Anatomy and Physiology: Parkinson's Disease - Essay Example

Anatomy & Physiology: Parkinsons disease Parkinsons Disease epidemiology, aetiology and prevalence between the genders Discovered in 1817 by James Parkinson, this malady up to date its aetiology remains a mystery (Grosset, Fernandez, Katherine & Okun, 2009). This is despite the state of the current advanced medical field’s expertise whereby it continues to affect numerous people’s lives detrimentally. However, numerous practitioners and researchers have come up with extremely conflicting, varying and confusing multifactorial theories, which they have postulated regarding what could be the aetiology of this condition (Grosset, Fernandez, Katherine & Okun, 2009). Recent concluded studies so far conducted contend the world has approximately 6.3 million people who are experiencing Parkinson’s disease (PD) (Medtronic, 2010). Out of this global population, 1.2 million emanate from Europe whereby according to varied medical practitioners and researchers the number keeps on increasing by the day. (Grosset, Fernandez, Katherine and Okun (2009) in their study claim approximately 750,000 up to 1Million are USA citizens whereas between 120,000 and 130,000 emanate from UK. However, PD’s prevalence and incidence studies for long have been affected by survival rates whereby the former is higher compared to the latter (Grosset, Fernandez, Katherine & Okun, 2009). Consequently, this implies those at risk of contracting PD their respective age is over 50 years as depicted in Figure 1. According to Grosset, Fernandez, Katherine and Okun (2009) study, the earliest symptoms of PD among numerous patients usually start showing up at 60 years. Hence, implying the disease is quite common among the elderly especially those whom their ages fall between 75 and 85 years living in Europe and USA’s regions (Peretz et al. 2014, p. 70). People comprising this demography their number in these regions is currently showing a rapid increase besides having complications that contribute to PD problem (Peretz et al. 2014, p. 70). This is because of dysfunction of nigra neurons, which are susceptible to loss with age (Reeve, Eve & Doug Turnbull, 2014, p. 19). Figure 1: Grosset, Fernandez, Katherine & Okun. (2009). Prevalence of Idiopathic PD by age. [E-Book] Available at: [Accessed 1st June 2014] Besides age, studies have also confirmed environmental and ethnicity comprises key predisposing factors towards contracting PD predicament. Globally, PD is quite rampant among Caucasians, but fewer in West Africans and Intermediate among Chinese people (Grosset, Fernandez, Katherine & Okun, 2009, p. 10). In emphasis on environmental factors, African Americans and Chinese comprising the Taiwan citizens seem to have higher PD prevalence rates contrary to their counterparts residing in West Africa or China (Grosset, Fernandez, Katherine & Okun, 2009). PD is quite common among the male gender as compared to the female whereby the former are 1.5 times likely to experience this predicament (Grosset, Fernandez, Katherine & Okun, 2009, p. 10). Other than deteriorating of nigra neurons and exposure of toxic substances in regions having high prevalence of PD, it is unknown why these ethnicities are vulnerable to this malady. Figure 2: Grosset, Fernandez, Katherine & Okun. (2009). PD prevalence across ages. [E-Book] Available at: [Accessed 1st June 2014] 2) Parkinsons Disease Pathophysiological process To date, PD Pathophysiology due to its progressive nature remains idiopathic (Visanji, Brooks, Hazrat & Lang, 2013). This is because physiologically PD predicament encompasses degeneration of varied neurotransmitters specifically dopamine, which also decrease with a person’s age as he or she advances in years. This implies that if not careful, medical practitioners may end up confusing PD’s aetiological factors with those of other conditions especially when the case involves an elderly person whereby due to age the claimed neurotransmitters seem to degenerate with age. The cause of PD is due to the degeneration of brains basal ganglia, which in turn affects adversely dopaminergic function (Asaad, 2013, p. 59). However, there are different factors that lead to PD including cerebral trauma, cerebrovascular disorders, encephalitis and administration of dopamine blocking agents ( like antipsychotic agents), intoxication by CO besides exposure to heavy metals like lead (Asaad, 2013, p. 59). Compared to other circumstances including ageing, PD’s rate of dopamine and other cells’ loss is extremely high. This is evident in numerous biochemical as well as imaging tests that confirm presence of a significant decrease in dopamine before motor symptoms show up (Asaad, 2013). 