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.
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.
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.
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
Back to Parkinson's Index.