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Dr. Andrew Rynne

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Article Home Adult and Senior Health Parkinson's disease or Shaking palsy

Parkinson's disease or Shaking palsy

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Parkinson's disease is a chronic, progressive degenerative disease of brain which impairs motor control, speech and other functions. It is one of the movement disorders. It occurs due to loss of dopamine producing brain cells.

 

It is characterized by muscle rigidity, resting tremor, slowing of movement (bradykinesia), complete loss of movement. It usually begins around 60 years.

Pseudo Parkinsonism or atherosclerotic Parkinsonism is a condition in which small multiple strokes caused damage to the blood vessels in the brain. It is often resistant to the treatment with antiparkinson’s drugs.

The symptoms are caused by loss of nerve cells that secrete dopamine in the mid brain called substantia nigra. The most common symptoms of Parkinson’s disease are trembling of hands, legs, jaws and face. Stiffness of the arms, legs and trunk, slowness of movement, poor balance and poor coordination.

Signs and symptoms

  • Tremors
  • Rigidity
  • Akinesia/bradykinesia
  • Postural instability
  • Gait and posture disturbances like shuffling gait, decreased arm swing, forward flexed posture,
  • Festination: It is combination of stooped posture, imbalance and short steps
  • Freezing gait
  • Dystonia
  • Speech and swallowing disturbances like hypophonia, monotonic speech, festinating speech, drooling, and dysphagia.
  • Fatigue
  • Mask like facies
  • Difficulty rolling in bed or rising form a seated position
  • Impaired dross motor coordination
  • Akathisia, inability to sit still
  • Short term memory loss
  • Procedural memory
  • Declarative memory
  • Prefrontal hypo metabolism
  • Excessive day time somnolence
  • Terminal insomnia
  • Dizziness
  • Fainting
  • Hyposmia
  • Anosmia
  • Urinary incontinence
  • Nocturia
  • Constipation
  • Weight loss
  • Altered sexual function
  • Seborrheic dermatitis
  • Gastric dysmotility

Treatment of Parkinson’s disease

  • Levodopa
  • Carbidopa
  • Dopamine agonists
  • MAO-B inhibitors
  • Amantidine
  • Anticholinergics
  • COMT , catechol-O-methyltransferase inhibitors
  • Pallidotomy: It is the common surgery done. It destroys the portion of the brain called globus pallidus.
  • Thalamotomy
  • Deep brain stimulation