3) Distinguishing main Parkinsons disease signs and symptoms PD symptoms based on studies so far conducted contend they normally vary across individuals and as the disease continues to progress. This implies there are symptoms, which a particular individual may exhibit while in the early stages that differs with other patients’ based on which motor the disease has adversely affected. In addition, age of the ailing also poses a great influence because this disease is common among people aged between 50 to 60 years. Signs Postural Instability This is the most common sign among people experiencing PD whereby one looses the entire body’s stability specially when standing such that he or she can topple at the slightest jostle (Kim, Allen, Canning & Fung, 2013, p. 98). In most cases, one tends to sway backwards when either raising from a chair or tries to move. Unable to perform tasks that need heightened level of precision This is evident especially in activities like writing or buttoning one’s clothes whereby he or she takes long and eventually not doing them normally. When writing, one may all of a sudden his or her handwriting start being small and overcrowded. Trouble in sleeping PD patients exhibit incidents of abnormal sleep patterns different from the ordinary (Wienecke et al. 2012, p. 711). The altered patterns of sleep result from varied medical agents besides the condition itself contributing under certain circumstances. Other signs embrace Absence of facial expression Fading sense of smell Constipations and incidents of bowel complications Neck pain Altered speech and voice Excessive sweating Sudden alterations in mood as well as one’s personality Symptoms These are either motor or non-motor symptoms whereby the former refers to how an ailing person experiencing this predicament moves. They include Tremor This is the most obvious confirmation of a PD condition in a person coupled with involuntary rhythmic shaking (Pfeiffer, Wszolek & Ebadi, 2012, p. 174). Its depiction may be through shaking of a limb when it is at rest or one part of the body before spreading to other regions as the condition progresses. According to Pfeiffer, Wszolek & Ebadi (2012), it occurs to approximately 70% of all PD patients. Bradykinesia The nature of this condition is quite opposite to the tremor whereby its nature encompasses slowness to spontaneous movements (Pfeiffer, Wszolek & Ebadi, 2012, p. 173). Hence, prompting the ailing person’s limbs and other repetitive responses appear abnormal like loss of normal response of facial expressivity (Cano-de-la-Cuerda, Vela-Desojo, Miangolarra-Page, Macías-Macías & Muñoz-Hellín, 2011). Rigidity This is the tendency of one’s limbs becoming inflexible and stiff including muscles not being able to relax as necessitated. Hence, leading to decreased motion to the extent when one is walking he or she cannot swing his or her arms (Cano-de-la-Cuerda, Vela-Desojo, Miangolarra-Page, Macías-Macías & Muñoz-Hellín, 2011). Others include Speech changes Depression 4) Standard medical Tests for Parkinson’s Disease Presently, there are no known or proven standard blood tests meant to ascertain whether one is experiencing Parkinson’s disease. Therefore, practitioners only utilize the patient’s symptoms, neurological determinations as well as medical history (Hpathy Ezine, 2014). However, there are tests conventionally used to diagnose PD including, 1. Unified disease rating scale  It aims at giving the exact severity of the PD’s patient in the case where it may be confusing (Hpathy Ezine, 2014). This is evident when the person is an elderly whereby other causes may be contributing to the PD’s condition. 2. Unified Parkinson’s Disease Rating Scale  - UPDRS In using this test, practitioners their core aim encompasses quantifying or evaluating the PD’s longitudinal course in a certain patient while both on and off medications (Starr, Barbaro & Larson, 2009, p. 188). Mainly, the outcome of this standard or “golden” test for PD is the extent of the ailing person’s condition against the already established scale (Jooeun et al. 2009). 3. Hoehn and Yahr Staging of Parkinson’s Disease Mainly, core aim of this tool ensures it gives each outcome to a distinct stage based on the PD’s severity progress on the ailing person (Hpathy Ezine, 2014). Hence, help practitioners ascertain at which stage at which the ailing person is before prescribing a certain medicinal agent. 