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Suggest Treatment For Progressive Parkinson's Disease

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Posted on Wed, 7 Jan 2015
Question: Hi, I have a question about Parkinson's Disease progression and respiration.
doctor
Answered by Dr. Ronald Schubert (25 minutes later)
Brief Answer:
Parkinsons disease and breathing

Detailed Answer:
Thanks for contacting HCM with your medical questions and concerns

You are curious if Parkinson's disease will cause any breathing abnormalities. Parkinson's disease is a disease that effects the brain neurotransmitters that deal with movement. This causes a change in motor movement and tremor at rest. There is no affect to the breathing centers or muscles of breathing as these are autonomic nerve centers and not connected to the centers affected by Parkinson's disease.

Parkinson's disease is a progressive disease which starts with tremor at rest and then progressing to walking and movement. The tell tale movement is a shuffling gait without arm swinging. With progression the mask face and finally there will progression to dementia.

I hope this answered your question.


Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ronald Schubert (3 hours later)
I have a pt who has perseverative humming and difficulty breathing due to the Parkinson's. When the pt consume food, he/she will hum songs quickly and sweat profusely into his meal. I tried pursed lip breathing to get him/her to breathe and he/she will stop humming and resume consuming his/her meal. Why is this? I'm going to tell the nurses NOT to do this because I don't want him/her to possibly aspirate (although no s/s of aspiration has been observed and no hx of pneumonia). I know it's not evidence based practice but the pt has to breathe during mastication. It will take between4-5 hrs just to consume 30% of the meal. The pt also rips out their feeding tube at night because he/she didn't agree on it (it was the mother's decision). I'm going to do caregiver education about posture and not playing music (because it makes the perseverations worse) but I feel bad I suggested the pursed lip breathing (because it worked for me and I tired getting nursing to do it but it's NOT evidence based practice and I don't want their to be a choking risk). What do I do besides meds because with the increase meds, it only seems to work for 2 weeks at most and the pt regress. Why is it that the breathing redirects the perseverations and causes a smoother movement?
doctor
Answered by Dr. Ronald Schubert (21 hours later)
Brief Answer:
Breathing abnormality

Detailed Answer:
Thanks for returning your questions on your patient.

You are describing a patient that has other breathing troubles and not from Parkinson's disease. The pursing of the lips is accomplishing positive pressure in the lungs to maintain aeration and opening of airways. Your patient may have underlying COPD and this may not be from smoking but just from old age. As we age the capacity of our lungs decreased and at the advanced age of your patient he may have lung problems. The humming is also a manifestation of attempting ways to create positive pressure in the lungs. If you can be patient with him during eating and allow him to breath with positive pressure he may eat and get enough nutrition.

The other problem you mention is his Parkinson's medication seems to last only a few short weeks. That is an inherent problem with Parkinson's medication. The body metabolizes the neurotransmitter more rapidly and hence more off time. There is nothing that can be done to reduce this phenomena other than frequent medication changes and sometimes drug holidays.

A hallmark of Parkinson's is that the tremor is at rest and gets better with movement. Because the neurotransmitter that causes the tremor is over ridden during purposeful movement and that includes voluntary breathing or concentration on breathing. When he relaxes the tremor will reappear until he consciously does motor activity again.

I hope this answers your question. Please contact us again for any further medical questions or concerns
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ronald Schubert

General & Family Physician

Practicing since :1984

Answered : 2407 Questions

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Suggest Treatment For Progressive Parkinson's Disease

Brief Answer: Parkinsons disease and breathing Detailed Answer: Thanks for contacting HCM with your medical questions and concerns You are curious if Parkinson's disease will cause any breathing abnormalities. Parkinson's disease is a disease that effects the brain neurotransmitters that deal with movement. This causes a change in motor movement and tremor at rest. There is no affect to the breathing centers or muscles of breathing as these are autonomic nerve centers and not connected to the centers affected by Parkinson's disease. Parkinson's disease is a progressive disease which starts with tremor at rest and then progressing to walking and movement. The tell tale movement is a shuffling gait without arm swinging. With progression the mask face and finally there will progression to dementia. I hope this answered your question.