What is Parkinson's Disease?

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Health.nytimes.com-Parkinson's disease. Do you remember Moh. Ali,  a boxer who get parkinson's  disease. parkinson's disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults. It affects both men and women. In some cases, Parkinson's disease runs in families. When a young person is affected, it is usually because of a form of the disease that runs in families. Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why these brain cells waste away is unknown. Parkinson's is rare in children. It may occur because the nerves are not as sensitive to dopamine. The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (called secondary parkinsonism) or certain medications.

Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, and can include:
Symptoms include:
Slow blinking
Constipation
Difficulty swallowing
Drooling
Problems with balance and walking
No expression in the face (like you are wearing a mask)
Muscle aches and pains
Movement problems, which include:
Difficulty starting movement, such as starting to walk or getting out of a chair
Difficulty continuing to move
Slowed movements
Loss of small or fine hand movements; writing may become small and difficult to read; eating becomes difficults
Rigid or stiff muscles, often beginning in the legs
Shaking, called tremors
Usually occurs in the limbs at rest, or when the arm or leg is held out
Goes away when you move
Eventually may be seen in the head, lips, tongue, and feet
May be worse when tired, excited, or stressed
Finger-thumb rubbing (pill-rolling tremor) may be present
Slowed, quieter speech and monotone voice
Stooped position
Low blood pressure when getting up, sweating, drooling, lack of body temperature control. These problems are due to something called autonomic dysfunction.
Other symptoms may include:
Anxiety, stress, and tension
Confusion
Dementia
Depression
Fainting
Hallucinations
Memory loss


There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms. Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wears off, and symptoms can return. If this happens to you, your health care provider may need to change the:
Type of medication
Dose
Amount of time between doses
How the medicine is taken
Work closely with your doctors and therapists to find a treatment program that works best for you. Never change or stop taking any medications without talking with your doctor.
Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.
Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.
Medications used to treat movement-related symptoms of Parkinson's disease include:
Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
Amantadine or anticholinergic medications to reduce early or mild tremors
Entacapone
Other medications may include:
Memantine, rivastigmine, galantamine for cognitive difficulties
Antidepressants for mood disorders
Gabapentin, duloxetine for pain
Fludrocortisone, midodrine, botox, sidenafil for autonomic dysfunction
Armodafinil, clonazepam, zolpidem for sleep disorders
Lifestyle changes may be helpful for Parkinson's disease:
Good general nutrition and health. Changes in what you eat or drink are needed if there are swallowing problems
Exercising, but adjusting the activity level to meet changing energy levels
Regular rest periods and avoiding stress
Physical therapy, speech therapy, and occupational therapy
Railings or banisters placed in commonly used areas of the house. Other changes may be needed around the home to prevent falls and make the bathroom safe.
Assistive devices, such as special eating utensils, wheelchairs, bed lifts, shower chairs, walkers, and wall bars
Social workers or other counseling services to help you cope with the disorder and get assistance (such as Meals-on-Wheels)
Surgery may be an option for some patients with Parkinson's disease. These surgeries do not cure Parkinson's, but may help ease symptoms.
Deep brain stimulation involves placing electrical stimulators in specific areas of the brain that control movement.
Another type of surgery destroys brain issues that cause Parkinson's symptoms.
Stem cell transplant and other clinical trials are currently ongoing in the USA.