What is Parkinson’s Disease?

Parkinson’s disease is a progressive neurodegenerative disease meaning this is a disease of the brain in which there is gradual brain damage in a specific part of the brain. This damage gets worse over time. The damage occurs in the part of the brain that produces a chemical called DOPAMINE.

Dopamine is an important chemical in the brain because it helps with the movement of the body, sleeping pattern, learning, memory and attention.

What are the main symptoms and problems In Parkinson’s?

FOUR key problems:

  1. Resting tremor – Patient has “कम्पन” especially in hands while resting. The tremor actually tends to get better when you do an action with the hand such as writing.
  2. Slowness in movements – Patient feels overall slowing of movements such as small steps, not able to walk fast. Many patients also report their hand writing is getting smaller due to this problem.
  3. Stiffness in arms and legs – This is not the usual type of muscle pain; this stiffness is being caused due to command from the brain missing. Patients feel that they are not able to walk properly, they sometimes “freeze” when they want to start walking, and turning around corners is even more difficult.
  4. Balance and coordination problems – Again due to abnormal command from the brain, patients experience significant problems in balance and coordination during walking, standing and doing daily activities.

What are the other problems associated with Parkinson’s?

  • Sleeping disturbances
  • Depression
  • Learning and memory problems
  • Hallucinations (seeing objects or hearing things when none exist)

How is Parkinson’s different from Essential Tremor (ET)?

Simply, ET is just tremor while Parkinson’s patients have many more symptoms. ET is a relatively benign disease.

ET tremors are mostly in hands, but also in head, jaw, legs at time.

Sometimes patients have both ET and Parkinson’s together. So good clinical evaluation is essential for diagnosis.

What is Parkinson Plus?

This is a group of diseases in which there are symptoms in addition to the typical Parkinson’s symptoms such as difficulty in vision, more pronounced memory and alertness loss, more pronounced speech loss, rapid worsening etc. The overall prognosis is worse than Parkinson’s.

How is Parkinson’s Treated?

  1. Medications: essential to the treatment. The goal is to replace the absent dopamine with various chemicals or reducing the breakdown of the dopamine present in the brain. One key problem to remember is that while Parkinson’s medications help one type of movement problem (tremor, freezing), they can also cause a different type of movement problem such as involuntary movement of the arms / head / leg. Careful and diligent monitoring is critical to proper dosing and schedule of meds.
  2. Exercise: Properly designed rehabilitation and exercise programs will help you (a) improve and maintain your quality of life, your ability to daily tasks and your daily activities. (b) Delay the disease from getting worse.

How do I delay the Parkinson’s from getting worse?

Lot of new research indicates that well designed good exercise program can delay the progression of disease especially in early Parkinson’s.

common problem when I see early Parkinson’s patients is the attitude that my disease is early yet so I don’t need to do anything; I will wait and start rehab when my disease gets worse. THIS IS THE MOST PROBLEMATIC MYTH.

Early rehabilitation in Parkinson’s disease can help in prevention of the problems in the first place.

At A4 Clinics, we follow many recommendations of the program from OHIO HEALTH, USA to delay the disease: http://www.delaythedisease.com/

Role of New Therapies in Parkinson’s

(a) Deep Brain Stimulation (DBS) – This is an invasive surgical procedure in which electrodes are inserted inside the brain to control and regulate movement. Often called “pacemaker” for the brain. Because it is a surgical procedure, there are more risks, benefits and costs.

(b) Non-invasive brain stimulation (tDCS) – This is a superficial non-invasive brain stimulation in which patient undergoes 20 min sessions daily for a certain duration. This is non-invasive and there are no side effects and it is much less expensive. See info at https://a4clinics.com/brainstimulation

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