Parkinson's Disease

Parkinson's disease is a progressive disorder of the nervous system that affects your movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.

In early stages of Parkinson's disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

Symptoms

Parkinson's disease symptoms and signs may vary from person to person. Early signs may be mild and may go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides. Parkinson's signs and symptoms may include:

• Tremor. Your tremor, or shaking, usually begins in your limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson's disease is tremor of your hand when it is relaxed (at rest).
• Slowed movement (bradykinesia). Over time, Parkinson's disease may reduce your ability to move and slow your movement. This may make simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, your feet may stick to the floor as you try to walk, making it difficult to move.
• Rigid muscles. Muscle stiffness may occur in any parts of your body. The stiff muscles can limit your range of motion and cause you pain.
• Impaired posture and balance. Your posture may have become stooped, or you may have balance problems as a result of Parkinson's disease.
• Loss of automatic movement
• s. In Parkinson's disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk. You may no longer gesture when talking.
• Speech changes. You often may have speech problems as a result of Parkinson's disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone, rather than with the usual inflections.
• Writing changes. Writing may appear small and become difficult.
Medications typically markedly reduce many of these symptoms. These 
medications increase or substitute for a specific signaling chemical (neurotransmitter) in your brain: dopamine. People with Parkinson's disease have low brain dopamine concentrations.
When to see a doctorSee your doctor if you have any of the symptoms associated with Parkinson's disease — not only to diagnose your condition but also to rule out other causes for your symptoms.

Causes

The cause of Parkinson's disease is unknown, but several factors appear to play a role, including:
• Your genes. Researchers have identified specific genetic mutations that can cause Parkinson's disease, but these are extremely uncommon, except in rare cases with many family members affected by Parkinson's disease. However, certain gene variations (polymorphisms) appear to increase the risk of Parkinson's disease, but with a relatively small risk of for each of these genetic markers.
• Environmental triggers. Exposure to certain toxins or environmental factors increase the risk of later Parkinson's disease, but the risk is relatively small.
In summary, there is much work to be done to identify the factors causing Parkinson's disease.
Many changes occur in the brains of people with Parkinson's disease, including:
• The presence of Lewy bodies. Clumps of specific substances within brain cells are microscopic markers of Parkinson's disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson's disease.


• A-synuclein is found within Lewy bodies. Although many substances are found within Lewy bodies, scientists believe the most important of these is the natural and widespread protein called a-synuclein. It's found in all Lewy bodies in a clumped form that cells can't break down. This is currently an important focus among Parkinson's disease researchers.


Risk factors
Risk factors for Parkinson's disease include:
• Age. Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk continues to increase with age.
• Heredity. Having a close relative with Parkinson's disease increases the chances that you'll also develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson's disease.
• Sex. Men are more likely to develop Parkinson's disease than are women.
• Exposure to toxins. Ongoing exposure to herbicides and pesticides may put you at a slightly increased risk of Parkinson's disease.



Complications
Parkinson's disease is often accompanied by these additional problems, which are variably treatable:
• Thinking difficulties. You may experience cognitive problems (dementia) and thinking difficulties, which usually occur in the later stages of Parkinson's disease. Such cognitive problems aren't very responsive to medications.
• Depression and emotional changes. Many people with Parkinson's disease may experience depression. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson's disease. You also may experience other emotional changes, such as fear, anxiety or loss of motivation.
• Sleep problems and sleep disorders. People with Parkinson's disease often may have sleep problems, including waking up frequently throughout the night, waking up early or suddenly falling asleep during the day, or rapid eye movement sleep behavior disorder — acting out your dreams. Medications may help your sleep problems.
• Bladder problems. Parkinson's disease may cause you to experience bladder problems, including being unable to control urine or having difficulty urinating.
• Constipation. Many people with Parkinson's disea
• se develop constipation primarily due to a slower digestive tract.
• Sexual dysfunction. Some people with Parkinson's disease may notice a decrease in sexual desire or performance.
Treatments and drugs


Parkinson's disease can't be cured, but medications can help control your symptoms, often dramatically. In some later cases, surgery may be advised. Your doctor also may recommend lifestyle changes, especially ongoing aerobic exercise. In some cases physical therapy that focuses on balance and stretching also is important.
MedicationsMedications can help you manage problems with walking, movement and tremor by increasing your brain's supply of dopamine. However, dopamine can't be given directly, as it can't enter your brain.
You may have significant improvement of your symptoms after beginning Parkinson's disease treatment. Over time, however, the benefits of drugs frequently diminish or become less consistent, although symptoms usually can continue to be fairly well controlled.
Your doctor may prescribe medications, which may include:
• Carbidopa-levodopa (Parcopa). Levodopa, the most effective Parkinson's disease medication, is a natural chemical that passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa, which protects levodopa from premature conversion to dopamine outside your brain, which prevents nausea. In Europe, levodopa is combined with a similar substance, benserazide (Madopar). Side effects include nausea or a drop in blood pressure when standing (may result in faintness).
  After years, as your disease progresses, the benefit from levodopa may become less stable, with a tendency to wax and wane ("wearing off"). Also, you may experience involuntary movements (dyskinesia) after taking higher doses of levodopa. Your doctor may lessen your dose or adjust the times of your doses to control these effects.
• Dopamine agonists. Unlike levodopa, dopamine agonists don't change into dopamine. Instead, they mimic dopamine effects in your brain. They aren't as effective in treating your symptoms as levodopa. However, they last longer and may be used with levodopa to smooth the sometimes off and on effect of levodopa.
  Dopamine agonists include pramipexole (Mirapex) and ropinirole (Requip). A short-acting injectable dopamine agonist, apomorphine (Apokyn), is used for quick relief.
  The side effects of dopamine agonists are similar to carbidopa-levodopa, but also include hallucinations, swelling, sleepiness or compulsive behaviors such as hypersexuality, gambling and eating. If you're taking these medications and you start behaving in a way that's out of character for you, talk to your doctor.
  Sincerely prepared by, Nurul Izzaty Norazlan

  MEJ03

  Thanks for reading :)