Parkinson’s disease is a neurodegenerative condition that means damage to certain parts of the brain. About five to ten percent of the cases are due to genetic issues who show parkinsons disease symptoms. But the other ninety-five percent of cases are idiopathic. There is a family member with Parkinson’s disease who slightly raises your risk of getting it. After diagnosed with this disease the cells start to become damaged and then that continues over time. There are no medications to slow down this disease.
Overview
As Parkinson’s disease progresses, the symptoms such as tremor, stiffness, loss of balance can progress to and other symptoms can come out such as problems with memory, problems with hallucinations, problems with speech becoming more difficult to understand, and problems with swallowing.
What are the indicators of Parkinson’s disease?
The first typical symptoms that people might experience is tremor usually occurs in one hand when the hands resting or some stiffness, slowness, or loss of balance. Their friends or family or themselves may notice that their voice is becoming a little bit softer and their facial expression changes and becoming a little bit more masked so not as expressive as it used to be.
They may start drooling and having a little bit of extra saliva and this is the first thing people notice. The other things that can come early on are the loss of sense of smell, constipation, urinating a little bit more frequently than usual, changes in sleep, and anxiety or depression.
When to consult a healthcare provider
Consult your doctor or a therapist immediately if you are experiencing any of the symptoms described above. Your doctor should evaluate you for other possible causes of your symptoms before treating the existing condition. Together, you and your doctor can determine the best way to manage your symptoms.
What are the risk factors of Parkinson’s disease?
There are a variety of well-established risk factors in developing this condition. It includes
- Age
- Heredity
- Gender
- Exposure to toxins
Let’s discuss the above risk factors in detail:
Age
The risk of this condition increases as you age. Young people are far less likely to develop Parkinson’s disease. Older people which means above sixty years of age have an increased risk of getting diagnosed with Parkinson’s disease.
Heredity
If any member in your family has diagnosed with Parkinson’s disease in the past or if you are living with a person who has this condition increases your chances of developing this disease.
Gender
Parkinson’s disease is far more common in men than in women.
Exposure to toxins
Heavy exposure to herbicides and pesticides can increase the risk of getting diagnosed with Parkinson’s disease.
What are the complications of Parkinson’s disease?
The complications of Parkinson’s disease include
- Unable to think
- Depression and emotional changes
- Difficulty swallowing
- Eating and chewing problems
- Problems related to sleeping
- Bladder problems
- Constipation
- Fatigue
- Sexual dysfunction
Let’s discuss the above complications in detail:
Unable to think
People with Parkinson’s disease experience thinking difficulties. It means they can’t think about anything. These problems are not resolved by medications.
Depression and emotional changes
Some people may suffer from mental health conditions like depression and anxiety. Taking medications to treat depression is the best way to handle Parkinson’s disease. Due to these emotional changes, people suffer from the following symptoms
- Fear
- Anxiety
- Loss of motivation
See your physician right away if you experiencing the above symptoms. Your physician may prescribe medications to treat these symptoms.
Difficulty swallowing
It will be difficult for you to swallow as your condition progresses.
Chewing and eating problems
Parkinson’s disease has its negative effects on your mouth. Due to those effects, it is very hard for people to eat.
Problems related to sleeping
Difficulty in sleeping or unable to sleep is the most common complication in people with Parkinson’s disease. Starting to act out their dreams and yelling out in their sleep, kicking out and punching in their sleep that can potentially lead them to fall out of the bed or injuring their bed partner accidentally can happen in the people with Parkinson’s disease. Your physician may recommend drugs to give you relief from sleep problems.
Bladder problems
One of the most common causes of Parkinson’s disease is bladder issues. It includes difficulty in urinating or frequent urination.
Constipation
People who are diagnosed with Parkinson’s disease are more likely to develop constipation, and it occurs due to the lower digestive tract.
Fatigue
This condition can cause extreme tiredness to the people and they often maintain low levels of energy. Researchers are yet to find the connection between fatigue and Parkinson’s disease.
Sexual dysfunction
Parkinson’s disease can affect a person’s sexual life like unable to maintain an erection during sexual intercourse or loss of desire to do sex.
How do physicians diagnose Parkinson’s disease?
When you see a physician either a primary care physician or neurologist, there are things that they look for in the history and the symptoms, you have that will clue them your physician that this could be Parkinson’s disease and then the examination will confirm those findings. Your doctor might order some additional tests such as an MRI scan or CT scan of the head and recommend blood tests if your physician thinks that it is necessary to rule out other mimicking conditions. They will also ask you about the medications that you are taking. There aren’t any specific blood tests and any other tests that will confirm this is a Parkinson’s disease.
What are the treatment options available for Parkinson’s disease?
