Wednesday, August 3, 2022

Patient Education On Parkinson’s Disease

Expert Care For Parkinson’s Disease In Louisiana

Neurology – Topic 13 – Parkinson’s disease female patient

If you are living with Parkinsons disease, it is recommended that you receive treatment from a neurologist who has specialized training in movement disorders. The NeuroMedical Center offers three movement disorder specialists who are highly experienced diagnosing and treating Parkinsons. Dr. Gerald J. Calegan, Dr. B. Glenn Kidder, and Dr. Rebecca E. Whiddon remain on the cutting-edge of knowledge and treatment of Parkinsons and other movement disorders. Our neurologists and DBS neurosurgeon, Dr. Paul J. Waguespack, have performed over 400 successful DBS surgeries to date. With access to advanced diagnostic services, our Parkinsons specialists are best equipped to tailor a plan of care for your specific needs.

Living With Parkinson’s Disease

Parkinson’s disease progresses over time, often taking years before symptoms appear. Because it develops gradually, most people have many years of productive living after being diagnosed.

The following are some tips from the National Parkinson Foundation for walking, standing and other day-to-day activities:

How Is Parkinson’s Disease Diagnosed

There is no test that can prove that you have PD. The diagnosis is based on you having the typical symptoms . In the early stage of the disease, when symptoms are mild, it may be difficult for a doctor to say if you definitely have PD. As the symptoms gradually become worse, the diagnosis often becomes more clear.

PD is sometimes confused with other conditions. Some conditions can give ‘Parkinsonism’ features – that is, symptoms similar to PD but caused by other conditions. For example, some medicines used to treat other conditions can cause side-effects which resemble symptoms of PD. Some rare brain disorders can also cause similar symptoms.

Therefore, it is normal practice in the UK to be referred to a specialist if PD is suspected. The specialist will be used to diagnosing PD and ruling out other causes of the symptoms. They will usually be either a neurologist or a doctor specialising in elderly care. If there is still doubt about the diagnosis, sometimes a scan of the brain is carried out. This helps to differentiate PD from some other conditions that can cause Parkinsonism features. Other tests sometimes needed include blood tests and tests of your sense of smell.

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Does Parkinson’s Disease Cause Dementia

The cells in the brain affected in PD are not in the ‘thinking’ parts of the brain and dementia is not a typical early feature of PD. However, if you have PD you have an increased risk of developing dementia. About half of people with PD develop dementia at some stage. If dementia occurs, it tends to develop in older people with PD . Early dementia in younger people with PD virtually never develops. It is thought that PD alone does not cause dementia however, other age-related factors in addition to PD may increase the risk of dementia developing.

Related Diagnosis: Lewy Body Dementia

April is Parkinson

Current research is helping to differentiate dementia related conditions in relationship to Parkinsonâs disease. Doctorâs use a 12-month arbitrary rule to aid in diagnosis. When dementia is present before or within 1 year of Parkinsonâs motor symptoms developing, an individual is diagnosed with DLB. Those who have an existing diagnosis of Parkinsonâs for more than a year, and later develop dementia, are diagnosed with PDD.

In the simplest terms, Lewy bodies are abnormal clumps of proteins that develop in nerve cells. Cholinesterase inhibitors, medications originally developed for Alzheimerâs disease, are the standard treatment today for cognitive DLB and PDD symptoms. Early diagnosis is important, as DLB patients may respond differently than Alzheimerâs disease patients to certain drug, behavioral, and dementia care treatments.

This challenging, multi-system disorder involving movement, cognition, behavior, sleep, and autonomic function requires a comprehensive treatment approach to maximize the quality of life for both the care recipient and their caregiver. It is very important to pay attention to symptoms of dementia and to search for an expert clinician who can diagnose the condition accurately.

