Friday, March 17, 2023

What Are Complications Of Parkinson’s Disease

What Causes Parkinson Disease

Parkinson’s Disease Overview & Treatment for PD Motor Complications

Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.

Ongoing Clinical Trials For The Treatment Of Motor Complications In Pd

Several novel levodopa formulations are under investigation to bypass the GI issues related to impaired absorption that contributes to motor fluctuations. Accordion pill levodopa/carbidopa is a gastroretentive slow release levodopa formulation containing a multilayer film folded in an accordion shape. Studies have been reported only in abstracts to date, and a phase III study is ongoing .

ND062L is a transcutaneous formulation available in a patch-pump device. Preliminary results are encouraging, however with limited data available . Minor adverse events reported so far are mostly local and related to subcutaneous administration. Studies at phase II and III level are ongoing .

CVT-301 is a levodopa inhalation powder that has been evaluated for sudden-OFFs. A Phase II trial showed onset of effect after 10 minutes, and significant mean OFF time change from baseline after 4 weeks . Most common side effects were dizziness, cough, and nausea. A phase III trial is currently ongoing .

Tozadenant is another adenosine A2A antagonist under development for motor fluctuations. A Phase IIb trial showed reduction of mean daily OFF time with tozadenant 120 mg and with tozadenant 180 mg group . Common adverse events were dyskinesia, nausea and dizziness. A phase III is currently active .

What Is Parkinson Disease

Parkinson disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinsons disease also have tremors and may develop cognitive problems, including memory loss and dementia.

Parkinson disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, it’s called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. It’s also much more common in men than in women.

Parkinson disease is a chronic and progressive disease. It doesn’t go away and continues to get worse over time.

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What Are The Complications Of Parkinson Disease

4.1/511 Complications of Parkinson’s Disease You Should Know About

  • Anxiety and depression. It’s normal to feel anxious or upset when you live with a chronic condition like Parkinson’s disease.
  • Difficulty swallowing.

Similarly, what are some complications of Parkinson’s disease?

According to the Mayo Clinic, these complications may include:

  • Cognitive Problems.
  • MORE: The five stages of Parkinson’s disease.
  • Sleep Disorders.
  • Sudden Changes in Blood Pressure.
  • MORE: How to manage freezing in Parkinson’s disease.

Additionally, what do Parkinson’s patients usually die from? But the most common cause of death in those with Parkinson’s is pneumonia, because the disease impairs patients‘ ability to swallow, putting them at risk for inhaling or aspirating food or liquids into their lungs, leading to aspiration pneumonia.

Then, what are the long term effects of Parkinson disease?

Over time, Parkinson’s patients may experience stiffness or rigidity of the arms and legs, slowness or lack of movement, and walking difficulties, in addition to tremors in their hands, arms, legs, jaw or face.

What is the life expectancy of someone with Parkinson’s disease?

Parkinson’s Disease is a Progressive DisorderIndividuals with PD have a somewhat shorter life span compared to healthy individuals of the same age group. Patients usually begin developing the disease around age 60, and many live between 10 and 20 years after being diagnosed.

What Are The Different Stages Of Parkinsons Disease

11 Complications Of Parkinson

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 stage

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.

Mid stage

Mid-late stage

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.

Advanced stage

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Beginning Of Dose Worsening/ End

These subtypes of motor fluctuations are usually a consequence of erratic levodopa absorption as described above. Delayed onset of the effect, partial or suboptimal clinical response or even dose failure can thus occur. Some patients report worsening of symptoms just after taking levodopa at the beginning of the dose cycle, most commonly described as worsening of tremor that subsequently settles down once levodopa levels increase and stabilize . Other patients may also experience symptoms more severe than in the untreated baseline state at the end of the dose .

What Are The Symptoms Of Parkinson Disease

Parkinson disease symptoms usually start out mild, and then progressively get much worse. The first signs are often so subtle that many people don’t seek medical attention at first. These are common symptoms of Parkinson disease:

  • Tremors that affect the face and jaw, legs, arms, and hands
  • Slow, stiff walking

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How Is Parkinson Disease Treated

Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.

A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.

Parkinsons Disease And Preparing For Surgery

Parkinson’s disease: treatment of complications

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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Other Concerns To Be Aware Of

There are a few other possible concerns to be aware of when having surgery. Again, not everyone will experience these issues, but it is wise to understand them and be aware so that you can plan accordingly and be prepared.

