Parkinson’s disease, causes, symptoms and treatment

Dr Tabish Saifee
Dr Tabish Saifee
Consultant Neurologist

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Parkinson’s Disease is a condition that affects the brain. It’s what we call a progressive condition in that it starts and gets worse slowly over time. Parkinson’s Disease is a condition that is caused by degeneration and death of certain brain cells, particularly those that are important in generating movements. Therefore, it’s a condition that primarily starts out with problems with the control of movement.

In the UK, about 120,000 people have Parkinson’s Disease and in our lifespans, any one of us may have a two or three percent chance of developing Parkinson’s Disease. Therefore, it is a pretty common disease in terms of other neurological diseases.

What causes Parkinson’s Disease?

We know that certain cells (primarily cells that are involved in the control of movement in the brain) seem to get damaged and then die off. These cells that are responsible for releasing dopamine for our everyday movements. When these cells die off, and dopamine is reduced, movements start to slow down and become stiffer. The reason these cells die is because of an accumulation of abnormal proteins in these cells which clump together and seem to be associated with damage to those cells.

What are the symptoms?

Classically, we’ve always thought of Parkinson’s disease as a movement disorder, so that reflects some of the main symptoms which tend to be stiffness in the limbs and the arms and legs, a shake or a tremor for example of the hand, and also slowness of movement. There are a host of other non-motor symptoms in Parkinson’s disease which are also very important. Patients may also experience a range of non-motor symptoms including anything from loss of sense of smell to depression and constipation.

Parkinson’s disease doesn’t typically affect your memory in the early stages of the disease. It is true however that some people at later, more advanced stages (after many years of Parkinson’s disease) can find that their memory becomes affected.

Parkinson’s disease can affect your speech and it typically tends to worsen speech later on in the condition. Some of our patients find that their speech becomes a little bit quieter, and they find it more difficult to project their voice or to speak loudly

How is Parkinson’s Disease diagnosed?

Parkinson’s Disease is diagnosed clinically so it’s a clinical diagnosis. A neurologist or an expert in clinic seeing a patient and hearing the story of the evolution of symptoms and examining the patient by the bedside is really all we need to make the diagnosis of Parkinson’s disease. Sometimes it’s not quite so straightforward and there are other diseases that we consider as possible diagnosis. In that situation sometimes we need specialist scans like an MRI scan of the brain or a DAT scan which is another specialist scan of the brain or maybe even some blood tests.

Treatment options for Parkinson’s Disease

The treatment options for Parkinson’s Disease are various. The first things to think about are a healthy lifestyle and exercise, as we know that exercise is really important for keeping people healthy and may even have protective effects in terms of the progression of Parkinson’s Disease.

There is a very significant importance in the involvement of therapists (for example physiotherapists and occupational therapists) in helping one to adapt to the problems that they develop with Parkinson’s Disease. There are also lots of medical treatments including tablets and other medicines that can provide really good symptomatic relief, and finally there’s a group of advanced treatment options for Parkinson’s disease that include surgery, for example a pacemaker into the brain (deep brain stimulation) or putting dopamine through a tube into the stomach or using injections to provide medications that are useful for the symptomatic treatment of Parkinson’s Disease.

Physio

There are lots of exercises and therapy exercises you can do for Parkinson’s Disease and it’s critical that you do get involved. There is no ‘one size that fits all’ with physical therapy or exercise and you need to find something that you find suitable for you or that you find interesting and that you can do regularly. Exercise that may improve your overall fitness and cardiovascular fitness as well as balance and maybe even strength are useful things for you and these can be anything from Tai Chi to yoga, swimming or going out for a walk. Finding the right thing for you and doing that regularly is key.

 

 

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