Parkinson’s disease

GC: n

S: PDF – (last access: 28 November 2013); NIH – (last access:12 December 2013); MEDLP – (last access: 12.12.2013).

N: 1. By definition, Parkinson’s is a progressive disease. Although some people with Parkinson’s only have symptoms on one side of the body for many years, eventually the symptoms begin on the other side. Symptoms on the other side of the body often do not become as severe as symptoms on the initial side.
2. At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms. Usually, patients are given levodopa combined with carbidopa. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can use levodopa to make dopamine and replenish the brain’s dwindling supply. Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all. Anticholinergics may help control tremor and rigidity. Other drugs, such as bromocriptine, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine. An antiviral drug, amantadine, also appears to reduce symptoms. In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD.
In some cases, surgery may be appropriate if the disease doesn’t respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.
3. Symptoms begin gradually, often on one side of the body. Later they affect both sides. They include:
Trembling of hands, arms, legs, jaw and face
Stiffness of the arms, legs and trunk
Slowness of movement
Poor balance and coordination
As symptoms get worse, people with the disease may have trouble walking, talking, or doing simple tasks. They may also have problems such as depression, sleep problems, or trouble chewing, swallowing, or speaking. There is no lab test for PD, so it can be difficult to diagnose. Doctors use a medical history and a neurological examination to diagnose it.
4. Cultural Interrelation: We can mention, among others, the books Lucky Man: A Memoir (2002) written by Michael J. Fox, A Life Shaken: My Encounter with Parkinson’s Disease (2004) written by Joel Havemann and the movies Aurora borealis (2005) directed by James Burke and A late quartet (2012) directed by Yaron Zilberman.

S: 1. PDF – (last access: 28 November 2013). 2. NIH National Institute of Neurological Disorders and Stroke. (last access:12 December 2013). 3. MEDLP – (last access: 12 December 2013). 4. (last access: 9 February 2016); (last access: 9 February 2016); (last access: 9 February 2016); (last access: 9 February 2016).

SYN: PD, idiopathic parkinsonism.

S: GDT (last access: 12 December 2013)

CR: biperiden, chorea, Fahr’s disease, ubiquitin, dementia.