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Parkinson’s disease is a degenerative disorder of the central nervous system. It was described for the first time in 1817 by James Parkinson, a British physician who published an essay on paralysis agitans; this paper sets out the main symptoms of the disease.
Researchers estimate that at least 500,000 people in the United States alone have Parkinson’s disease, although some estimates are even higher. Insurance companies pay an enormous price for Parkinson’s disease, the total cost in the United States alone has been estimated to exceed $ 6 billion a year.
The risk of developing Parkinson’s disease increases with age, so analysts expect that the aging population’s financial impact on public health is worse.
Parkinson’s disease belongs to the group of conditions that cause movement disorders.
The four primary symptoms are:
These symptoms begin slowly and get worsen with time. As the disease becomes more pronounced, patients may have difficulty walking, talking, or completing other simple actions. Not all those with one or more of these symptoms have Parkinson’s disease, as these symptoms sometimes occur in other diseases.
Parkinson’s disease is:
Although some cases of Parkinson’s disease appear to be hereditary, and a few can be attributed to specific genetic mutations, most cases are sporadic. The disease seems to be transmitted in the family. Many researchers believe that Parkinson’s disease results from a combination of genetic predisposition and exposure to one or more environmental factors contributing to the cause of the disease.
Parkinson’s disease is the most common form of parkinsonism, the name of a group of diseases with similar symptoms and characteristics. Parkinson’s disease is also called primary parkinsonism or idiopathic Parkinson’s disease; the term idiopathic is indicative of a disease for which there is still no cause was found.
While most of the forms of parkinsonism are idiopathic, there are cases in which the cause is known or suspected, or another disease causes the symptoms. For example, Parkinsonism may be caused by changes in the blood vessels of the brain.
Parkinson’s disease is due to chronic and progressive degeneration that affects some central nervous system structures, mainly where it produces dopamine, a neurotransmitter essential to the control of body movements.
The disease affects about 50% more men than women, but the reasons for this discrepancy are not clear. However, it is found in people worldwide; numerous studies have found a higher incidence in developed countries. Other studies have found an increased risk in people who live in rural areas and carry out certain professions, although studies to date are inconclusive. The underlying causes of risk factors are not clear.
Indeed, it can appear due to trauma to the head (widespread among former boxers), exposure to toxic substances in the environment, and cerebral arteriosclerosis.
A specific cause of an increase in the frequency of occurrence of Parkinson’s disease is age: the average age of initial symptoms is 60 years, and the incidence rises significantly with increasing age. Approximately 5-10% of people with Parkinson’s disease show first symptoms before the age of 50, and often these symptoms are considered hereditary, though not always connected to specific gene mutations.
People with one or more close relatives with Parkinson’s disease have an increased risk of contracting the disease themselves. Still, the absolute risk is only 2-5%, except in those cases with a known genetic mutation for the disease. It is estimated that 15-25% of patients have a close relative with the same disease.
In sporadic cases, the symptoms of Parkinson’s disease may occur in people who are than 20 years of age; this condition is called juvenile parkinsonism. It is most commonly found in Japan, but we know of cases in other countries; it usually starts with dystonia and bradykinesia (both movement disorders), and symptoms often improve with the drug levodopa. Juvenile parkinsonism often is transmitted in the family and is sometimes linked to a mutated gene.
Although there are many theories about the cause of Parkinson’s disease, none of them has been proven. The prevailing view holds that one or more environmental factors have caused the infection, severe symptoms like those of Parkinson’s disease have been described in people who used illegal drugs contaminated with MPTP chemicals and in people who have contracted a particularly severe form of influenza during an epidemic in early 1918, Recent studies on twins and families with Parkinson’s disease suggest that some people have a hereditary predisposition to the disease, which environmental factors can influence.
The substantial family inheritance of the chromosome 4 gene is the first evidence that an alteration in gene expression alone can lead to the development of Parkinson’s disease.
The first symptoms of Parkinson’s disease are mild and occur gradually. Affected individuals may:
This early period may last a long time before the more classic and obvious symptoms occur. Friends or family members may be the first to notice changes in someone with Parkinson’s disease; they may see that his face appears devoid of expression and liveliness (face amnesia) or no longer able to move, usually an arm or a leg. You might also notice that it seems stiff, unsteady, or unusually slow.
As the disease progresses, the tremor that affects most patients with Parkinson’s disease may begin to interfere with daily activities, i.e., patients may no longer be able to hold tools, fasteners may realize that the flicker makes reading difficult of a newspaper.
Tremor is usually the symptom that needs medical care.
People with Parkinson’s disease often develop the so-called parkinsonism gait, which includes:
They may also have difficulties starting a movement and may stop suddenly as they walk.
Parkinson’s disease does not affect everyone the same way. The rate of progression differs among patients; the Tremor is the primary symptom for some patients, while for others, tremor is nonexistent or very slight.
The symptoms of Parkinson’s disease often occur initially in only one half of the body (left or right), but with time will affect both sides (although often the symptoms are less severe in part than the other).
Parkinson’s disease is usually diagnosed by a neurologist that assesses the symptoms and their severity. No test can identify the disease; sometimes, people with suspected Parkinson’s disease are given anti-Parkinson drugs to test the response. Other tools diagnostics can assist physicians in diagnosis, i.e., the microscopic structures of the brain called Lewy bodies that can be seen only in an autopsy, are regarded as a classic hallmark of Parkinson’s.
Autopsies have found Lewy bodies in a surprising number of older people without them being diagnosed with Parkinson’s disease. As a result, some experts believe that Parkinson’s disease is much more common than you think, and even some argue that almost everyone would develop Parkinson’s disease if they live long enough.
There is no hope of a cure for Parkinson’s disease. Many patients with mild forms do not need to care for several years after the initial diagnosis; when the symptoms become worse, doctors usually prescribe levodopa (L-dopa), which helps restore the balance of dopamine in the brain.
They are sometimes also prescribed other drugs that affect dopamine levels in the brain in patients with a severe brain surgery known as pallidotomy was found to be indirectly effective in reducing symptoms.
Parkinson’s disease is not fatal in itself, but it gets worse with time. The average life expectancy of a patient with Parkinson’s disease is generally the same as a person who has the disease. Still, the latter stages of Parkinson’s disease can cause complications such as choking, pneumonia, and falls, leading to death.
The progression of symptoms in PD may take 20 years or more, but in some people, the disease progresses more quickly. There is no way to predict what course the condition will take for every single person.
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