Severe Parkinson’s Disease Symptoms

What Is The Outlook For Persons With Parkinsons Disease

Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.

Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.

The future is hopeful. Some of the research underway includes:

• Using stem cells to produce new neurons, which would produce dopamine.
• Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
• Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.

Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.

Doctor’s Notes On Parkinson’s Disease

Parkinson’s disease is an age-related degenerative disorder of certain brain cells that affects body movements. In some people, one or more cognitive processes are impaired. When this impairment is severe enough to interfere with a persons ability to perform daily tasks, this is considered Parkinson’s disease dementia.

Symptoms of Parkinson’s disease include tremors , stiffness of the trunk and limbs, slow of movement, loss of balance and coordination, shuffling, problems speaking, facial masking , swallowing problems, and stooped posture. Parkinsons patients may also become indecisive, fearful, dependent, and passive.

Dementia in Parkinsons disease may range from mild to severe. Symptoms of Parkinson’s disease dementia include

• the inability to make decisions,
• difficulty adapting to changes,
• memory loss ,
• difficulty sequencing events in correct order, and
• problems using and understanding language.

What Is the Treatment for Parkinson’s Disease Dementia?

There are no current treatments to specifically treat Parkinsons disease dementia. A team of providers including psychiatrists, geriatricians, and neurologists may be involved in the care of Parkinsons disease dementia patients.

Various medications and therapies are used to treat the symptoms of Parkinsons disease dementia. These medications and therapies include:

Dementia from Parkinsons disease is progressive and patients may ultimately need full-time nursing care.

What To Expect In The Late Stages Of Parkinsons Disease

The late stages of PD are medically classified as stage four and stage five by the Hoehn and Yahr scale:

• Stage Four of Parkinsons Disease In stage four, PD has progressed to a severely disabling disease. Patients with stage four PD may be able to walk and stand unassisted, but they are noticeably incapacitated. Many use a walker to help them. At this stage, the patient is unable to live an independent life and needs assistance with some activities of daily living. The necessity for help with daily living defines this stage. If the patient is still able to live alone, it is still defined as Stage Three.
• Stage Five of Parkinsons Disease Stage five is the most advanced and is characterized by an inability to arise from a chair or get out of bed without help. They may have a tendency to fall when standing or turning, and they may freeze or stumble when walking. Around-the-clock assistance is required at this stage to reduce the risk of falling and help the patient with all daily activities. At stage five, the patient may also experience hallucinations or delusions.1,2

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What Are The Primary Motor Symptoms Of Parkinsons Disease

There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.

It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.

Tremors

Rigidity

Bradykinesia

Postural Instability

Walking or Gait Difficulties

Dystonia

Vocal Symptoms

Vagus Nerve Stimulation For Parkinsons Disease

Vagus Nerve Stimulation has been shown to improve walking in patients with Parkinsons Disease.

What is Parkinsons Disease?

Parkinsons disease is a progressive, neurodegenerative disorder with no known cure. The majority of medical treatment is aimed at relieving the individual of symptoms rather than attempting to cure the disease. Many are often limited by debilitating symptoms that significantly reduce quality of life. Parkinsons symptoms include the following:

• A tremor
• Changes in writing and speech
• Weight loss

The Beginning of Parkinsons

Parkinsons disease actually begins outside of the brain, and travels through nerves, such as the vagus nerve, to enter the brain. Classically, Parkinsons is associated with the loss of the neurotransmitter dopamine due to the degeneration of an area of the brain called the substantia nigra . However, there is actually a decrease in norepinephrine before dopamine becomes depleted. There is degeneration in an area of the brain called the locus coeruleus before there is a problem with the substantia nigra.

Existing treatment strategies for Parkinsons disease are purely to relieve symptoms. However, the treatment is often accompanied by terrible side effects. New treatments are vital to developing more effective ways of treating Parkinsons.