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What Diseases And Conditions Resemble Parkinsons Disease

PD is the most common form of parkinsonism, in which disorders of other causes produce features and symptoms that closely resemble Parkinsons disease. Many disorders can cause symptoms similar to those of PD, including:

Several diseases, including MSA, CBD, and PSP, are sometimes referred to as Parkinsons-plus diseases because they have the symptoms of PD plus additional features.

In very rare cases, parkinsonian symptoms may appear in people before the age of 20. This condition is called juvenile parkinsonism. It often begins with dystonia and bradykinesia, and the symptoms often improve with levodopa medication.

What Is Parkinson’s Disease

Parkinsons disease is movement disorder of the nervous system that worsens over time. As nerve cells in parts of the brain weaken or are damaged or die, people may begin to notice problems with movement, tremor, stiffness in the limbs or the trunk of the body, or impaired balance. As these symptoms become more obvious, people may have difficulty walking, talking, or completing other simple tasks. Not everyone with one or more of these symptoms has PD, as the symptoms appear in other diseases as well.

No cure for PD exists today, but research is ongoing and medications or surgery can often provide substantial improvement with motor symptoms.

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What Is The Prognosis

The average life expectancy of a person with PD is generally the same as for people who do not have the disease. Fortunately, there are many treatment options available for people with PD. However, in the late stages, PD may no longer respond to medications and can become associated with serious complications such as choking, pneumonia, and falls.

PD is a slowly progressive disorder. It is not possible to predict what course the disease will take for an individual person.

One commonly used scale neurologists use for describing how the symptoms of PD have progressed in a patient is the Hoehn and Yahr scale.

Do Symptoms Get Worse

Mark Burek – Parkinson’s Disease Patient

PD does not affect everyone the same way. The rate of progression and the particular symptoms differ among individuals.

PD symptoms typically begin on one side of the body. However, the disease eventually affects both sides, although symptoms are often less severe on one side than on the other.

Early symptoms of PD may be subtle and occur gradually. Affected people may feel mild tremors or have difficulty getting out of a chair. Activities may take longer to complete than in the past. Muscles stiffen and movement may be slower. The persons face may lack expression and animation . People may notice that they speak too softly or with hesitation, or that their handwriting is slow and looks cramped or small. This very early period may last a long time before the more classical and obvious motor symptoms appear.

As the disease progresses, symptoms may begin to interfere with daily activities. Affected individuals may not be able to hold utensils steady or they may find that the shaking makes reading a newspaper difficult.

People with PD often develop a so-called parkinsonian gait that includes a tendency to lean forward, taking small quick steps as if hurrying , and reduced swinging in one or both arms. They may have trouble initiating movement , and they may stop suddenly as they walk .

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Parkinsons Foundation Partners With Medscape Education To Deliver Patient Education

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, 2018The Parkinsons Foundation has collaborated with Medscape Education to launch an online learning program entitled Parkinsons Disease Psychosis: A Learning Destination for Care Partners and Patients, available on Medscapes patient portal, WebMD Education. The program is intended to provide Parkinsons patients and their caregivers with information about Parkinsons disease progression, self-care and shared decision-making in the management of Parkinsons disease and Parkinsons disease psychosis.

Parkinsons disease psychosis is known to be a significant cause of distress and impaired quality of life for patients and their care partners. The program is founded on the belief that through education, patients and their caregivers can be empowered to develop informed long-range care plans in concert with their health care professionals and preserve their quality of life.

WebMD Education is a resource that provides easy-to-understand, commercial-free coursework, tools, and resources that help patients and their care partners better understand their condition and treatment options so they can have an informed discussion with their health care professional about their treatment goals, preferences, and plan of care.

The evidence-based online curriculum consists of three text-based activities accompanied by brief videos:

All of the modules are free and can be accessed via the following link: .