  • The effect of even mild dehydration may be exacerbated in PD.
  • People with PD may have swallow dysfunction. This can be exacerbated by anesthesia and make people with PD at higher risk for aspiration, defined as the tendency for food or liquid to get into the airway. Therefore, it is best to introduce soft foods slowly after surgery.
  • People with PD may have significant fluctuations of blood pressure which can be magnified in the post-operative period. Episodes of low blood pressure can cause dizziness and even fainting. This problem is most prominent when changing head position that is moving from lying down, to sitting to standing. Therefore, these changes should be made very slowly.
  • Urinary dysfunction is common in PD, and people with PD may be particularly prone to urinary tract infections . It is important to note that UTIs or any infection may first manifest as an unexplained worsening of PD symptoms or initiation of hallucinations.
  • People with PD are particularly prone to constipation and this can be exacerbated in the post-operative period. Taking a daily medication to prevent constipation may become necessary after surgery.

Tips and takeaways

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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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Monoamine Oxidase Type B Inhibitors

Another add-on class is the MAO-B inhibitors, with two currently approved formulations: selegiline or rasagiline . These two medications are easy to use due to once or twice daily dosing and minimal side effects. There are no comparative trials between rasagiline and selegiline. Side effects of selegiline include insomnia due to amphetamine metabolites thus, selegiline may be helpful in patients with daytime fatigue. Interaction with serotonergic drugs can theoretically cause serotonin syndrome. However, co-use of a MAO-B inhibitor with several commonly used antidepressants has been shown to be safe from allowed use in randomized control trials.

Maintaining Your Normal Pd Medication Schedule

Parkinsons disease and exercise

Maintaining your PD medication schedule is crucial for anyone with PD. The correct timing and dosage are essential to your comfort and well-being. However, oftentimes when undergoing surgery, there may be restrictions regarding when you can and cannot take medications. Here are a few tips to navigate this issue:

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What Causes Parkinsons Disease

Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.

People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.

Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.

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.
  • Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
  • Pain, lack of interest , fatigue, change in weight, vision changes.
  • Low blood pressure.

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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.

How Is Parkinsons Disease Diagnosed

Author Joan Didion Passes From Parkinson’s Disease Complications

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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Living With Parkinson Disease

These measures can help you live well with Parkinson disease:

  • An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
  • High protein meals can benefit your brain chemistry
  • Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
  • If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.

Two Areas In Which Parkinsons Disease May Bring About Death

I. Falls

PD patients are at an increased risk of falling and bad falls can lead to death. This usually occurs as a complication of a fall that requires hospitalization, particularly if it involves surgery. While most people do not fracture their hips when they fall, some do, and hip surgery, while routine, is still major surgery. It carries the risk of infection, delirium related to pain medications and anesthesia, heart failure, pneumonia, blood clots in the legs that then go to the lungs, and general weakness from immobility. Hip fractures are probably the main cause for death for those who fall, but people can fracture other bones and require surgery. They may fracture their ribs, which leads to reduced coughing, because of the pain, and an increased risk of lung infections . It is surprisingly uncommon for Parkinsons Disease patients to die from brain injuries related to falls, but it still may occur.

II. Pneumonia

PD patients also may develop pneumonias completely unrelated to difficulties with swallowing, just like their non-PD friends and relatives.

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Balance And Coordination Issues

Issues with stability and balance usually happen later on in the course of Parkinsons as the disease advances, but its quite common, explains Dr. Pan. You may lose balance if you try to turn too quickly, for example. You may also experience whats called freezing of gait, where your feet struggle to catch up with your brain while youre walking, which can throw you off balance, she says. This may happen when starting to walk, turning, or going through doorways, you can get stuck, so its very impairing.

Urinary Incontinence And Constipation Issues

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Both constipation and urinary problems are common with Parkinsons. Again, this is because the disease affects the muscles. Weak muscles in the digestive system slow down digestion, which leads to constipation.

Likewise, you may have trouble completely emptying your bladder, or have frequent urges to use the bathroom.

Let your doctor know if you have bladder or . There are medicines as well as changes you can make to your daily routine that will help with these complications. For example, dietary changes can often help with .

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Can Parkinsons Disease Be Prevented

Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.

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