Parkinson's Disease

Deanne York Douglas
Deanne York Douglas
Last updated 

What is it? 

It is a progressive nervous system disorder that affects movement, often diagnosed when a tremor in one hand is observed. Other symptoms are slow movement, stiffness and loss of balance. People with Parkinson's Disease are a falls risk and require support aids and/or supervision when mobilising.

Some suggest that the disease is dietary-related, linked to hyperinsulinemia, and known as Diabetes 4.
 
A YouTube video from the Michael J. Fox Foundation.
https://www.youtube.com/watch?v=cRLB7WqX0fU    5:15 mins

People with Parkinson's Disease may experience the following symptoms:
  • Tremor: can occur at rest, in the hands, limbs, or can be postural
  • Muscular: stiff muscles, difficulty standing, difficulty and slowness with walking, slowness with bodily movements, involuntary movements, muscle rigidity, problems with coordination and balance, rhythmic muscle contractions, slow bodily movement, or slow shuffling gait
  • Sleep: early awakening, nightmares, restless sleep, or sleep disturbances
  • Whole-body: fatigue, dizziness, poor balance, or restlessness
  • Cognitive: amnesia, confusion in the evening hours, dementia, or difficulty thinking and understanding
  • Speech: difficulty speaking, soft speech, or voice box spasms
  • Olfactory: a distorted sense of smell or loss of smell
  • Urinary: dribbling of urine or leaking of urine
  • Mood: anxiety or apathy
  • Facial: jaw stiffness or reduced facial expression
  • Also common: blank stare, constipation, depression, difficulty swallowing, drooling, falling, fear of falling, loss in contrast sensitivity, neck tightness, small handwriting, trembling, unintentional writhing, or weight loss 
How to Spot Early Symptoms = TRAP 
  • Tremor
  • Rigidity
  • Akinesia
  • Postural instability

What can be done for Parkinson's Disease? 

Medications
  1. Levodopa/benserazide, Levodopa/carbidopa - Kinson, Atamet, Parcopa, Sinemet. Dopamine promoter stimulates Dopamine receptors in the brain. 
  2. Bromocriptine, Cabergoline, Pergolide or Pramipexole, Ropinirole, Apomorphine. Dopamine agonists (DA) are medications that work by imitating the actions of dopamine when levels are low. Improves condition-related symptoms by fooling the brain into thinking dopamine is available.
  3. Entacapone and Tolcapone - are COMT  (catechol-o-methyl transferase) inhibitors and are used together with carbidopa and levodopa to treat "wearing-off" symptoms of Parkinson's disease, such as stiffness, tremors, muscle spasms, and poor muscle control by increasing the levels of levodopa in the body. COMT inhibitors work by blocking the action of enzymes that break down levodopa to extend the time of levodopa activity. 
  4. Selegiline, Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam) Tranylcypromine (Parnate) are Monoamine oxidase B inhibitors - MAOI medications are used as Antidepressants - to relieve symptoms of depression, can be used to manage anxiety and chronic pain.
  5. Amantadine, Benzhexol, Benztropine, Biperiden, Orphenadrine, Procyclidine 
    NMDA antagonists, Anticholinergics are used as anti-tremor medications - to help control tremors, shaking and unsteadiness.
  6. Cognition-enhancing - improves mental function, lowers blood pressure and may balance mood.
  7. Deep Brain Stimulation surgery
Diet and Exercise
Soon after diagnosis, a healthy diet and regular/daily exercise are essential in maintaining current mobility capacities.
 
Physiotherapists and occupational therapists can provide gait and balance retraining and instruction about compensatory strategies that emphasise external cues to help initiate movement or break down complex movements into more straightforward sequences. Speech therapy can improve speech clarity and volume, and swallowing difficulties necessitate careful assessment and treatment. Dietary advice should be offered, especially regarding the effects of meals and protein intake on drug pharmacokinetics.

Early Parkinson's Disease   5:47 mins


Research for early diagnosis and a cure

RMIT University has developed an assessment tool to diagnose Parkinson's Disease early, before the TRAP symptoms. The very early sign is difficulty drawing and writing. A computer program can analyse the drawing of a spiral.

Watch the Youtube videos below to see what new research is evolving.
Notes:
Medical conditions MUST always be diagnosed by a medical professional.
The following information is structured to provide basic information to HWH Support Workers and Clinical Care Managers.

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