What Genes Are Linked To Parkinsons Disease

Several genes have been definitively linked to PD:

  • SNCA. This gene, which makes the protein alpha-synuclein, was the first gene identified to be associated with Parkinsons. Research findings by the National Institutes of Health and other institutions prompted studies of the role of alpha-synuclein in PD, which led to the discovery that Lewy bodies seen in all cases of PD contain clumps of alpha-synuclein. This discovery revealed the link between hereditary and sporadic forms of the disease.
  • LRRK2. Mutations in LRRK2 were originally identified in several English and Basque families as a cause of a late-onset PD. Subsequent studies have identified mutations of this gene in other families with PD as well as in a small percentage of people with apparently sporadic PD. LRRK2 mutations are a major cause of PD in North Africa and the Middle East.
  • DJ-1. This gene normally helps regulate gene activity and protect cells from oxidative stress and can cause rare, early forms of PD.
  • PRKN . The parkin gene is translated into a protein that normally helps cells break down and recycle proteins.
  • PINK1. PINK1 codes for a protein active in mitochondria. Mutations in this gene appear to increase susceptibility to cellular stress. PINK1 has been linked to early forms of PD.
  • GBA . Mutations in GBA cause Gaucher disease , but different changes in this gene are associated with an increased risk for Parkinsons disease as well.

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What Are Common Parkinson’s Symptoms

Parkinsons disease tends to start with subtle symptoms which get worse over time. It may begin with a slight tremor, usually in one hand or arm. Eventually it begins to affect both sides of your body. It can cause trembling, stiffness, and slow movements. It can cause loss of balance and coordination. You may develop a stooped posture. You may speak softly and in a monotone, and you may pause frequently when you speak. These symptoms vary from person to person, and they may progress slowly or quickly.

Easing Cramps Spasms Or Tremors Due To Parkinson’s

Parkinsonâs disease patients invited to support research ...
  • Massage your legs nightly to relieve leg cramps.
  • Take warm baths and use heating pads to help relieve muscle spasms and ease cramps.
  • Use mineral ice to relax sore joints and muscles.
  • Squeeze a small rubber ball to reduce hand tremors.
  • At first indication of a tremor, if possible, try lying on the floor, face down, and relaxing your body for five to 10 minutes.

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What Causes The Disease

The precise cause of PD is unknown, although some cases of PD are hereditary and can be traced to specific genetic mutations. Most cases are sporadicthat is, the disease does not typically run in families. It is thought that PD likely results from a combination of genetics and exposure to one or more unknown environmental factors that trigger the disease.

The protein alpha-synuclein. The affected brain cells of people with PD contain Lewy bodiesdeposits of the protein alpha-synuclein. Researchers do not yet know why Lewy bodies form or what role they play in the disease. Some research suggests that the cells protein disposal system may fail in people with PD, causing proteins to build up to harmful levels and trigger cell death. Additional studies have found evidence that clumps of protein that develop inside brain cells of people with PD may contribute to the death of neurons.

Genetics. Several genetic mutations are associated with PD, including the alpha-synuclein gene, and many more genes have been tentatively linked to the disorder. The same genes and proteins that are altered in inherited cases may also be altered in sporadic cases by environmental toxins or other factors.

Environment. Exposure to certain toxins has caused parkinsonian symptoms in rare circumstances . Other still-unidentified environmental factors may also cause PD in genetically susceptible individuals.

Caregiving For People Living With Parkinsons

Caring for a loved one with PD can be a challenging job, especially as the disease progresses. Former caregivers of a loved one with PD suggest doing the following : Get prepared, Take care of yourself, Get help , Work to maintain a good relationship with your loved one, and Encourage the person with PD for whom you care, to stay active.

Preparing for caregiving starts with education. Reading this fact sheet is a good start. More resources are available to you in theResources section of this fact sheet. Early Parkinsonâs disease usually requires more emotional support and less hands-on care. It is a good time for family members/caregivers to educate themselves about the disease.

