Parkinson's disease involves a breakdown of the nerve cells in the motor area of the brain. As the cells break down, there is a shortage of dopamine. Dopamine is a neurotransmitter, or chemical that carries messages to the body. When there is a shortage of dopamine, the messages that regulate movement aren't sent properly.
The cause of Parkinson's disease is not known. There may be a hereditary tendency to the disease that is worsened by factors in the environment. Some people with Parkinson's disease have an abnormality on chromosome 4. I have yet to find a relative afflicted with the same disease.
There is evidence that Parkinson's disease may be caused by a defect in the body's normal methods for breaking down protein. This defect allows debris to build up in the brain and damage brain cells. The defect may be caused by one or more of the following factors:
- an environmental toxin, such as pesticides
- a gene defect, such as the abnormality on chromosome 4
- a viral infection.
All I can remember about my brother's past medical history is that he had seizures and was diagosed to have encephalitis/meningitis when he was less than a year old.
The symptoms of Parkinson's disease usually begin at about age 60. It is most common in people in their 70s and 80s. Parkinson's disease is twice as frequent in men than in women. Preliminary research suggests that estrogen, a female hormone, may protect against Parkinson's disease.
However, my brother presented the symptoms of Parkinson's disease at the age of 35, initially seen as tremors of the right hand which progressively involved the forearm and then the upper arm later on.
There is no cure for Parkinson's disease. The major goal of treatment is to prevent deterioration. Symptoms can usually be well controlled for several years in the early stages of the disease.
Early in the disease, medications are used. One of the most common medicines is a combination of levodopa and carbidopa. Although this combination is effective, it tends to work less and less over time. Other medications used to treat Parkinson's disease include the following:
- amantadine
- pergolide
- pramipexole
- ropinirole
- selegiline
My brother was intially started on levodopamine and pramipexole with note of decrease in the tremors through time.
Another treatment is surgery. Surgery can include removal of a tiny part of the brain. Another approach is deep brain stimulation with electricity. This is not an option for my brother right now.
People may need other treatments to deal with the many problems associated with the disease. If dementia is present, close monitoring may be needed. Treatment with antidepressants, antipsychotic medications, or sedatives can also help relieve some symptoms. Physical and occupational therapy, as well as speech therapy may help. The use of a service dog and in-home care may be needed.
Other medications may be used in late-stage Parkinson's disease to control symptoms. Medicines can be helpful when there are problems with bladder control, for example. Men with Parkinson's disease may be given medications for erectile dysfunction.
Researchers continue to test new treatments for Parkinson's disease. Implanting fetal cells into the brain of people with Parkinson's disease was recently tried and failed. In some people, the treatment caused severe problems with movement.
Medications used to treat Parkinson's disease may cause abnormal body movements. Other side effects include nausea, drowsiness, confusion, and dry mouth which were all experienced by my brother that he needs to take other medications to counteract the side effects of the drugs.
Surgery may cause difficulty with speech or paralysis on one side of the body.
Deep brain stimulation usually requires more than one operation. There is also a risk of bleeding, infection, or allergic reaction to anesthesia.
People with Parkinson's disease need treatment for life. Hence, this can be a big financial burden for every member of the family.
A family member or caregiver is important when it comes to monitoring Parkinson's disease. They can give the healthcare provider day-to-day input on benefits and side effects of treatment. Any new or worsening symptoms should be reported to the healthcare provider.
