parkinsons experiences the same combination of symptoms they vary from person to person.
Also, how Parkinsons affects someone can change from day to day, and even from hour to hour. Symptoms that may be noticeable one day may not be a problem the next.
Many of the symptoms can be treated or managed with medication and therapies.
Many people with Parkinsons lead active and fulfilling lives. An important part of coping with Parkinsons is understanding how it affects you and how to work around it.
It may not always be easy to maintain a positive outlook, especially immediately after diagnosis. But we can give you help and support.
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What Makes Pd Hard To Predict
Parkinsonâs comes with two main buckets of possible symptoms. One affects your ability to move and leads to motor issues like tremors and rigid muscles. The other bucket has non-motor symptoms, like pain, loss of smell, and dementia.
You may not get all the symptoms. And you canât predict how bad theyâll be, or how fast theyâll get worse. One person may have slight tremors but severe dementia. Another might have major tremors but no issues with thinking or memory. And someone else may have severe symptoms all around.
On top of that, the drugs that treat Parkinsonâs work better for some people than others. All that adds up to a disease thatâs very hard to predict.
What Should Be Your Role As A Caregiver In The End
During the final stage of dementia, the affected individual becomes completely dependent on the people around them to carry out basic activities.
If a person is a caregiver, they need to take care of the patient regarding certain important aspects, including:
Nutrition
The appetite of the affected individual may decrease in the final stages of dementia due to the inability to stay physically active. They may forget to eat food or drink fluids.
To help ensure that the person in the final stage of dementia receives adequate nutrition, try the following tips:
Bowel and bladder function
The patient may eventually lose control of bladder and bowel function in the final stage of dementia.
To maintain bowel and bladder function, try the following tips:
Skin and bone health
A patient with end-stage Alzheimers disease can eventually become bedridden or chair-bound. This can result in skin breakdown, pressure sores, and freezing of joints .
To keep the skin healthy and bones functioning, try the following tips:
Oral hygiene
Good oral hygiene reduces the risk of bacteria in the mouth that can lead to infections, including pneumonia. Brush the patients teeth every time after the patient eats. If the patient wears dentures, remove them and clean them every night.
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Changes In Cognition And Parkinsons Disease
Some people with Parkinsons may experience changes in their cognitive function, including problems with memory, attention, and the ability to plan and accomplish tasks. Stress, depression, and some medications may also contribute to these changes in cognition.
Over time, as the disease progresses, some people may develop dementia and be diagnosed with Parkinsons dementia, a type of Lewy body dementia. People with Parkinsons dementia may have severe memory and thinking problems that affect daily living.
Talk with your doctor if you or a loved one is diagnosed with Parkinsons disease and is experiencing problems with thinking or memory.
Parkinsons Disease Symptoms Of Dementia
Up to one-third of people living with Parkinson’s disease experience dementia, according to the Parkinson’s Disease Foundation. Problems with dementia may include trouble with memory, attention span, and what is called executive function the process of making decisions, organizing, managing time, and setting priorities.
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