Vagus Nerve Stimulation

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More About Carbidopa / Entacapone / Levodopa

1. Product Information. Stalevo 150 . Novartis Pharmaceuticals, East Hanover, NJ.

2. Product Information. Stalevo 50 . Novartis Pharmaceuticals, East Hanover, NJ.

3. Hauser RA Levodopa/carbidopa/entacapone . Neurology 62 : S64-71

4. Product Information. Stalevo 100 . Novartis Pharmaceuticals, East Hanover, NJ.

5. Giner V, Rueda D, Salvador A, Hernandez JC, Esteban MJ, Redon J Comments, opinions, and brief case reports: thrombocytopenia associated with levodopa treatment. Arch Intern Med 163 : 735-6

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What Causes Parkinson’s 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 Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die.

People with Parkinson’s 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 Parkinson’s, 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 Parkinson’s 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.

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What To Do With Deep Brain Stimulation At The End Of Life

Deep brain stimulation uses an Implantable Pulse Generator, usually placed in the infraclavicular area, connected to leads within the brain. There is a remote programmer, and also a charging unit in the case of a rechargeable device, which are given to the patient and their carer. It improves dyskinesias and also has a levodopa sparing effect.37

Deactivation of DBS may lead to increased symptom burden as mentioned in the section above and so awareness of features of PHS should be considered if there is failure at the end of life. Supportive treatment should be given if possible,38 and anticipation of symptoms of distress from rigidity and fever.

After death, deactivation of the device with the patients handheld programmer is required before removing the pulse generator and battery in the case of a cremation.

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What Is Parkinsons Disease

Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.

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Vagus Nerve Stimulation Techniques

Given all of the above, how do these new understandings help us? Well, the good news is the research tells us we can, after all, do something to help ourselves and to improve our condition/minimize our symptoms. This is because, like muscles, an atrophied Vagus Nerve can be strengthened once more through appropriately exercising and stimulating it. In short, we can improve our Vagal Tone to help us begin to escape from being stuck in the freeze stress response. In other words, we can learn how to relax our way out of the symptoms of PD.

I first learned about this when I found Cheryl Townsleys video on Sparking the Vagus Nerve:

I do this exercise daily, using a standard Pain Gone pen. This re-setting technique demonstrated by Cheryl, shows just how quick and easy VN stimulation techniques can be I spend just 30 seconds a day on this method.

I also quickly learned that deep breathing exercises are integral to VN stimulation, and practising diaphragmatic breathing for a few minutes a day can end up making a large cumulative difference. I particular recommend the method demonstrated by Ellie Drake:

The next video gives a more in depth explanation about the therapeutic values of VN stimulation in tackling illnesses, and suggests coffee enemas as a method for this

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Exercise And Healthy Eating

Regular exercise is particularly important in helping relieve muscle stiffness, improving your mood, and relieving stress.

There are many activities you can do to help keep yourself fit, ranging from more active sports like tennis and cycling, to less strenuous activities such as walking, gardening and yoga.

You should also try to eat a balanced diet containing all the food groups to give your body the nutrition it needs to stay healthy.

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Hospice Eligibility Of End

Since Parkinsons disease is progressive, patients need hospice care. If your family member or any loved one has been diagnosed with Parkinsons disease, expect that there will be a decline in their motor abilities. They will need professional nursing care to attend to their needs because it will be harder for them to speak and express their struggles.

Here are the things you need to observe to determine if the patient already needs hospice care:

• Difficulty in breathing and oxygen supply is necessary
• Difficulty in walking where a wheelchair is already needed
• Hard to understand speech
• Difficulty in eating and drinking
• More complications occur, such as pneumonia, sepsis, pyelonephritis, decubitus ulcers, and other comorbidities

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Myth : Parkinsons Is Only A Motor Condition

Fact: While its true that Parkinsons disease symptoms include shaking and tremor, rigid muscles, slowness of movement, and a frozen or flat expression, its a lot more than that.

Nonmotor symptoms deserve and are getting more attention from doctors and researchers. These symptoms include cognitive impairment or dementia , anxiety and depression, fatigue, sleep problems and more.

