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Parkinson’s DiseaseNidhi G. VekariaBrookdale Community Collage
HESC-105 Medical Terminology

Parkinson Disease
In medical world, there are many diseases out there but most of them do have proper treatment, medications, and procedures. Some of them do not have reliable treatment. One of them is Parkinson’s disease has not proper treatment to get ride off. The purpose of choose this topic is that, one of the common disease in older people which my elder aunt is suffering from last five years. I often talk to her to know about her condition and I came to know more about Parkinson’s and its symptoms.

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“Parkinson’s disease (PD) is a type of neurological disorder that targets brain cells that can affect the ability to perform common daily activities also a chronic and progressive disease, meaning that the symptoms become increase over time” (Bradley, 2009, p.129). Mandybur and Gartner (2018) describe PD as: “Parkinson’s involves the failure and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the front of the midbrain. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.” The specific group of symptoms that an individual experiences varies from person to person (Mandybur ; Gartner, 2018). Primary motor signs of Parkinson’s disease include the following (Bradley, 2009, p.130):
Tremor of the hands, arms, legs, jaw and face
slowness of movement
Rigidity or stiffness of the muscles
Postural instability
In Massano and Bhatia (2012) summary article reviewing the incidence increases dramatically with increasing age. More than one million people in the United States have PD. Parkinson’s is more frequent in older populations. Symptoms of Parkinson’s disease can appear at any age, in people over the age of seventy.

“The term Parkinsonism is used to refer to a group of disorders that produce abnormalities of Basal Ganglia (BG) function. PD is the most common form, affecting approximately 78 percent of patents. Secondary Parkinsonism results from a number of different identifiable cause, including toxins, drugs, tumors, and many more. The term Parkinsonism-plus syndrome refers to those conditions that mimic PD in some respects, but the symptoms are caused by other neurodegenerative disorder” (O’Sullivan ; Schmitz, 2007, p. 853).

According to Massano, and Bhatia (2012), a symptoms that patients feel, and a sign is individuals see, such as physician. For instance, might be laziness is a symptom while an expanded pupil is a sign. Some patients may experience tremor as their primary symptom, while others may not have tremors, but have postural instability. While the disease may develop slowly for some individuals, for others it progresses quickly (Mathew ; Aggarwal, 2012, p. 297). “The primary motor symptoms generally involve movement, while non-motor symptoms do not” (Mathew ; Aggarwal, 2012, p.297).

In O’Sullivan and Schmitz (2007, p. 856-857) summary of the primary motor symptoms related with Parkinson’s disease are: Rigidity that refers to a tightness or muscle stiffness of the limbs. Rigidity, especially in the early stages of PD, may be painful and limit range of motion. Also, Bradykinesia (slow physical movements) refers to absence of movement. Bradykinesia is refers to slowness and difficulty maintaining movement. Patients typically make simple tasks difficult, time-consuming and also a lack of coordination. Furthermore, Characteristic tremor of the head, trunk and postural tremor, can be seen when muscles are used to maintain an upright position against gravity. Tremor tends to be less severe when the patient is relaxed. Tremor may start in a foot or one side of the body, and usually more likely to occur when that part of the body is resting may make the tremor more noticeable. Moreover, Patient with PD demonstrate abnormalities of posture and balance. These changes are rare in the early years of PD. Patient also experience increasing difficulty during activities such as self-initiated movements and increasing risk to fall down (O’Sullivan & Schmitz, 2007, p. 856-857).

In constant, Mathew and Aggarwal (2012, p. 298) refers that Parkinson’s disease is a type of movement disorder; the associated non-motor symptoms can be overlooked. However, there are several common symptoms of PD that do not primarily involve movement. Sleep problems are commonly experienced by people with Parkinson’s and there are many due to side effects of medications for PD. However, sleep problems are a core sing of the disease (Mathew & Aggarwal, 2012, p. 298). “Patients with PD experience by decreased voice volume, and uncontrolled speech level. Sensory problems may also contribute to speech difficulties. There may be repeated words or slurring and hesitate before talking” (Mathew & Aggarwal, 2012, p. 298).

“Parkinson’s disease is usually diagnosed clinically, meaning that a physician looks for the presence or absence symptoms and medical history of PD by interviewing the patient and performing a detailed by physical examination” (Mathew & Aggarwal 2012, p. 299). It is purely clinical and there is no complete diagnostic test to conform PD (Mathew & Aggarwal 2012, p. 299.) “Symptoms that suggest a diagnosis other than PD include lack of response to levodopa, hallucinations, prominent and early dementia, early postural instability, and involuntary movements other than tremors” (Mathew & Aggarwal 2012, p. 299). Sometimes it takes time to diagnose PD so doctors may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate patient’s condition and symptoms over time (Mathew & Aggarwal, 2012, p. 299).

