What is Parkinson's disease?
Parkinson's disease is a combination of slowing of movements,
tremor, stiffness usually starting on one side of the side of the
body together with a stooped posture that occurs when one part of
the brain (the basal ganglia) has run out of a specific chemical
(dopamine). The basal ganglia controls the 'programme' for movement
and as it becomes depleted of dopamine there is a slowing down of
the programmes that control movement. Patients with Parkinson's may
notice other symptoms, sometimes starting some time before the
tremor and slowness, such as lack of sense of smell, constipation,
depression and memory loss. We do not know what causes Parkinson's:
it is one of the only disorders that is more common in non-smokers,
only rarely does it run in families.
What do you do to treat it?
The first stage is to accurately diagnose Parkinson's as at
least 25% of patients who appear to have Parkinson's actually have
another disorder mimicking Parkinson's which may need different
treatment. There is no cure for Parkinson's but there is a range of
medication which helps stimulate the dopamine depleted nerve cells
in the brain. The two main types of treatment are dopamine agonists
and L-dopa. The former probably have fewer long-term side effects
but the latter control symptoms more quickly so the options need to
be discussed with your doctor. Most patients find they need to
gradually increase the dose of their treatment over the years and
most will eventually need several different medications to control
their symptoms. It is important that someone with Parkinson's keeps
fit and active and physiotherapy may be useful to encourage
mobility.