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For example, in Parkinson's disease the symptoms are caused by the selective loss of a small population in the brain consisting of about 500,000 dopaminergic cells. The dopaminergic cells are situated deep in the midbrain and carries messages back and forth to nerve cells. In any brain that grows older, some of these dopamine cells will die over time. The rate at which the cells die is different among individuals. Some people, whose rate of dopamine cell death is slightly higher than normal. the chance that they will soon lose critical 85-90 percent of the cells that are needed for normal function is high. The brain can somehow manage to compensate for a loss of about 85 percent of these cells, but when only a small number of working dopamine cells or less remain on each side of the brain, the symptoms of Parkinson's disease appear. The neurotransmission that takes place at the nerve terminals that produce dopamine is needed for all of us to initiate movements, and without it, we freeze Tremors are the symptom the public most often identifies with Parkinson's disease, but in fact up to 25 percent of patients experience very slight tremor or non at all. When it is present, the tremor may be worse on one side of the body. Besides affecting the arms and legs, it sometimes spreads to the head, neck, face, and the jaw. Another symptom of Parkinson's disease is Rigidity, which is an increased tone or stiffness in the muscles. Unless it is temporarily eased by anti-Parkinson's medications, rigidity id always present. However, it increases during movement. It is often responsible for a mask-like expression of the face. In some patients, rigidity leads to sensations of pain, especially in the arms and shoulders. Bradykinesia is the slowness of movement a person with Parkinson’s disease will usually have. This symptom is characterized by a delay in initiating movements, caused by the brains slowness in transmitting the necessary instructions to the appropriate parts of the body. when the instructions have been received, the body responds slowly in Poor balance also tends to affect people with Parkinson’s disease. This is mainly true when they move harshly, causing a sudden change in the position of their bodies. Some patients experience repeated falls due to poor balance. Walking problems commonly include a decreased or non-existent arm swing, short shuffling steps, difficulty in negotiating turns, and sudden freezing spells that make a person unable to take their next step. People with Parkinson’s disease may also suffer from many secondary symptoms. These include depression, sleep disturbances, dizziness, hunched posture, constipation, dementia, and problems with speech, breathing, swallowing, and sexual function. Also, it is important to take notice that different patients experience different symptoms. Although there is no specific tests for Parkinson’s disease, there are several ways of making a diagnosis. No blood test can detect the disease. Usually a diagnosis is based on a neurological exam that covers evaluation of the patients symptoms and their stiffness. Some kinds of x-rays can help a doctor make sure nothing else is causing your symptoms. But x-rays cannot show whether the person has Parkinson’s disease or not. If symptoms are serious enough, a trial test of anti-Parkinson’s drugs may be used. If the symptoms go away or get better when the person takes a medicine called Levodopa, it’s fairly certain that the person has Parkinson’s disease Brain scans also can be made to rule out other diseases whose symptoms relate to Parkinson’s disease. Symptoms usually affect one side of the body more than the other side. There are always two primary symptoms present when a diagnosis of Parkinson’s If the disease progresses beyond just the minor symptoms, drug treatment may be suggested. Drug therapy for Parkinson’s disease typically provides relief for ten to fifteen years or more. The most commonly prescribed medication is L-dopa (also called levodopa) which helps replenish some of the lost dopamine in the brain. Sinamet, a combination of levodopa and carbidopa, is the drug most doctors use to treat Parkinson’s Recent clinical studies have suggested that the class of drugs called “dopamine agonist” should be used prior to levodopa except in patients with mental problems or hallucinations. In those older than seventy-five, dopamine agonists should be used cautiously because of an added risk of hallucination. Other drugs are also used and new drugs are constantly being tested. It is common for multiple drugs to be prescribed because many of them work well together to control symptoms and reduce side effects. Many of the drugs used to treat Parkinson’s disease become less effective over time so doctors will often try different combinations of drugs as the disease progresses. People with Parkinson’s respond differently to drugs so they may need to work with their doctor to find the drug or combination of drugs that works best for them. It may take several weeks or months before a drug begins to work. Many Parkinson’s drugs can also wear off in between doses during the day so people with Parkinson’s disease need to pay close attention to the times they take their medication and to plan their activities Side effects of medications can also be a problem. For some medications the side effects are worst when the person first begins taking the drug and gradually disappear or lessen. For other medications, side effects may appear after several years. For example, long-tern levodopa use may result in very uncontrollable movements called dyskinesias, or on-off attacks where a person will become frozen for a few seconds. Confusion may develop as a side effect after about eight years. Care for people with Parkinson’s disease includes a well-balanced diet and regular exercise. Physical, occupational, or speech therapy may be suggested for some people. Physical therapy and muscle strengthening exercises can be a key part of managing Parkinson’s disease. A physical therapist can help develop and monitor a home exercise program. A good exercise routine should include strengthening and flexing all limbs, stretching legs and feet, walking, facial and breathing exercises, and specific exercises to gain better control in swallowing. An occupational therapist can help with walking and accomplishing everyday activities. People with Parkinson’s disease lose the ability to move automatically. A good exercise program can help people with Parkinson’s learn how to think about their movements and to plan their movements A speech therapist can help improve voice volume and quality. Therapeutic exercises, including verbalization and tongue movements, often can make a difference. In some cases where speech is severely impaired, a machine or computer generated voce can be used. It also may be important for families to learn new strategies to help the person communicate. If the person is confused, it may be a good idea to use verbal cues to understand or assist. The inability to understand can be very frustrating. Offer reassurance and support. This may ease some of the person’s anxiety over not being able Diet also plays an important role in keeping a person with Parkinson’s disease healthy and as active as possible. Choose foods that are easy to eat when someone is It is also important that people get enough nourishment. Some doctors recommend that people taking levodopa eat foods that are lower in protein because protein can make the levodopa less effective. It is also very important for the person with Parkinson’s and their caregivers to take care of themselves emotionally. Support groups A caregiver is required to take care of a person with Parkinson's desease. It's usually a family member. The role of the caregiver is usually one that a person must take on without any prior warning. It's a major change to anyone's lifestyle. A caregiver must be on call twenty-four hours a day. They always have to be there for there loved one no matter what. They have to be organized, well informed, and watchful. They must be very patient, helpful, and kind toward's their loved one's changing conditions. They basically just help them with their diets and do exercises with them. Sometimes they have to be there for them emotionally too. Prescription drugs are not the only effective tools for the treatment of Parkinson's. For some patients in advanced stages of Parkinson's disease, surgery can dramatically reduce symptoms. Surgery is an option for patients who have been taking combinations of drugs over a long period of time, and as a result, those drugs will of became less One common surgical procedure is a pallidotomy. Surgeons actually change the structure of the brain to help restore the balance required for normal motion. The majority of patients who have this surgery have shown immediate improvements. The benefits of the surgery last about a year. Some doctors also use a procedure known as Although these and other types of surgery for Parkinson's disease have produced some good results, the long term effects of such surgeries are not yet known. So doctors usually only perform these surgeries as last resort treatments. From doing research on Parkinson’s disease I have learned a lot. I never would have realized what these people have to go through. They not only have physical challenges, but mental also. People with the disease have to learn to live with the fact that they will never be cured, and that their disease will keep progressing. I give anyone who has Parkinson’s disease credit, because I now understand what they have to go Bibliography: Bibliography Mac Millan Health Encyclopedia. Non-communicable disease and disorders. Vol. 3. New York, Mac Millan Publishing company, 1993. NINDS PArkinson’s diesease info page. www. apdaparkinson.com Word Count: 1669
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