Parkinson's disease

A disease relating to a progressive degenerative disorder of the central nervous system, Parkinson's disease leads to shaking/tremor and difficulty in movement, walking, coordination etc. As the disease progresses, it could lead to cognitive and behavioral problems. In its advanced stages, this disease could lead to dementia. Parkinson's disease commonly occurs in people aged over 50. James Parkinson, a general practitioner in London was the first to describe the symptoms of the disease and thus the disease has taken the name Parkinson's disease.

The disease progresses gradually, initial symptoms might be just a tremor in the hands. Slowly the disease leads to slowing or freezing of movements. There is no complete cure for the disease. However there are treatments that can handle the symptoms of the disease. Parkinson's disease is also known as Parkinsonism.

Diagnosed as the most common movement disorder, Parkinson's disease is classified into three types based on the age of onset of the disease

Juvenile Parkinson's disease: Sets in before the age of 21. This kind is a rare occurrence.

Young-onset Parkinson's disease: The disease sets in between the age of 21 and 40. Reportedly common in East Asian countries.

Adult-onset Parkinson's disease: The most common and prevalent type of Parkinson's disease, the disease sets in after the age of 60. The symptoms aggravate with advancing age.

Causes for Parkinson's disease

Parkinson's disease sets in usually after the age of 50 and affects both men and women.

• The major cause of Parkinson's disease is attributed to the death of the dopamine-containing cells in the brain.
  
• Toxins present in the environment can also contribute to the death of dopamine cells in the brain thus causing the disease.
  
• Family history of the disease.
  

• Tremor sets in from the hands and gradually spreads over to the rest of the body.
  
• Rigid muscles, stiffness in the muscles, this limits movement and induces pain.
  
• Loss of automatic movements like swinging arms, blinking.
  
• Slowed motion – The disease restricts the voluntary movement of the body.
  
• Change in speech – Few people speak in a monotone; few have soft or rapid speech based on the severity of the condition.
  
• Impaired posture and balance – There could be problems in the posture and balance of a person.
  
• Dementia – This usually occurs in the advanced stages of the disease.
  

The physician asks for the medical history of the patient and does a neurological examination of the patient. Hand co-ordination, walking, etc are assessed through neurological examination.

Treating Parkinson's disease

• Medications to tackle the symptoms
  
• Physical therapy to increase muscle tone and strength
  
• Lifestyle changes like healthy diet, exercises, speech therapy, etc
  
• In a few cases surgery for deep brain stimulation, in this process they implant an electrode into the brain. This electrode in turn takes care of the stimulation of the brain.
  

Hallervorden spatz disease

Hallervorden Spatz disease or HSD is a rare neurological movement disorder that is passed down through families. It is characterized by progressive degeneration of the nervous system. According to the National Institute of Health, Hallervorden Spatz disease or its subtype affects less than 200,000 people in the US population.

Hallervorden Spatz disease was first described in 1922 as a form of brain degeneration characterized by iron deposition in the brain. The most recently used term for HSD is 'panthothenate kinase – associated neuro degeneration' as HSD specifically causes neuro degeneration and excessive iron accumulation. Onset of the disease is commonly in late childhood or early adolescence but there are cases with adult onset as well. The disease can be familial or sporadic. When familial it is inherited recessively.

Symptoms of Hallervorden spatz disease

• Motor disorder of extra pyramidal type and gait difficulty.
  
• Rigidity of extremities, slowness of movement.
  
• Predominant tremor – continuous shaking especially in the hands.
  
• Dystonia or involuntary muscle contractions – tight, weak and spastic muscles.
  
• Movement defects with uncontrollable twisting and squirming.
  
• Spasticity and dysarthria (speech disturbance caused by lack of control over muscles involved in speech) , brisk reflexes and extensor plantar responses.
  
• Significant disturbance in speech at an early age.
  
• Dementia is present in most individuals with HSD.
  
• Visual impairment from optic atrophy or retinal degeneration.
  
• Seizures
  

Hallervorden Spatz disease may possibly cause several other diseases including Cerebellar syndrome, Choreoathetosis, Chronic brain failure, Fits, Parkinsonism, Retinitis pigmentosa and Spastic ataxia.

Diagnosis of Hallervorden spatz disease

A neurological examination will reveal abnormal postures and movements, muscle rigidity, tremors and weakness. Genetic tests help to detect defective gene that causes the disease. However, this test is not widely available. MRI and similar other tests help to rule out the movement disorders and diseases.

Hallervorden Spatz disease gets worse and nerves are damaged over time. This leads to lack of movement and often death by early adulthood. Hence, treatment to control the symptoms becomes imperative. But there are no specific lines of treatment for HSD, consuming certain vitamins like panthothenate, Coenzyme Q10 and antioxidants can help the patient to some extent as they help ease the symptom severity. Sometimes medications used to treat symptoms for HSD can cause additional complications. These include blood clots, respiratory infections and skin breakdown.