There are lots of treatments to help Parkinson’s disease. Symptoms such as stiffness, slowness, will respond well to the medications in the early stage. Non-motor symptoms such as constipation, urinary problems, mood disorders, sleep problems and there are lots of medications that can be used to treat those symptoms. There is no cure for Parkinson’s disease and the main objective of any type of treatment is to manage the symptoms of the disease. These treatment options include
- Carbidopa-levodopa
- Carbidopa-levodopa infusion
- Dopamine agonists
- MAO B inhibitors
- COMT inhibitors
- Anticholinergics
- Amantadine
- Deep brain stimulation
Let’s discuss the above treatment options in detail:
Carbidopa-levodopa
It is considered as the most effective medication to treat Parkinson’s disease. This medication enters into your brain and converted into dopamine.
Your physician often prescribes levodopa medication with carbidopa, as this combined medication can prevent the side effects such as nausea. If your condition becomes serious, then the effects of this drug reduce. As a result, you will experience more side effects.
Pain in the head, skin rash, poor appetite, feeling sleepy all the time, unable to see, heartburn, and light-headedness are the possible side effects of this medication.
Carbidopa-levodopa infusion
You are advised to take this drug in a gel form and deliver directly to the small intestine. This medication is for the people with an advanced stage of Parkinson’s disease who are still responding to the Carbidopa-levodopa medication.
Dopamine agonists
This medication doesn’t convert into dopamine but it can produce the same effects of it. Dopamine agonists are not as effective as Carbidopa-levodopa. Examples of this medication include
- Pramipexole (Mirapex)
- Ropinirole (Requip)
- Rotigotine (Neupro)
- Apomorphine (Apokyn)
Your physician prescribes the above medications to give you relief from the symptoms of Parkinson’s disease. The following are the possible side effects of the above drugs. It includes
- Feeling sleepy all the time
- Fast heart rate
- Pain in the head
- Stuffy nose
- Hypertension
- Unable to concentrate on the other things
- Swelling of arms
- Fainting
- Swelling of the legs
The above side effects can occur at any time during drug use. It is advised to consult a physician when you are experiencing the side effects of this medication. Your physician may change the dosage of the medication or switch you to another drug.
MAO B inhibitors
These drugs are used to prevent the further breakdown of brain dopamine by stopping the function of brain enzyme Monoamine oxidase B. Examples of MAO B inhibitors include
- Selegiline (Eldepryl, Zelapar)
- Rasagiline (Azilect)
- Safinamide (Xadago)
Mild nausea, dry mouth, light-headedness, hard bowel movements, unable to understand, and hallucinations are the common side effects associated with MAO-B inhibitors.
COMT inhibitors
The full form of COMT is Catechol O-methyltransferase inhibitors. Entacapone is an example of COMT. The object of this medication is to prolong the effect of levodopa therapy and the risk of this drug is Dyskinesia. When this medication kicks in people get some involuntary movements. Sometimes they are mild and sometimes they are more dramatic but it can be treated with certain medications.
Anticholinergics
Sometimes, tremor is hard to control with other medications alone. Your physician may recommend this medication to control tremors when other medications failed.
Amantadine
Amantadine drugs are used to treat mild symptoms of Parkinson’s disease. This drug is also recommended to control the involuntary movements. The following are the possible side effects of this medication.
- Purple mottling of the skin
- Ankle swelling
- Hallucinations
Deep brain stimulation
Deep brain stimulation is now used more frequently to help treat the symptoms of Parkinson’s disease. This procedure will be done in specific patients where it is felt to be of benefit to patients before prescribing medication. It is impacted because the patient will become very stiff and come healthy. In this procedure, your physician will implant electrodes into a specific part of your brain and that will send signals to your brain and in turn, ease the indicators of Parkinson’s disease.
Lifestyle Changes
Some things that can help Parkinson’s disease are ensuring adequate sleep, maintaining a healthy diet, and exercises. Exercises are almost as good as medication. It can help a lot of symptoms and also potentially slow the progression of Parkinson’s disease. That is a possibility and not yet proven. Exercise will help things like improving sleep quality, improving mood, improving constipation, improving stiffness, and improving balance. It is almost like one medication to cover all of those aspects.
Conclusion
Everybody is different who develops Parkinson’s disease. In some people, it can be slowly progressive or some people can progress more rapidly. Some people have lived with Parkinson’s disease for more than twenty years. If you are experiencing the symptoms that you think is Parkinson’s disease then talk with your physician about your symptoms. Your doctor can complete a physical exam and review your medical history to determine which treatment option would be best for you.
References
- https://onlinelibrary.wiley.com/doi/abs/10.1111/ene.13412
- https://www.tandfonline.com/doi/abs/10.1080/07853890.2017.1412088?journalCode=iann20
- https://pubs.rsc.org/en/Content/ArticleLanding/2017/FO/C7FO00809K#!divAbstract
- https://jnnp.bmj.com/content/87/9/952.info
- https://www.hindawi.com/journals/omcl/2018/2038267/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371408/
- https://pubmed.ncbi.nlm.nih.gov/28586827/
- https://link.springer.com/article/10.1007/s10534-018-0131-5
- https://jamanetwork.com/journals/jamaneurology/fullarticle/1149703
Sirisha B 
Raju Ch