Dealing with Parkinson’s

Parkinson’s disease elicits fear because of the ‘unknowns’ associated with it.

When diagnosed with Parkinson’s disease, patients and their families almost always find themselves faced with questions to which they have no answers for and as a result, are overwhelmed by fear. This fear stems from the many ‘unknowns’ linked to the disease, such as how and why it occurs, what happens as it progresses, whether it can be treated and whether patients can lead a normal life after the diagnosis. Here, we would like to provide some answers to these and other frequently asked questions on Parkinson’s:

The what & the why of it?

Parkinson’s disease is a neurodegenerative disorder, caused by progressive damage to nerve cells in the brain. This leaves the nerve cells unable to communicate with each other or transmit signals from the brain to other parts of the body. As a result, patients start experiencing tremors, a loss of mobility, changes in memory and personality, unsteadiness and eventually the inability to walk or perform simple everyday activities. We do not yet know why PD happens, but researchers believe that genetic mutations and environmental factors play a role.

Who can get PD?

People with a family history of PD are at a higher risk and the disease usually affects people who are above the age of 50. There are some rare cases of early-onset Parkinson’s disease in which people get the disease as early as 21 to 40 years. Some cases of juvenile-onset Parkinson’s disease have also been observed in people below the age of 21.

Do all patients lose movement?

The symptoms of Parkinson’s disease vary from person to person and depend largely on the stage of the disease. There are five main stages of PD, classified by symptoms that progress from mild to severe. Some people go through the five stages sequentially, while others skip some stages entirely. There are also patients who spend years in stage one with few symptoms while others progress quickly to a later stage that results in a complete loss of mobility. This is why Parkinson’s patients should track their symptoms carefully and inform their doctor of any changes or the emergence of new symptoms.

How is Parkinson’s treated? Can it be cured?

Parkinson’s disease is a progressive disorder that cannot be cured and requires life-long management with the help of medicines. We know that the level of a brain chemical called dopamine falls in people with PD and this is why Parkinson’s patients are given dopamine medicines or substances that aid the natural production of dopamine in the body. These medicines have now become the standard of care for patients with Parkinson’s, who show many noticeable improvements in symptoms.

Another relatively new treatment is an advanced surgical procedure called deep brain stimulation (DBS). This employs a thin wire placed in the brain that, by sending electrical signals to specific areas, corrects neurological dysfunction and reduces the symptoms of Parkinson’s disease. A growing number of patients are turning to DBS for long-term relief.

What are the benefits of DBS?

The major benefit of DBS is its continuous and sustained ability to control symptoms for 24 hours a day. Once implanted, it helps reduce the frequency of tremors and leads to improvements in overall body movement. Most patients who undergo DBS require half the number of medicines that were initially required to control symptoms, and some patients no longer have the need for medicines at all! People with Parkinson’s disease are usually recommended this form of treatment when they do not show any improvement with dopamine medication for three to four years.

Parkinson’s disease is finally receiving more attention and investment from members of the medical and research community. There has been a rise recorded in the number of diagnosed cases in India. One reason for this is more awareness about the disease and the other is the increase in life expectancy. As people live longer, they are more prone to developing age-related conditions such as Parkinson’s.

(The author is senior consultant neurosurgeon and spine surgeon, Columbia Asia Hospitals)