Parkinson’s disease is named after James Parkinson, the English physician who described this degenerative disease of later life. Here are the history, symptoms, causes and treatment options for Parkinson's.
What characterizes Parkinson’s disease?
- Slowness of movement with slow, shuffling gait, short steps
- Rigidity or stiffness of the limbs and trunk
- Impaired balance and coordination
- Head held forward, and body stooped forwards
- Drooping eyelids, open mouth, drooling
Who first identified Parkinson’s disease? The disease we call Parkinson’s was known to ancient eastern Indians as “Kampavata.” A man by the name of Charaka is known to have described this disease as “kampa” meaning shaking and “vata” meaning decreased muscle movement or weakness. About 500 years later in Greece, Galen, a student of Hippocrates, also described a “shaking palsy.” But it wasn’t until the 1800s when Dr. Parkinson described the criteria of patients with the “shaking palsy” and separated out other diseases that may shake or have weakness. We actually still call the syndromes that look like Parkinson’s disease by the name “Parkinsonism.”
What are the brain changes we see in Parkinson’s disease? Parkinson’s patients experience a slow, progressive loss of cells that make dopamine in the brain. Dopamine, in the right amount and right places, plays a vital role by making our bodies move faster, including arms, legs, mind and even bowels. It also makes us feel good when it is released, like during social events, eating or sex. It is also released as a reward during events such as fishing, hunting, shopping or gambling.
What are the early signs of Parkinson’s? Early Parkinson’s disease is easy to miss by doctors because the symptoms can mimic common ailments:
- Feeling “dizzy” or easily off balance
- Loss of sense of smell
- Loss of arm swing on one side of the body
- Daytime sleepiness
- Depression
- Constipation
What causes a loss of dopamine? We don’t know. Certainly, there are familial forms of Parkinson’s, but these are much less common than the sporadic type.
How do we treat Parkinson’s disease?
- Promote the release of dopamine
- Replace dopamine with medication
- Alternatives/additions to dopamine treatment
- Deep brain stimulation surgery
What your doctor can do for you to help increase dopamine? We can directly replace that dopamine with a dopamine precursor, Levodopa. Levodopa was found to be effective in the 1950s by a Swedish scientist, Arvid Carlsson, who later won a Nobel Prize for that work. It is now available in several formulations and is always paired with carbidopa to help absorption.
We can mimic dopamine with drugs called “dopamine agonists.” Pramipexole, ropinerole and rotigatine patch are all in this category.
We can limit the breakdown of your own dopamine using drugs belonging to a family called the MAO-B inhibitors. Two examples are selegiline and rasagiline.
As with some medications, there can be side effects, so be sure to talk to your doctor about a treatment plan that is going to be right for you.
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