What
is Parkinson's?
Parkinson's is a progressive disorder of the central nervous system
that may lead to tremors, rigidity, slowness of movements, gait
disorder and a loss of balance. It's important to know that every
case is different and that not all people with Parkinson's will
experience all symptoms.
There is an area of the brain called the substantia nigra
that contains specialized cells that produce dopamine, a chemical
that allows the smooth transition of nerve impulses among nerve
cells. These impulses are necessary to the transmission of voluntary-movement
messages to the muscles. When these specialized cells die, there
is a dopamine deficiency. This results in interference in the transmission
of the messages and can make voluntary movement difficult. Such
a condition is known as Parkinson's.
What
causes Parkinson's and who gets the disease?
Research to date has not been able to identify the exact cause
of this condition. There is evidence to suggest that some people
may have a genetic predisposition to Parkinson's, but there is no
clear evidence to suggest that it is hereditary. Other risk factors
that have been identified are head injury, direct occupational pesticide
exposure and the age-related loss of brain cells that transmit nerve
impulses.
Despite popular belief, Parkinson's is not found only in the elderly.
As many as one out of five Parkinson's cases are found in people
under 50 years of age.
Parkinson's is one of the most common neurological disorders and
affects one out of every 100 adults in Canada. Parkinson's affects
men and women equally and the disease crosses all ethnic lines.
Is
there a cure?
Although there is no cure, modern treatments and therapies can
allow people with Parkinson's to lead active lives.
What
are the treatments?
Medications are most commonly used to treat Parkinson's although
some people may require brain surgery. Medications are prescribed
to help control symptoms and aid in the flow of dopamine within
the brain.
The most common medication is levodopa, a chemical that
the body converts into dopamine. Other drugs may be used to decrease
the dopamine breakdown in the body, enhance the release of dopamine
or stimulate the dopamine receptors.
Surgical treatments may include:
Pallidotomy/Thalamotomy - Thalamotomy procedures involves
making tiny scars in the thalamus region of the brain by inserting
small stereotactic needles. This procedure is usually used to treat
severe, one-sided tremors. Pallidotomy involves a similar technique
but in the globus pallidus section of the brain. It is usually reserved
for people with bradykinesia (slowness in movement). It is not clear
if either procedure delays the progress of the disease.
Deep Brain Stimulation - This is a new technique where
a small electrode, placed in the brain, emits a current that affects
the faulty signals. The electrode is connected to a pacemaker-like
device that is placed in the patient's chest near the collarbone.
Patients use a hand-held device to turn it on and off.
Tissue Transplantation - This type of operation is still
experimental. Because Parkinson's relates primarily to the degeneration
of the cells that make dopamine, tissue transplantation aims to
replace these cells with healthy ones.
In addition to these treatments, an exercise program or speech
and occupational therapy may be prescribed.
Is
Parkinson's fatal?
Research shows that Parkinson's is not fatal. A recent study,
however, indicates that "mortality is two to five times as high
among affected persons as among age-matched controls resulting in
a marked reduction in life expectancy." (Lang, A.E. & Lozano, A.M.
Medical progress: Parkinson's Disease; First of two parts; New England
Journal of Medicine, 1998; 339:1044-1063.)
Is
Parkinson's contagious?
While the exact cause of the disease is not known, what is
known indicates that Parkinson's is not contagious.
Does
Parkinson's affect the mind?
Parkinson's is a neurological, not a mental, disorder. In the
majority of cases, it slows the body, not the mind. However, when
brain cells are affected by medication, some emotional changes can
be expected.
Anxiety and depression are very common among people with Parkinson's
and may occur due to seratonin imbalance, a side effect of certain
medications. This may eventually lead to loss of memory. Anxiety
and depression are difficult to diagnose in patients with Parkinson's
because the symptoms are parallel to those of the disease.
Parkinsonians may also suffer from nightmares and vivid dreams
that are not a result of the Parkinson's but instead, the side effects
of medications.
Parkinson's medication, which controls production of dopamine,
may affect the person's ability to concentrate, i.e. processing
two cognitive tasks simultaneously. Sleep deprivation and depression
may also cause difficulty in concentrating.
Another side effect of the medication may be occasional mild hallucinations.
This side effect can occur when the medication effectively controls
the person's Parkinson's symptoms. The hallucinations are not frightening
and the Parkinsonian is well aware they are not real. If the drugs
are working well, the person may chose to live with this side effect.
Some people with Parkinson's also get dementia, but then, so do
some people who do not have Parkinson's.
Where
can I turn for support?
The mission of Parkinson Society Ottawa is to
lend support and provide services to people with Parkinson's. Becoming
a member of the Society will give you an opportunity to meet
other people with Parkinson's and their families. This, in turn,
could help you deal with your own feelings about the disease.
To find out more about how we might
help you, please contact us.
