BENGALURU: Parkinson’s disease: two innocuous words is a degenerative disease that affects the brain nerve cells that produce dopamine. The symptoms of this disease include muscle rigidity, tremors, and changes in speech and gait.Typically, symptoms start manifesting between 50 and 60 years of age. Incidence of Parkinson’s disease (PD) increases with age, but approximately four per cent of those diagnosed with Parkinson’s are under the age of 50. Men are 1.5 times more likely to have PD than women. Tremor is often the first symptom that people associate with Parkinson’s disease. The symptoms develop slowly, and often go unnoticed by family, friends, and patients themselves.
The scariest part, however, is that while more than 10 million people worldwide are living with this disease, in India, there is no concentrated effort to understand or create awareness about this disease. What’s worse is that people are fed with misinformation about this disease.
Though it is true that exposure to pesticides and a history of head injuries have been linked to developing PD later in life, the actual risks are modest. There are other secondary causes, such as stroke and drugs, too, that lead to PD. Parkinson’s is manageable, even though it is degenerative. While muscle movement is most affected, with rigidity in muscles, and pain being most common, other early signs of PD are:
■ Reduction in the swing of the arm on one side while walking.
■ Slow and limited movement, especially when trying to move from a resting position.
■ Weakness of face and throat muscles making it harder to swallow and speak
■ Difficulty with balance and thus walking.
Untreated, individuals could lose independent movement in eight years, and be bedridden for another ten years. It is true that there is no cure for PD, but medications, surgery, and physical treatment can provide relief and better quality of life.
The good news is that medical science has advanced enough to help manage the disease better. Treatment for PD is much more effective than those available for other neurological disorders such as Alzheimer’s, motor neuron disease, and Parkinson plus syndromes. Taking dopamine by itself does not help as it cannot enter the brain through bloodstream.
MRI scans are more accurate than computed tomography (CT) scans to diagnose PD, as CT usually appear normal in a PD patient. Deep Brain Stimulation (DBS) is the most common surgical treatment for Parkinson’s, but it is not for everyone. It is performed on those who have been suffering from PD for at least four years, get medication’s benefits, but have motor complications, such as significant periods when medication doesn’t work, and there are recurring symptoms and/or uncontrolled, involuntary movements.
Regular physical exercise, with or without physical therapy is suggested. Exercise in middle age may reduce the risk of PD later in life. Caffeine also appears protective with a greater decrease in risk. Antioxidants, such as vitamins C and E, have been proposed to protect against the disease.
The author is a consultant- Neurology MBBS, MD, DM at Aster CMI Hospital