What is Parkinson’s?
Parkinson’s is a progressive neurological condition that causes problems in the brain and gets worse over time. There are about 145,000 people living with Parkinson’s in the UK – that’s around 1 adult in every 350, with the relative risk being 1.5 times greater in men than women. A very small number of Parkinson’s cases are hereditary and research is underway to try and understand why it happens.
People with Parkinson’s don’t have enough of the chemical dopamine because some of the nerve cells that make it have died. Researchers are working hard to develop new and better treatments – and one day a cure, but until then, there are lots of different treatments, therapies and support available to help manage the condition.
There are 3 main symptoms:
Tremor – a type of shaking that you can’t control and movement in a part of your body
Slowness of movement and less co-ordination.
Rigidity or muscle stiffness.
There are also many other symptoms too and everyone experiences it differently.
Parkinsonism is a term that covers several conditions, including Parkinson’s and other conditions with similar symptoms such as slow movement, rigidity (stiffness) and problems with walking.
Vascular Parkinsonism (also known as arteriosclerotic Parkinsonism) affects people with restricted blood supply to the brain. Sometimes people who have had a mild stroke may develop this form of Parkinsonism. Common symptoms include problems with memory, sleep, mood and movement.
Some drugs can cause Parkinsonism. Neuroleptic drugs (used to treat schizophrenia and other psychotic disorders), which block the action of the chemical dopamine in the brain, are thought to be the biggest cause of drug-induced Parkinsonism. Drug-induced Parkinsonism only affects a small number of people, and most will recover within months and often within days or weeks of stopping the drug that’s causing it.
If some of the symptoms of Parkinson’s are present, it’s vital to seek early help via the GP and ask for referral to a Parkinson’s specialist. They’ll look at the medical history, ask about symptoms and do a medical examination.
Telling the difference between types of Parkinsonism isn’t always easy, for the following reasons:
- The first symptoms of the different forms of Parkinsonism are very similar.
- In many cases, Parkinsonism develops gradually. Symptoms that allow a doctor to make a specific diagnosis may only appear as the condition progresses.
- Everyone with Parkinsonism is different and has different symptoms.
The motor symptoms of Parkinson’s include:
- tremor or uncontrolled shaking
- rigidity and stiffness in the muscles
- slowness of movement
- falls and dizziness
- freezing – where limbs won’t obey commands to move
- muscle cramps and dystonia
Dystonia is a movement disorder that happens when incorrect brain signals cause contractions in various muscles. This is when muscles become tighter and shorter than normal, making them stiff. Dystonia can feel painful and uncomfortable. The contractions may also involve visible twisting movements, or spasms, which create unusual postures in the affected body part. They may be constant or last for a short period of time.
Non-motor symptoms of Parkinson’s don’t affect movement but include other issues like mental health and memory problems:
- low blood pressure
- restless legs
- bladder and bowel problems such as incontinence or constipation
- skin and sweating, oily skin or skin that peels and flakes, and may develop thick crusts or scales.
- sleep problems
- eating, swallowing and saliva control
- speech and communication issues
- eye problems
- foot care
- dental health
Mental health issues
- mild memory and thinking problems
- hallucinations and delusions
As you can see, they symptom list is very long, hence why it’s not straightforward to get a diagnosis, but if any of the symptoms seem familiar, then it’s best to see a health professional.
Dopamine is a chemical messenger made in the brain and the symptoms of Parkinson’s appear when dopamine levels become too low. This is due to the build up of alpha-synuclein protein which forms toxic clumps and essentially kills the dompamine producing nerve cells. Therefore most drug treatments work by:
- increasing the amount of dopamine in the brain
- acting as a substitute for dopamine by stimulating the parts of the brain where dopamine works
- blocking the action of other factors (enzymes) that break down dopamine
All prescribed drugs can have potential side effects, including those used to treat Parkinson’s.
New research from the University of Edinburgh and Dundee has identified a probiotic (a.k.a good bacteria) which prevents the build-up of the protein that causes the motor symptoms of Parkinson’s. These new findings could pave the way for future studies that gauge how supplements such as probiotics impact Parkinson’s. The link between brain function and gut health has been explored before;
Dr Beckie Port, Research Manager at Parkinson’s UK, said: “Changes in the microorganisms in the gut are believed to play a role in the initiation of Parkinson’s in some cases and are linked to certain symptoms. That’s why there is ongoing research into gut health and probiotics…Studies that identify bacteria that are beneficial in Parkinson’s have the potential to not only improve symptoms but could even protect people from developing the condition in the first place.”
Whilst these findings are promising there is still a lot of work and research to be undertaken with various clinical trails still to take place. However, this is a positive new step for those researching Parkinson’s and how to manage/prevent it. Read more about this here.
Medication side effects – With some Parkinson’s drugs, particularly dopamine agonists, (drugs which mimic dopamine to stimulate cells) and in a small number of cases levodopa, (a chemical building-block that the body converts into dopamine) some people have problems with impulsive or compulsive behaviour. This is behaviour like gambling, becoming a ‘shopaholic’, binge eating or focusing on sexual feelings and thoughts. This behaviour can have a hugely negative impact on people’s lives, so if you think this is happening to you or the person you are caring for, tell your GP, specialist or Parkinson’s nurse straight away.
- Occupational therapy – helping with adaptations to make daily living easier
- Physiotherapy – a programme of exercise and muscle stretching to combat mobility and limb issues
- Speech and language therapy – strengthening the muscles that help make speech and adapting for any losses.
Parkinson’s is not a pleasant illness, but many people live with it for many years once it’s being controlled. As with any illness, early detection makes living with the condition easier.
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