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Parkinson's Disease
 
 

Understanding Parkinson's Disease

Parkinson's Disease is a progressive degenerative medical condition that affects neurons (nerve cells) that use dopamine, a neurotransmitter. Dopamine has many functions in the brain including the control of movement and co-ordination. In Parkinson's Disease, these dopamine producing neurons die or lose their function resulting in dopamine depletion. The cause for the damage of these neurons (nerve cells) remains unclear.

Symptoms

Symptoms of Parkinson's Disease may include:

  • Slowness in movement
  • Stiffness of the limbs and trunk
  • Tremors that are worse at rest and improves when the person moves
  • Poor balance and co-ordination

Other areas of the brain may also be affected, resulting in non-motor symptoms such as:

  • Giddiness when in an upright posture
  • Poor bladder control
  • Poor memory

Causes

Low levels of dopamine, a brain chemical (neurotransmitter) involved in controlling movement, cause symptoms of Parkinson's disease. The shortage of this brain chemical occurs when nerve cells in a part of the brain (substantia nigra) that produces dopamine fail and deteriorate. The exact cause of this deterioration is not known.

The links between Parkinson's disease and factors such as genetics, ageing, toxins in the environment, and free radicals are all under investigation. Although these studies are beginning to provide some answers, experts do not know the exact cause of the disease.

There are ongoing studies to determine whether there is a genetic cause of Parkinson's disease. Only a small percentage of people with Parkinson's disease have a parent, brother, or sister who has the disease; however, abnormal genes do seem to be a factor in a few families where early-onset Parkinson's disease is common.

Diagnosis

The condition is detected and diagnosed based on medical conditions and clinical or neurological findings. There is no single blood test or scan that can detect Parkinson's Disease. Your doctor may not require any further investigations if classical symptoms occur and are not suggestive of an alternative illness.

Treatment

Currently, there is no cure for Parkinson's Disease. However, there are medications to improve the symptoms. Mild cases of Parkinson's Disease may not require treatment unless the person's activities of daily living are affected or he is in an occupation that requires complete control of the symptoms.

Commonly-used medications to treat symptoms of Parkinson's Disease include:

  • Levodopa (e.g. MadoparĀ® or SinemetĀ®)
  • Dopamine agonists
  • Anticholinergic agents (e.g. Artane)
  • Amantadine
  • Catechol-O-methyltransferease (COMT) inhibitors (e.g. Entacapone)
  • Monoamine oxidase-B inhibitors (e.g. Selegiline)

Medication will be prescribed based on the following:

  • Risk profile
  • Cost
  • Side effects
  • Drug interaction
  • Patient preference

Your doctor will advise you on the most suitable treatment for you.

Prevention

Because doctors are not sure what causes Parkinson's disease, there is no way to prevent it.

Resources

Find out more information from:

Health Promotion Board
National Healthcare Group
Parkinson's Disease Society of Singapore
Parkinson's Australia

FAQs

1. How do I know I have Parkinson's disease?

Parkinson's disease can affect anyone - male or female and at any age, although it is more common in older age. The four key symptoms are tremor, slowness of movement, muscle rigidity and instability. However, the nature and severity of symptoms can vary considerably from one individual to another. In the early stages of the disease, symptoms can be vague and non-specific such as fatigue or muscle pain.

2. What will my doctor do if I am suspected to have Parkinson's Disease?

Your family doctor may order some tests to exclude other possible causes of your symptoms. However there is no definitive test for Parkinson's disease. A diagnosis of Parkinson's disease relies very much on the symptoms. It is possible you may have to wait for symptoms to develop further to confirm the diagnosis. You may also be referred to a specialist neurologist for assessment.

3. Is Parkinson's disease hereditary?

The short answer is no. Although about 10 per cent of people with Parkinson's disease will have a relative who is also affected, the vast majority do not. You should not worry about having passed the disease on to your children. Like many other diseases, Parkinson's disease is likely to be the result of a complex interaction between both genetic and environmental factors.

4. Is there a cure?

Not yet. Parkinson's disease is usually slowly progressive. This is despite the availability of many medications, and new surgical options which can help control the symptoms. Many people with Parkinson's disease live full and productive lives. Parkinson's Australia is working with researchers and others in the community to help find a cure.

5. Other than taking my prescribed medications, what else can I do?

Become well informed about the possible manifestations of the disease. Symptoms can fluctuate widely from day to day, in different situations and in response to different medications. It is also important to stay as active as possible. Don't give up on daily activities and incorporate some regular exercise into your life.

6. Where can I get help?

Medical practitioners, physiotherapists, occupational therapist and speech therapists are amongst those who can provide professional advice on managing your disease. Many people also benefit from talking to other people who are similarly affected with the disease.

This article is reproduced with the permission from Agency for Integrated Care (AIC) and Singapore Sliver Pages.

For more information, please visit http://www.aic.sg/silverpages.

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