Causes Of Parkinsons Disease
Parkinsons disease is usually a result of certain neurons in the brain dying after gradually breaking down. This causes a fall in dopamine levels, which leads to abnormal brain activity. This, in turn, causes impaired body movements and triggers other PD symptoms.
However, the exact causes of Parkinsons disease are still unknown. There are some factors that play a role according to scientific research. These are:
Genes: Studies reveal that specific genetic mutations can cause PD. However, it is uncommon unless several family members are affected by the disease. Although certain gene variations indicate higher risks of Parkinsons, there is a relatively lower risk of PD for each of these genetic markers.
Environmental Triggers: In some cases, Parkinsons disease is caused by environmental factors like toxins in the atmosphere or exposure to other factors. However, the risk is lower.
Scientists also claim that they notice distinct changes in the brain affected by Parkinsons. These are:
Lewy Bodies: Clumps of specific substances within your brain cells are microscopic markers to identify Parkinsons. These clumps are referred to as Lewy bodies. Scientists believe that these clumps hold the clue to determine what causes Parkinsons disease.
How Is Parkinsons Disease Diagnosed
There are no specific tests available to diagnose Parkinsons disease. It is mostly diagnosed based on the patients health history, reviewing the signs and symptoms, and with a physical and neurological exam. Diagnosing Parkinsons at the earliest stage is quite challenging as the symptoms of Parkinsons are more similar to other movement disorders. A neurologist who is specialized in movement disorders can make the most accurate diagnosis.Imaging tests like Magnetic Resonance Imaging , Computerized Axial Tomography , or Dopamine Transporter scan will be performed to confirm the Parkinsons and if not Parkinsons, these tests can help the neurologist to rule out other disorders causing the symptoms.
Whats The Difference Between Multiple System Atrophy And Parkinsons
Parkinsons and MSA both affect the movement control system and the involuntary autonomic control system and early symptoms can make a differential diagnosis a challenge. MSA, however, tends to progress faster than Parkinsons balance problems and a stooped posture happen earlier and get worse more quickly with MSA and autonomic functions such as blood pressure, heart rate, breathing, sweating, bladder function, and sexual problems are more severe in people with MSA.
For more information on multiple symptom atrophy, read this fact sheet.
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Dip Can Easily Be Misdiagnosed As Pd
Both DIP and PD have identical symptoms, which makes certain cases extremely hard to differentiate and can lead to DIP being misdiagnosed by PD. These symptoms can include some or all of the following: tremor, resting tremor, muscle stiffness, impaired speech, slow gait and movements, and problems with posture and balance. Collectively, these symptoms are known as parkinsonism. In some cases, these symptoms have also been called atypical Parkinsons disease, secondary parkinsonism, or Parkinsons plus. Of course parkinsonism can be caused by PD, but it can also occur as a result of DIP. The main difference between parkinsonism associated with DIP and PD is that parkinsonism associated with DIP generally comes on rapidly, while parkinsonism associated with PD tends to develop gradually.
What Drugs Can Cause Parkinsons Disease
Physiologically, Parkinsons disease is caused due to low levels of dopamine secretion in the body. Thus, any medication that blocks the level of dopamine in the body and cause Parkinsons symptoms. Dopamine is a brain chemical that essentially helps control movement of a person. The various drugs include-
Antipsychotic Drugs- Parkinson symptoms are seen to be common in patients who are prescribed antipsychotic drugs. Parkinsonism as a side effect of chlorpromazine is quite common. Typical antipsychotic drugs include chlorpromazine, promazine, haloperidol, perphenazine, fluphenazine and pimozide. Dopamine receptors are widely distributed in the brain and typical antipsychotics may affect dopamine receptors in the striatum.
GI Motility Drugs- GI prokinetic drugs like metoclopramide, levosulpiride, clebopride, itopride and domperdone may cause side effects thereby making the patient prone to Parkinsonism.
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How To Prevent Parkinsons Disease
As the exact cause of Parkinsons is not known, it is unclear how to prevent the disease. But researchers say that some of the following lifelong habits can reduce the risk of developing Parkinsons disease.
- Avoiding reheated edible oil
- Aerobic exercise
- Antioxidants rich diet
If you have a family history of Parkinsons disease, we recommend you to consider genetic testing as certain genes have been connected to Parkinsons disease.
