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.
  

MAO inhibitor - Antidepressant drug

MAO (Monoamine oxidase) inhibitors are a genre of drugs that are used to treat depression and Parkinson's Disease. Brand names of some MAO inhibitor drugs are Marplan, Nardil, Parnate and Eldepryl. MAO inhibitors are used in the treatment of mental depression as well as anxiety and panic attacks.

MAO inhibitors are seen to work adversely in the presence of tyramine. It leads to a build-up of tyramine thereby causing High Blood pressure and increasing the chances of a stroke. Persons on MAO inhibitors must ensure that they avoid foods that contain high levels of tyramine. Legumes, cheese, fish, ginseng, meat, shrimp paste and alcohol are foodstuffs that are high in tyramine. Other foods that must not be consumed in excess when on MAO inhibitors are chocolate, soy sauce, yogurt and sour cream.

Side Effects of MAO inhibitor: Typical side effects of MAO inhibitors are headache, fainting, muscle twitches and confusion. MAO inhibitors are known to cause increased sun sensitivity, blurred vision and drowsiness. Stomach upsets, loss of appetite and irritability can also result. Some persons on MAO inhibitors tend to experience heart palpitations, memory impairment and anxiety. It is essential to consult your physician in case you notice skin rash, fever and yellowing of the eyes or skin.

Dosage of MAO inhibitor: It is essential to check the dosage of the MAO inhibitor with your physician. Larger or more frequent doses must be avoided nor should the drug be taken for longer than prescribed. Since the effects of the MAO inhibitors take some time to be felt, it is essential to continue the dosage as directed. Dosage must be slowly tapered down. Ensure that you follow the diet restrictions that are recommended for those on MAO inhibitors.

Dysarthria

Dysarthria is a condition where speech is slurred due to muscular problems. When it occurs in children, it is called developmental dysarthria. In later life, it can occur due to a stroke, brain tumor, Parkinson's disease, Multiple sclerosis, Myasthenia gravis or Cerebral palsy.

The patients tend to exhibit quieter or slurred speech, hoarse voice or altered speech rhythm. Swallowing problems might be noticed. A laryngoscopy might be done. MRI or CAT scans of the brain might be ordered. Barium swallow, Nerve conduction tests and electromyogram are other diagnostic tests that help detect the cause for Dysarthria.