For some patients, nonmotor symptoms are more disabling than motor symptoms, which are the focus of treatment. Be sure to talk to your doctor about other issues so you can get all of your symptoms addressed.

Is Parkinsons Disease Fatal

Parkinsons disease itself doesnt cause death. However, symptoms related to Parkinsons can be fatal. For example, injuries that occur because of a fall or problems associated with dementia can be fatal.

Some people with Parkinsons experience difficulty swallowing. This can lead to aspiration pneumonia. This condition is caused when foods, or other foreign objects, are inhaled into the lungs.

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How Common Is Parkinsons Disease Psychosis

Between 20-40% of people with Parkinsons report the experience of hallucinations or delusions. When followed as the disease progresses over the years, this number increases. The increase does not mean that the hallucinations are persistent across the majority of patients. However, it is important to note that these statistics sometimes include delirium, in which the symptoms are temporary due to medication that needs to be adjusted or infection that needs to be treated, and isolated minor symptoms or minor hallucinations, including illusions, where instead of seeing things that are not there , people misinterpret things that are really there. These are the most common types of psychosis in people with PD, with different studies placing the occurrence between 25-70% of people with Parkinsons. Typically, if the person with PD only has these minor hallucinations, their doctor will not prescribe an antipsychotic medication, though more significant psychosis that requires medication may develop over time. In one study, 10% of those with minor hallucinations had their symptoms resolved within a few years, while 52% saw their symptoms remain the same and 38% saw their psychosis symptoms get worse.

We recommend that people with Parkinsons not use a single percentage to represent the prevalence of hallucinations and PDP. Parkinsons is a complex disease and as it progresses the percentages and risk of symptoms will change.

Parkinsons Disease Diet And Nutrition

Maintaining Your Weight With Parkinsons Disease

Malnutrition and weight maintenance is often an issue for people with Parkinsons disease. Here are some tips to help you maintain a healthy weight.

• Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
• If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
• Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.

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Primary Motor Symptoms Of Parkinson’s

The primary motor symptoms of PD are the symptoms that are the key characteristics of the disease. They are:

• Tremor a shaking of the hands, arms, or legs, especially when the limb is at rest it often initially occurs only in one arm or leg, and it may even begin as a small tremor in one finger
• Rigidity an abnormal stiffness in a limb or part of the body
• Postural instability impaired balance or difficulty standing or walking
• Bradykinesia gradual loss and slowing down of spontaneous movement1,2

The 5 Stages Of Parkinsons Disease

Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.

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Medications For People With Parkinsons Disease

Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements. Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:

• levodopa dopamine replacement therapy
• dopamine agonists mimic the action of dopamine
• COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
• anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
• amantadine has anticholinergic properties and improves dopamine transmission
• MAO type B inhibitors prevent the metabolism of dopamine within the brain.

The Vital Need To Encourage Relaxation In People With Parkinsons Disease

for background information on the autonomic nervous systems. The VN regulates the relaxed state of the body and brain, promoting rest, digestion, higher emotionality and sociability. It is responsible for discharging the system from excited states caused by automatic fight or flight responses to perceived threats, as governed by the sympathetic nervous system, and also, when the system perceives extreme threat, recovery from the freeze or playing dead response.

The role of the VN in health should not be understated. When our nervous systems are startled into fight-flight-or-freeze responses, the body quickly becomes inflamed and pain signals result. The ability to rapidly discharge from such a state, once the perceived dangers pass, or not to be hypersensitized to the perception of dangers in the first place, is largely determined by the strength of the VN or Vagal Tone. The VN and its functions therefore have major and primary roles in addressing inflammation and detoxifying the body, and in pain reduction.

In fact, all the major symptoms of Parkinsons can be mapped easily and directly onto a malfunction of one or more of the cranial nerves. Therefore, I suggest that the disease can now be readily and most succinctly understood through the concept that PwP are stuck in freeze and their cranial nerves are critically weak.

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