5) Parkinson’s Disease red flags that may entail immediate attention of a GP Due to the degeneration of essential neurotransmitters in the body of an ailing person, PD’s victims besides the core malady end up developing other complications (Red Flags) that entail immediate intervention of a GP. Since, the condition of a degenerating neurotransmitters leads to other serious consequences like hallucinations, early Dysautonomia and Dysphagia (Hawley, Armstrong, & Weiner, 2014). According to Hawley, Armstrong and Weiner (2014), red flags in the event of PD’s condition are extremely detrimental whereby lack of adequate attention may lead to even death. Hence, entail alternative diagnosis with the intention of lengthening the victim’s survival besides helping in managing varied Parkinson-plus disorders appropriately. Besides the earlier mentioned “Red Flags”, other common incidences embrace early dementia, postural hypotension, and sudden occurrences of symptoms like cerebrovascular and poor therapy response (Grosset, Fernandez, Katherine & Okun, 2009, p. 43). 6) Main Orthodox treatment for Parkinson’s Disease The common preferred Orthodox treatment for this condition is the administration of L-Dopa, which is an amino acid. However, for this medicinal agent to work as necessitated the presence of NADH is imperative as a co-enzyme. L-Dopa acts as dopamine’s precursor whose availability is common in certain leguminous plants (Jankovic & Tolosa, 2007, p. 113). Studies so far conducted contend L-Dopa’s use as a PD’s medicinal agent has improved patients’ conditions from being good to excellent. This is because of its tolerability and non-toxic nature thus improving PD patients’ quality of life (Jankovic & Tolosa, 2007, p. 114). However, this treatment despite numerous practitioners advocating for its use as an effective agent, it has a conventional predicament referred as “on off" effect. Hence, implying due to some circumstances this approach usually works better at certain times of the day compared to others due to fluctuations emanating from proteins’ consumption. To avoid such incidences, it is necessary for the patients to be taking proteins in the evening or substitute with niacin but as per practitioner’s directives. 7) Therapeutic remedies for PD Since each PD medical intervention seeks to minimize the severity of its symptoms, I suggest the following remedies. ARG NIT Mainly, this remedy has great affinity for Nerves (cerebro-spinal), hence stimulating the mind to get rid of phobia (Vermeulen, 2004). This is because due to PD nature its victims are always experiencing the fear of loosing their bodies’ control. Hence, end up lacking self-confidence and fearing walking in places where there are corners whereby through this remedy will improve their respective conditions by a great extent (Vermeulen, 2004). This remedy is appropriate when patients are walking fast for it will make them feel better especially when involving oneself in any given physical activity. RHUS-TOX This has a heightened affinity for Tissues comprising cellular, ligaments and fibrous joints. It is appropriate for symptoms commonly characterizing upper left and right lower sides. The remedy ensures continued motion especially in the affected areas thus increasing change of position, stretching limbs and while lying on something, which is very hard. However, the patient using this remedy is always experiencing mental restlessness, stiffness as well as in physical agitation throughout the entire day. ZINC This has affinity for both brain and nerves in its quest of ensuring motion and warm open air. However, it has certain setbacks like prompting the patient becoming mentally weak besides him or her lacking the necessary facial expressions. The person ends up complaining besides being sensitive to noise and light. In addition, studies have other serious effects brought by this remedy including, Increased legs’ weakness and Restlessness Twitching, jerking, spasms and tremor 8) Relevant Adjunctive advice that may appropriate for PD patients Effective PD management entails complete change of one’s convectional way of living and embracing new lifestyle that will enable him or her reduce symptom’s severities. This comprises of varied steps from setting goals up to having a reliable medical support as outline in Table 1. Table 1: Adjunctive advice that may appropriate for PD patients Strategy Description Goals These encompass targets, which the ailing intends to attain and maintain, which will ensure his/her independence Reducing PD symptoms Minimizing side effects Finding the right therapy Persistent with daily activities Emotional well-being Maximizing personal independence Exercise Undertaking exercises