Taking A Closer Look At Your Options
Since the drug levodopa was synthesized in the 1960s, levodopa in combination with carbidopa , has been the gold standard for treating the symptoms of Parkinsons. However, after several years of taking this medication some people experience dyskinesias, or involuntary writhing movements. This is sometimes referred to as levodopa-induced dyskinesias or LIDS. The fear of these side effects has led many clinicians and patients to avoid levodopa-carbidopa for as long as possible.
But some experts do not believe this levodopa phobia is warranted . In short, they say that levodopa can be considered as a potential first-line therapy in all age groups—although caution should be exercised in younger patients. In most cases, the dosage will start low then increase slowly, often in combination with other medications, to adjust to a persons changing condition.
Other first-line medications that can be used to control Parkinsons symptoms include drugs known as dopamine agonists and monamine oxidase inhibitors. Dopamine agonists provide relief by mimicking the action of dopamine within the brain, and monamine oxidase inhibitors help maintain motor control by slowing the breakdown of dopamine within the brain. These drugs can help younger patients buy some time before starting levodopa-carbidopa.
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Symptoms Of Parkinsons Disease
In most cases, people above 60 years of age show the symptoms of Parkinsons. When the symptoms are shown in people below 50 years of age, it is called early-onset Parkinsons disease. The symptoms develop gradually, worsen over time, and may be different for each person. The early signs and other common symptoms of Parkinsons disease are explained below.
Who Are At Risk Of Developing Drug Included Parkinsonism
Some patients may be at a higher risk of developing medication-induced Parkinson
ism than others. Some of the risks include-
Women: Women are seen to be two times as much at risk of having drug inducing Parkinsons disease than men.
AIDS Patients: People with AIDS are at a higher risk.
Family History: Patients having a family history Parkinsons disease are at a higher risk of having drug induced Parkinsonism.
Elderly: Since elder people are usually on multiple medicines, they are at risk of having drug induced Parkinsonism.
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What Are Parkinsons Disease
Delusions are false beliefs that are not based on reality. These beliefs are fixed. People experiencing them are unlikely to change or abandon these beliefs, even when presented with evidence that they are false.
Delusions experienced by people with Parkinsons disease are usually of a common theme. These may include:
- Spousal infidelity
- Thinking that people are stealing their belongings
- Thinking people are trying to harm them
- Thinking people may put poison in their food
- Thinking people are switching out or substituting their medications
- Other beliefs based on paranoia
Can Drug Induced Parkinsonism Be Prevented
Although there is no surety in the prevention of drug-induced parkinsons disease, but efforts may be made to check the dosage of drugs so prescribed-
Be Cautious with Antipsychotics: The patient or in some cases the caregiver should make sure that antipsychotic drugs are given at their least effective dosage.
Inform the Doctor: The doctor should be informed well before in case the patient already has symptoms of Parkinsons disease so that they do not appear to get worse with the starting of some prescribed drugs.
Abrupt Stoppage of Medicine: It is never a wise decision to stop taking a medicine by oneself. It is important to talk to the doctor in case of any concerns.
Diagnosis Of Parkinsons Disease Dementia
There are no tests or combinations of different tests to help doctors confirm their patients have Parkinsons Disease Dementia. The following guidelines are used by healthcare workers when confirming this diagnosis.
- The patient has a Parkinsons Disease diagnosis based on symptoms related to movements, and it has been at least one year after this diagnosis before Dementia symptoms appear.
Can These Symptoms Be Reversed
In general, Parkinsons-like symptoms should improve after the medication causing the problem is stopped. Unfortunately, its not a quick fix it could take months.
In some cases, the drug-induced symptoms might actually reveal a previously unknown chronic condition like actual Parkinsons disease or Lewy body dementia.
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Whats The Difference Between Vascular Parkinsonism And Parkinsons
As the name implies, vascular parkinsonism is caused by cerebrovascular disease which affects the blood supply to the brain. Vascular parkinsonism is caused by one or more small strokes, while Parkinsons is caused by a gradual loss of nerve cells. One major difference from Parkinsons is that its not progressive, while Parkinsons becomes worse with time. Another difference is that there are no tremors in vascular parkinsonism.
For more information on vascular parkinsonism, read this journal article.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
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Conditions That Can Cause Tremors Besides Parkinsons:
The tremor of Parkinsons disease occurs even at rest. Hence it is called a rest tremor. Very few other conditions produce rest tremor.
