PARKINSONS DISEASE parkinsons disease

About Parkinson's Disease

Symptoms
Cause
Progression of Parkinsons
Self Help
Support for Carers
Medication

Introduction
Parkinsons disease is quite common. The condition generally develops very slowly. It affects between 1 and 2 people per thousand of the whole population and approxiamately 10 per thousand of those over 60.

Parkinsons is a progressive neuro-degenerative disorder which affects movement or the control of movement. With good medical treatment Parkinsons has a limited affect, if any, on life expectancy but it can be disabling. With a positive outlook, good medical care and good support from other resources, most people with Parkinsons can lead a productive life for many years after diagnosis.

The Main Symptoms of Parkinsons
Tremor
About 75% of people develop a tremor at the onset of their illness. However, a number of people with Parkinsons never develop a tremor. The tremor tends to occur when the limb is relaxed and tends to disappear when performing tasks.

Stiffness
Stiffness or rigidity is often detected by the examining doctor and can contribute to deep aching sensations felt in the limbs.

Slowness of Movement (Bradykinesia)
Bradykinesia can slow down the body's normal movements. This can affect various parts of the body:
It can cause a flat or expressionless face
When it affects body movements it can cause difficulties with rolling over in bed or getting out of a chair.
Bradykinesia can affect rapid limb movements.
People with bradykinesia of the hands develop a distinctive change in handwriting where the letters get progressively smaller and less legible as writing proceeds across the page.

Loss of Balance
This tends not to occur in early Parkinsons. People need to learn to get up safely if they have falls.

Other Symptoms
Individuals may experience many other symptoms to varying degrees. The list below covers some of the most frequent:
Skin sensations and Pain
Many people develop unusual skin sensations such as electric or tingling sensations of the limbs. They are often more prominent at night.
Constipation
This is common in Parkinsons and is caused by a reduction in the ability of the bowel to contract.
Tiredness
Some find tiredness can be improved with regular exercise and rest. It is important to recognise when this symptom occurs as people often have to be careful not to take on too many responsibilities or task that they cannot complete.
Depression
Approximately one third of people with Parkinsons experience depression at some time.
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The Causes of Parkinsons
The causes of Parkinsons is not completely understood but a known cause is the degeneration of a group of nerves in the centre of the brain called the substantia nigra. These nerves produce a chemical messenger called dopamine. When 80% of dopamine is lost, the symptoms of Parkinsons disease are produced.
At present, it is not known what causes the degeneration of the substantia nigra.

The Progression of Parkinsons
Parkinsons develops slowly as the nerves of the substantia nigra gradually degenerate. The first symptom is sometimes a tremor or slowness of movement.

At the time of diagnosis, the symptoms may be obvious but are usually not disabling. No treatment stops the degeneration of the nerves of the substantia nigra. For this reason, early medical treatment of the condition may not be necessary, and drugs and other treatments are usually introduced when a person becomes disabled or slowed by Parkinsons.

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Self Help for Parkinsons
People with Parkinsons can achieve a lot of benefit from a range of self help activities. The main ones are:

Exercise
Exercise is very important for people with Parkinsons. As well as improving general health and well-being, it seems to improve the body's response to dopamine. People with Parkinsons should attempt to get at least 20 to 30 minutes of exercise each day. Stretching exercises are particularly beneficial. Always seek expert advice before beginning any exercise programme.

Sleep
The brain recharges its dopamine overnight. Most people with Parkinsons feel that they have good mornings and tend to deteriorate throughout the day. Most people also find that a good night's sleep leads to a good day with Parkinsons. For these reasons it is important to get a good night's sleep.

Work Simplification and Energy Conservation
Carrying out tasks in the simplest, least tiring way gives you more energy for other, more pleasurable tasks. Remember the 4 P's:
Planning
Plan your day. Work out what you need to do and what you want to do.
Organise each task to make it as easy as possible.
Combine errands with a trip to another part of the house.
Avoid rushing and last minute jobs.
Alternate light / heavy tasks.
Don't worry if everything is not done.
Priorities
Set Priorities - if something is unimportant and you don't want to do it, forget about it. Sort out what is important and what is not.
Positioning
Stand straight
Lift correctly.
Sit well.
Take weight off your feet.
Check your posture throughout the day.
Sit to do an activity, rather than stand.
Pacing
Balance work / rest activity e.g. alternate light / heavy tasks.
Take short frequent rest periods during the day.
Break activities down into short tasks.
Take breaks when tired rather than pushing yourself to exhaustion to complete an activity.

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Support for Carers
Many people with Parkinsons, as their condition worsens, are supported or cared for to some degree or other by their spouse, partner or another family member, etc. It is important that anyone in this supporting role take care of their own physical and mental health.

Such carers may need to make an effort to keep up their own hobbies and social contacts, have breaks away from the "caring" role, or seek advice and support from fellow carers.

Medications for the Treatment of Parkinsons
The symptoms of Parkinsons are caused by a lack of dopamine and a relative excess of acetylcholine. Most specialist Parkinsons medication aims to restore the balance between dopamine and acetylcholine.

There are various forms of the main medications, eg slow release, different dosages. As some people have different reactions and sensitivities to the drugs, it is most important to discuss your needs and reactions with your doctor or specialist to get the best possible individual prescription.

In additon, the drugs may have side effects you should be aware of, so again it is important you have full discussions with your doctor or specialists.

Possible side effects include:
Dizziness and lightheadedness
Mood swings, hallucinations and confusion can occur with high doses.
Headache, dry mouth, constipation and diarrhoea may occur.

Contact your doctor if the above become troublesome or you experience
Uncontrolled body movements
A fast heartbeat
Any unusual behaviour or mood changes.
Swelling of the feet or ankles, or any leg cramps.
Loss of bladder control

Disclaimer: The information on this website is for your interest only. For medical advice for your individual needs, please see your doctor or other health professional.
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