ought to be in line with practitioner’s advice. This is in accordance to one’s stability, PD’s stage and age. Enabling one having adequate control of his/her movements Enhancing one’s stability, stamina as well as cardiovascular wellbeing Enhancing body flexibility Improving muscles’ strength & steadiness Nutrition Among other strategies, this is the appropriate adjunctive advice that normally reduces incidences of rehospitalisation. Appropriate diet avoids one hospitalized due to fracture, dehydration, bowel complications and finally loss of weight. Ensuring in-take of 6-8 glasses of water Taking natural laxatives like prunes and vegetables Taking something, which is cold and sour to help in shunning incidences of dry mouth Adhering to practitioner’s directives in regard to diet and sometimes consulting Sleep This is relaxing period enables one’s body function as necessitated. Shunning stimulants before bedtime like alcohol. Reduce on in-take of fluids that will interfere with sleep pattern in the evening Ensure ample and comfortable setting in the bedroom. Sun occasions of having TV or other electronic media gadget in the bedroom. Exercise regularly Support Not only this encompasses seeking practitioner’s advice but also help from family and friends Developing a habit of keeping journal Ensuring open and honest communication with relatives as well as own practitioner Joining social clubs or organization that will avail PD support in terms of information or heightening one’s emotional well being Join other people experiencing the same condition to share and stay as a community References 2010. About Parkinsons disease. Medtronic. [Online] Available at: [Accessed 1st June 2014] Asaad, G. 2013. Understanding Mental Disorders Due To Medical Conditions Or Substance Abuse: What Every Therapist Should Know. London: Routledge. Cano-de-la-Cuerda, R, Vela-Desojo, L, Miangolarra-Page, J, Macías-Macías, Y, & Muñoz-Hellín, E 2011, Axial rigidity and quality of life in patients with Parkinsons disease: a preliminary study, Quality Of Life Research, 20, 6, pp. 817-823, Academic Search Premier, EBSCOhost, viewed 2 June 2014. Grosset, D., Fernandez, H., Katherine, G. & Okun, M. 2009. Parkinsons Disease: Clinicans Desk Reference. Boca Raton, Florida: CRC Press. Hawley, J. S., Armstrong, M. J., & Weiner, W. J. (2014). Parkinsons disease: improving patient care. Hpathy Ezine. 2014. “Homeopathy for Parkinson’s Disease.” Hpathy. [Online] Available at: [Accessed 2nd June 2014] Jankovic, J., & Tolosa, E. (2007). Parkinsons disease and movement disorders. Philadelphia, Lippincott Williams & Wilkins. Jooeun S. M. S. et al. 2009. The Relationships Between the Unified Parkinson’s Disease Rating Scale and Lower Extremity Functional Performance in Persons With Early-Stage Parkinson’s Disease. Neurorehabil Neural Repair, 20, 7, pp. 657-661. Kim, S, Allen, N, Canning, C, & Fung, V. 2013, Postural Instability in Patients with Parkinsons Disease, CNS Drugs, 27, 2, pp. 97-112, Academic Search Premier, EBSCOhost, viewed 2 June 2014. Losing your sense of smell? 2012, Harvard Health Letter, 38, 2, p. 5, Academic Search Premier, EBSCOhost, viewed 2 June 2014. Peretz, C, Chillag-Talmor, O, Linn, S, Gurevich, T, El-Ad, B, Silverman, B, Friedman, N, & Giladi, N 2014, Parkinsons disease patients first treated at age 75 years or older: A comparative study, Parkinsonism & Related Disorders, 20, 1, pp. 69-74, Academic Search Premier, EBSCOhost, viewed 1 June 2014. Pfeiffer, R. F., Wszolek, Z. K. & Ebadi, M. 2012. Parkinsons Disease. Boca Raton, Florida: CRC Press. Reeve, Amy, Eve Simcox, and Doug Turnbull. "Ageing and Parkinsons disease: Why is advancing age the biggest risk factor?." Ageing Research Reviews 14, (March 2014): 19-30. Academic Search Premier, EBSCOhost [Accessed June 1, 2014]. Starr, P. A., Barbaro, N. M., & Larson, P. S. (2009). Neurosurgical operative atlas. New York, Thieme. Vermeulen, F. 2004. Prisma: the arcana of materia medica illuminated: similars and parallels between substance and remedy 3rd Edition. Haarlem, Emryss. Visanji, N. P. Brooks, P. L., Hazrat, L. & Lang, A. E. (2013). The prion hypothesis in Parkinsons disease: Braak to the future. Acta Neuropathologica Communications, 1, 2, pp. 1-12 Available at: [Accessed 2nd June 2014] Wienecke, M, Werth, E, Poryazova, R, Baumann-Vogel, H, Bassetti, C, Weller, M, Waldvogel, D, Storch, A, & Baumann, C 2012, Progressive dopamine and hypocretin deficiencies in Parkinsons disease: is there an impact on sleep and wakefulness?, Journal Of Sleep Research, 21, 6, pp. 710-717, Academic Search Premier, EBSCOhost, viewed 2 June 2014. Read More