But, many other diseases produce a tremor which is seen only when moving, for example when writing. This is called an Action tremor or posturokinetic tremor. Even these diseases are sometimes misdiagnosed as Parkinsons disease.
|Causes of Rest Tremor|
What Are The Risk Factors Of Parkinsons Disease Dementia
While the causes of Parkinsons Disease are still unknown, there are many factors that scientists believe which contribute to Parkinsons Disease that are both genetic, environments, and a combination of both.
Typically, when healthcare providers diagnose Parkinsons Disease, they describe it as idiopathic, which means its cause is unknown.
Over time, memory and thinking problems can develop by changes in the brain structure and chemistry, causing Parkinsons Disease Dementia. It is essential to know the risk factors of Parkinsons Disease while discussing Parkinsons Disease Dementia.
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Parkinson’s Surgery: Deep Brain Stimulation
Another treatment method, usually attempted as effectiveness of medical treatments for Parkinson’s disease wane, is termed deep brain stimulation. The technique involves surgery to implant electrodes deep into the brain in the globus pallidus, thalamus, or the subthalamic nucleus areas. Then electric impulses that stimulate the brain tissue to help overcome tremors, rigidity, and slow movements are given. Impulses are generated by a battery. This surgery is not for every Parkinson’s disease patient it is done on patients that meet certain criteria. Also, the surgery does not stop other symptoms and does not end the progression of the disease.
Myth : Aside From Medication There Isnt Much You Can Do
Fact: This it is what it is theres nothing I can do to help myself myth is counterproductive. There is a lot you can do chiefly, keeping as active as you can. A recent study found that patients with Parkinsons who took part in weekly, hourlong exercise sessions were able to do more in their daily lives than those who did not.
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
Store cassettes containing levodopa and carbidopa enteral suspension in the refrigerator in their original carton, protected from light. Do not freeze the suspension.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
What Should I Do If I Forget A Dose
Take the missed dose of the regular tablet, orally disintegrating tablet, extended-release tablet, or extended-release capsule as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
If you are using levodopa and carbidopa enteral infusion and will be disconnecting the infusion pump for a short time , other than the normal nightly disconnection, ask your doctor if you should use an extra dose before you disconnect the pump. If the infusion pump will be disconnected for longer than 2 hours, call your doctor you probably will be advised to take levodopa and carbidopa by mouth while you are not using the suspension.
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When To Be Suspicious Of Medications
In many cases, symptoms of Parkinsons could be caused by a new medication that was started a few days or a few months ago.
In other cases, it could be caused by medications that start out at one dose and are increased to higher doses. If the dose increases move too quickly, that can also cause these symptoms.
Other factors also make it more likely that someone will develop Parkinsons symptoms from medications. These include having a history of:
- Strokes or transient ischemic attacks
- Parkinsons in the family
Diagnosis Of Dip And The Role Of Dat Imaging
The clinical diagnostic criteria for DIP are defined as 1) the presence of parkinsonism, 2) no history of parkinsonism before the use of the offending drug, and 3) onset of parkinsonian symptoms during use of the offending drug. Since asymmetrical rest tremors are common in many DIP patients and symptoms persist or progress after cessation of the offending drug, patients clinically diagnosed with DIP may include individuals in the preclinical stage of PD whose symptoms were unmasked by the drug.,,,
DATs are presynaptic proteins in the membrane on terminals of dopaminergic neurons. They take up dopamine from the synaptic cleft projections that extend from the substantia nigra to the striatum. These transporters control dopaminergic transmission by spatial and temporal buffering, rendering the molecule an imaging target in diseases affecting the dopaminergic nigrostriatal pathway. Single-photon-emission computed tomography and positron-emission tomography scans are available using several DAT ligands., SPECT radioligands include 123I-N-3-fluoropropyl-2-carbomethoxy-3-nortropane , 123I-ioflupane, DaTSCAN, and 123I-2-carbomethoxy-3-tropane . PET scans may be superior to SPECT for imaging DATs, in that the lower energy of positrons provides higher resolution, resulting in better image quality with widespread clinical applications. However, most DAT imaging studies, including those in patients with DIP, have utilized SPECT.,-
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What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to levodopa and carbidopa.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking levodopa and carbidopa.
Levodopa and carbidopa can lose its effect completely over time or only at certain times during the day. Call your doctor if your Parkinson’s disease symptoms worsen or vary in severity.
As your condition improves and it is easier for you to move, be careful not to overdo physical activities. Increase your activity gradually to avoid falls and injuries.
Levodopa and carbidopa can cause false results in urine tests for sugar and ketones .
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.