Bradley (2009, p. 236-238) summarized that, Parkinson’s disease can’t be cured, but medications can help to control symptoms, or some later cases, surgery may be advised. Doctor may also recommend lifestyle changes, especially aerobic exercise and physical therapy that focuses on balance and stretching. Treatment approaches include medication, surgery, exercise, and alternative medicine.
“Levodopa (L-dopa) drug is the support of symptomatic treatment for PD. L-dopa highly effective in treating motor symptoms of bradykinesia” (Mathew & Aggarwal, 2012, p. 299-300). L-dopa, which is converted to dopamine in the brain, reduces tremor, stiffness, and slow movement in people. Parkinson’s symptoms are caused by low levels of dopamine in the brain (Mathew & Aggarwal, 2012, p. 299-300). Furthermore, “Dopaminergic medications reduce rigidity, improve speed, help with coordination, and reduce tremor. Moreover, Anticholinergics drug are rarely used as first-line drugs unless patient has sever tremors” (Mathew & Aggarwal, 2012, p. 300). Physician should be avoided if the patient is above 65 years. Medications may help patients to manage problems with walking, movement and tremor (Mathew & Aggarwal, 2012, p. 300).

“A combined approach of physical therapy and pharmacological intervention plays a key role in the management of the patient with PD” (O’Sullivan & Schmitz, 2007, p. 854-855). For most patients, physical therapy is not prescribed until the disease has progressed to the point when function has declined (O’Sullivan & Schmitz, 2007, p. 854-855). “A variety of interventions are used to achieve goals and outcomes, including direct interventions, patient/family/caregiver instruction, environmental modification, and supportive counseling.” (O’Sullivan & Schmitz, 2007, p. 854-855). Education of patients, family members, and caregivers is critical to attaining best outcomes. O’Sullivan and Schmitz (2007, p. 855) give suggestions that may also help:
Try not to move too quickly.

Aim for your heel to strike the floor first when you’re walking.

If you notice yourself shuffling, stop and check your posture. It’s best to stand up straight.

Look in front of you, not directly down, while walking.
Bradley (2009, p. 138-139) summarized that, Surgery is an accepted treatment for patients with advanced PD who respond poorly to medication or who experience complications related to pharmacotherapy. There are three main surgical approaches (Bradley, 2009, p. 139):
Ablative surgery
Deep brain stimulation (DBS)
Neural transplantation
In addition, Alternative medicine as some of the symptoms and complications of Parkinson’s disease, such as pain, fatigue and depression can be help through supportive therapies. When performed in combination with PD patient treatments, massage therapy might improve quality of life such as reduce muscle tension and help in to relaxation. Also, poses may increase patient’s flexibility; balance and mild stretching movements can be helpful in yoga. Moreover, Alexander technique focuses on muscle posture, balance and thinking about how to use muscles and may reduce muscle tension and pain (O’Sullivan & Schmitz, 2007, p. 859-860).

In conclusion, Parkinson’s disease may only directly affect about a million people in the U.S. but it touches the lives of billions of individuals, millions of families, and thousands of scientists that all give their lives to the disease. Parkinsonism and PD are a clinical diagnosis with the primary motor and non-motor symptoms. Parkinson’s disease impacts people in different ways, as the disease progresses. Not everyone will experience all the symptoms of Parkinson’s, and if they do, they won’t necessarily experience them in quite the same order or at the same intensity (O’Sullivan & Schmitz, 2007, p. 884).

References
Bradley, W. G. (2009). Treating the Brain. Washington, DC: Dana Press.

Mandybur, G. & Gartner, M. (2018 April). Parkinson’s disease (PD). Retrieved from https://www.mayfieldclinic.com/PE-PD.htm
Massano, J. & Bhatia, K. P. (2012). Clinical Approach to Parkinson’s Disease: Features, Diagnosis, and Principles of Management. Cold Spring Harbor Perspectives in Medicine, 2(6), a008870. http://doi.org/10.1101/cshperspect.a008870
Mathew, K. G. & Aggarwal, P. (2013). Medicine Prep Manual for Undergraduates. New Delhi, India: Elsevier.

O’Sullivan, S. B. & Schmitz, T. J. (2007). Physical Rehabilitation. Philadelphia, PA: F.A. Davis.

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