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Parkinson’s disease
In 1817, James Parkinson, a physician in Hoxton, London, published “The Shaking Palsy”’, the monograph describing a condition that is common and worldwide with prevalence of 150/1,00,000, increasing sharply over 70 years. As the disease is relatively uniform worldwide the environmental agent is not so much responsible for the cause of the disease.
Parkinsonism is a disturbance in motor functions characterized by expressionless face, stooped posture, slowing of voluntary movement and tremor. It is not a single disease but is the clinical manifestation of disturbance causing degeneration and disorder.
This disease illustrates the classical features of extra pyramidal damage having mask-like expressionless face, often with drooling due to change of muscle tone and reflexes. Some factors possibly involved with the disease are:
Nicotine – Several epidemical studies suggest the curious and unexplained fact that the disease is less prevalent among tobacco smokers than in life long abstainers.
Viral encephalitis – Some survivors developed severe Parkinsonism.
Genetic – It is not usually familiar but there is clustering of early onset of Parkinson’s disease in some families.
Severe blow on the head – Some suggest wrestlers, boxers and even the sportsmen are often attacked with the disease due to injury of brain cells during competition. The main features and possible treatment of this disease may be enumerated in order to follow the cases in our subsequent analysis.
Features of the disease
The combination of tremor, rigidity and akinesia develops slowly, over months or several years, together with changes in posture. The most common initial symptoms are tremor and slowness. Patients complain that they feel that their limbs and joints become stiff and ache and physical movements are difficult. Slowness causes characteristic symptoms of difficulty in rising from sitting position or getting into or out of bed. Writing becomes small, tremulous and often illegible and spidery. Relatives quite often note an impassive facial expression. Dementia often develops in late stages. Anxiety and depression are very common. Usually the course of the disease ranges over 10-15 years, with death resulting from bronchopneumonia or other infections. Apart from these clinical features we have found some other symptoms of the disease in our sample studies which we will develop in our paper.
Treatment
Parkinsonism is so acute that prognostic treatment is impossible. Physicians, however, prescribe some drugs which are to be carefully administered. While no drugs alter the course of Parkinson’s disease, levodopa and /or dopaminergic agonists produce striking initial symptomatic improvement. These drugs should be avoided until they are clinically necessary because of delayed unwanted effects.
Antioxidants like Vitamin C and E possibly acting as neuroprotective agents are sometimes prescribed. There are also some surgical interventions which are restricted to specialist centres. Skilled and determined physiotherapy can improve gait and help to overcome particular problems. Some patients with Parkinson’s disease have shown improvement through surgery and transplantation of gland cells. However, the treatment is still in its stage of infancy. Apart from all this approach soft and sympathetic attitude of the relatives and the attendants often take the patients into sublimity and helped them to endure the pain.
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