What is Parkinson’s Disease?

Neurological disorders affect at least 1 billion people worldwide according to the World Health Organization. The most common illnesses include epilepsy, headache disorders, multiple sclerosis, dementia, and Parkinson’s disease. In Singapore, it was estimated in 2015 that 4,000 people suffer from Parkinson’s and 3 out of a thousand of these are the elderly.

What are the Symptoms?
Parkinson’s disease is a form of movement disorder that can disrupt the person’s ability to perform everyday activities. It is also a chronic and progressive illness that cannot be reversed. Parkinson’s affects a specific region of the brain called substantia nigra, where loss of neurons occurs. The neurons in this area are responsible for producing dopamine, which help in the movement of the body. Low levels or loss of dopamine will result in the inability to control movement.

Most of the people afflicted are aged 50 and above, but there are cases of early-onset or young-onset Parkinson’s. A person with Parkinson’s disease will suffer from various symptoms (and symptoms will usually manifest on one side of the body), but the most common are following:

1. Muscle tremors at rest
2. Slow voluntary movements or akinesia
3. Stiff or rigid muscles
4. Stooped posture
5. Less control over facial expressions
6. Mood swings, anxiety and/or depression
7. Fatigue and difficulty concentrating
8. Sleep problems
9. Digestion and bladder problems
10. Deterioration or loss of the sense of smell
11. Poor memory and speech difficulties

At stage 5 of the disease, the person might not be able to stand and walk and will experience hallucinations.

What are the Treatments?
The causes of Parkinson’s depend on the form of the illness. The most common type of Parkinson’s is idiopathic, which means that there is no clear cause that can be found. The damage is done to the nerve cells that produce dopamine, a neurotransmitter that sends electrical impulses to the muscles from the brain. There are cases, however, where Parkinson’s is caused by other neurological disorders, tumors, infections, or it could be a side effect of drugs.

The symptoms of Parkinson’s are apparent even before the person can get a diagnosis. The doctor, however, needs to do a physical exam and examine all the symptoms by testing the person’s reflexes, agility, and sensitivity to pain. Additional tests such as the L-Dopa, CT and/or MRI scans are also performed to rule out other potential illnesses that share the same symptoms with Parkinson’s.

There is no cure for Parkinson’s to date, but there are treatments that will help ease the symptoms so that the afflicted can still function and live a productive life. The treatment will be based on the stage or progression of Parkinson’s using the Hoehn scale, Yahr scale or UPDRS.

Parkinson’s is treated with medications to replenish the dopamine levels. This is adjusted as the symptoms progress and are paired with other treatments such as occupational therapy, physiotherapy, speech therapy, and deep brain stimulation.

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