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Named after Dr. James Parkinson, a London physician who first described the condition in 1817, Parkinson's disease is a chronic, slowly progressive disease of the central nervous system. About 1.5 million people in the United States alone suffer from this condition. Usually Parkinson's disease affects people in later life, but about 15% of cases occur in people before age fifty. Past age sixty, approximately one out of every one hundred adults is affected by Parkinson's disease.
Parkinson's disease affects a small area of cells in the midbrain called the substantia nigra. The loss of neurons leads to a deficit in the neurotransmitter dopamine. The drug levodopa (L-dopa), which is a dopamine precursor, is used to treat Parkinson's disease. By synthetically replacing dopamine in the brain, L-dopa can control symptoms for awhile, but the use of L-dopa requires close supervision, and as the disease progresses the drug begins to lose its efficacy.
Because Parkinson's disease progresses differently in different people, not every victim will show all of the symptoms of the condition. Furthermore, some cases are more severe than others, and some progress more rapidly. However, there are a number of characteristic signs of the condition:
1. resting tremor on one side of the body
2. head-nodding
3. slowness of movement (a "walking through quicksand" effect)
4. rigidity in the muscles, especially in the limbs
5. problems with balance
6. an awkward or uneven gait
7. a fixed facial stare and decrease in facial mobility and expression
8. "freezing"--i.e., a sudden, temporary inability to initiate movement
Unfortunately, there is no cure yet for Parkinson's disease, though many promising avenues of research are currently under investigation. There are, however, a number of treatments that are used to mitigate the
symptoms of the disease. Because people respond differently to different treatments, failure of one approach to produce positive results does not mean that another approach will not work. All treatments, however, are able only to slow the development of symptoms and to keep them under control for a time. In severe cases
or advanced cases, the patient will eventually lose a certain amount of independence--especially as fine motor dysfunction makes it hard to accomplish such basic tasks as brushing one's teeth or buttoning a shirt. As the disease progresses, problems with gait and balance become more pronounced, and care must be taken
to prevent falls and injury.
In mild or less advanced cases, physical, occupational, or speech therapy can help the patient to maintain independence for a longer period of time. Anticholinergic drugs (drugs that block the physiologic action of the neurotransmitter acetylcholine), like trihexphenidyl (Artane) or antihistamines with anticholinergic properties, may be prescribed to control symptoms. As the disease progresses, some patients respond well to surgery on the affected area of the brain. But the beneficial effects of all currently available treatments are only temporary, which is why further research into this all too common condition is so important.
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