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Getting Dressed With Parkinson’s Disease

  • Get dressed while sitting in a chair that has armrests — this will help you keep your balance.
  • Roll from side to side to get pants over your hips. You can do this while sitting in a chair or lying down on your bed.
  • Wear clothes that are loose fitting and have elastic waistbands.
  • Choose wrap-around clothing instead of the pullover type. Also choose clothing that opens in the front, not the back so you don’t have to reach behind you.
  • Wear clothing with large, flat buttons, zippers, or Velcro closures.
  • Use a button hook to button clothing.
  • Use a dressing stick if you have shoulder weakness to get your coat or shirt on or off.
  • Use a zipper pull or attach a leather loop on the end of the zipper to zip pants or jackets.
  • Wear slip-on shoes or buy elastic shoelaces that allow you to slip your shoes on and off without untying the laces. Use devices such as a sock donner and long-handled shoehorn for additional assistance.

Eating Drinking And Parkinson’s Disease

Neurology – Topic 14 – Parkinsons disease – examining a patient
  • Don’t rush your meals. Allow the extra time you need to finish your meal. Rest your elbows on the table to provide more motion at your wrist and hand.
  • Sit with your knees and hips bent at a 90-degree angle in a straight-back chair.
  • Use utensils with built-up, lightweight handles, or use a “spork” — a spoon and fork in one. Use a rocker knife for cutting food.
  • Use a non-skid mat to stabilize objects on the table.
  • Use a plate guard or plate with a raised lip to prevent food from spilling.
  • Use a long straw with a non-spill cup or use a plastic mug with a large handle.

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Some Other General Points

Stay as active as possible. Exercise regularly as much as you are able. This may not be possible when the condition is more advanced. However, it is something to consider when symptoms are not too bad. You may walk more slowly than before but a daily walk is good exercise and may help to loosen up stiff muscles. Well-meaning relatives or friends may tell you to rest and take things easy. However, as much as possible and for as long as possible, resist the temptation for others to do things for you just because it may be quicker.

Constipation is common in people with PD. Help to reduce the chance of this by having lots to drink and eat plenty of vegetables, fruit, and foods high in fibre. Exercise can also improve constipation. Sometimes laxatives may be needed to treat constipation.

Some medicines taken for other conditions can interfere with dopamine and make PD worse. These may be prescribed for such things as mental illness, sickness, vertigo and dizziness. Check with your doctor if you are unsure about any medicines that you take.

Driving. If you are a driver you should tell the DVLA and your insurance company if you develop PD. Your insurance may be invalid if you do not. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.

Parkinson’s Disease: Resources For Patients And Families

Parkinsons disease affects every patient differently. This information can help you gain a better understanding of how the disease may affect you and your caregivers.

Resources include:

  • A handbook on Parkinsons disease
  • Links to national Parkinsons organizations
  • Exercise resources
  • Worksheets to help you manage your condition

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Key Programs And Resources

The Parkinsons Disease Biomarkers Programs , a major NINDS initiative, is aimed at discovering ways to identify individuals at risk for developing PD and Lewy Body Dementia and to track the progression of the disease. It funds research and collects human biological samples and clinical data to identify biomarkers that will speed the development of novel therapeutics for PD. Goals are improving clinical trials and earlier diagnosis and treatment. Projects are actively recruiting volunteers at sites across the U.S. NINDS also collaborates with the Michael J. Fox Foundation for Parkinsons Research on BioFIND, a project collecting biological samples and clinical data from healthy volunteers and those with PD. For more information about the PDBP and how you can get involved, please visit the PDBP website.

The NINDS Morris K. Udall Centers of Excellence for Parkinsons Disease Research program supports research centers across the country that work collaboratively to study PD disease mechanisms, the genetic contributions to PD, and potential therapeutic targets and treatment strategies.

The NINDS Intramural Research Program conducts clinical studies to better understand PD mechanisms and develop novel and improve treatments.

The NINDS Biospecimens Repositories store and distribute DNA, cells, blood samples, cerebrospinal fluid, and autopsy tissue to PD researchers around the world.

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