Parkinson's disease: What is it and what are the symptoms?

Parkinson's disease is common neurological condition that causes tremulousness or shivering of limbs, slowness in performing activities, walking difficulty with slowness and change in walking style, reduced facial expressions and speech volume. Dr Sandeep Nayani, Senior Consultant Neurologist, Apollo Health City, Hyderabad, says "Persons affected with Parkinson's disease have difficulty performing their routine activities, may need assistance for chores, may experience change in handwriting and have difficulty keeping pace with peers when they go for a walk." He also says, "They may also experience changes in sleep routine with reduced sense of smell and constipation."

Parkinson's disease- causes

Parkinson's disease usually affects middle aged and elderly individuals. It is more common after the age of 60 years. Incidence is similar in men and women. Rural dwellers are more commonly affected than the urban population. Parkinson's disease is idiopathic, which means there is no known cause as to why the disease occurs.

Treatment of Parkinson's disease

In Parkinson's disease, there is deficiency of neurotransmitter Dopamine in the brain connections. Dopamine transmission in a region of brain called basal ganglia is essential for smooth movement of limbs and deficiency of dopamine results in reduced movement and stiffness in limbs.

Drugs that increase dopamine levels in brain are used to treat Parkinson's disease. With medication, there will be good improvement in movement of limbs and gait. There are various types of medication which increase dopamine levels in brain through different mechanisms. These medications are chosen by the neurologist as per the patient's age, stage of the disease and other co morbidities.

Deep Brain Stimulation for Parkinson's disease

In People suffering with Parkinson's disease for many years, over a period of time the beneficial effect of medication doesn't sustain for the whole day and they experience Off episodes where they cannot walk or move well. At this stage, Deep Brain stimulation is the surgery that can be offered to them. In Deep Brain stimulation surgery, electrodes are implanted in certain areas of brain and stimulated through a battery implanted at chest level. This leads to sustained benefit with better quality of life.

Deep brain stimulation surgery is ideally done before 70 years of age. The ideal time to perform surgery varies from person to person but it can be considered 5 years after the onset of disease.