Parkinson Disease as a Side Effect of Medication: Symptoms of Parkinsonism - Research Paper Example

Parkinson Disease is an ailment of the nervous system affecting the movement of the muscles. Patients’ suffering from this disease exhibit shaking of the hands and legs, stiffness of the muscles, and unsteadiness. Its development is gradual and results in difficulty of speech and locomotion. No cure has been forthcoming for this disease, although, some relief has been provided by medication and surgery. This disease is named after a British doctor, namely James Parkinson, who identified this illness in 1817. He had termed it as paralysis agitans, which denotes shaking palsy in Latin (Lieberman). Parkinsonism is chiefly characterized by akinesia or sluggishness in commencing movement, resting tremor and inflexibility of the trunk and limbs. A sizeable number of patients, who exhibit Parkinsonism, also suffer from Parkinson’s disease. The latter is the outcome of the loss of specific pigmented neurons in substantia nigra, which is located in the midbrain (Wolpow, May 2009. p. 7). These neurons employ dopamine, a neurotransmitter; and a significant number of the medications used in the treatment of this disease, attempt to imitate or replace the effects of dopamine. Furthermore, Parkinsonism can also transpire, as a side effect of medication, a notable instance being the drugs utilized in the treatment of schizophrenia. In addition, Parkinsonism can result from being exposed to toxic substances or on account of neurological conditions (Wolpow, May 2009. p. 7). Parkinson’s disease affects 1% of the adults, who are more than 60 years old. The cause for this disease has not been clearly determined, in most of the cases. The frequency of occurrence of this disease, and the major breakthroughs in controlling it require, even the general physicians to acquire functional knowledge about this ailment (Samii, Nutt, & Ransom, 29 May 2004. p. 1783). Parkinson’s disease is frequently observed among people who use pesticides and insecticides, regularly. However, a clear relationship between this disease and these toxic substances has not yet been established. Other substances, suspected to result in this disease are carbon monoxide, cyanide, manganese, some tranquilizers, and certain viruses. Direct exposure to these substances could result in this ailment. Some head injuries have also led to Parkinsonism (What Causes Parkinson's?). Some of the environmental factors responsible for Parkinson’s disease are injury or exposure to an environmental toxin. All the same, it has not been established, beyond any doubt that an environmental factor, in isolation, can result in this disease. Epidemiological research has pointed an accusing finger at rural living, well water, use of herbicides, and exposure to pesticides as the likely culprits in causing Parkinson’s disease. However, MPTP, a narcotic substance causes immediate and permanent Parkinsonism on being injected into the blood stream (What Causes Parkinson's?, 2009). Medical experts have identified aging as a cause for Parkinson’s disease in some people. However, the chief cause of this disease has been thought to be a combination of environment and genetics. Some 13 genes had been isolated, which were related to this disease. These genes have the capacity to bring about this affliction in some families (What Causes Parkinson's?, 2009). Despite the small number of cases, in which genetics seem to be involved; considerable research is being conducted on the effect of genetics on Parkinson’s disease. Such study is motivated by the hope that an understanding of the rarer forms of this disease could prove invaluable insights into the more common forms. The genes identified in this disease are PARK1, DJ-1 (PARK7), Pink1 (Park6), dardarin (DRDN), Tau, lrrk2, parkin, uchl-1, park3, park9, park10, and park11 (What Causes Parkinson's?, 2009). The principal symptoms of Parkinson’s disease are tremor or shaking at rest; rigidity and slowness in starting movement or bradykinesia. At least two of these symptoms should be present to diagnose the ailment as Parkinson’s disease. With the advancement of this disease a fourth characteristic symptom, namely postural instability develops. This last symptom, typically occurs after 8 years of this affliction (Parkinson Disease, 2009). The tremors experienced in this disease, generally commence in one of the arms. An increase in tremors is noticed in times of stress, and there is significant reduction in these tremors, while sleeping. With the passage of time both the arms of a patient could develop tremors. These tremors can extend to the chin, lips and the tongue. Specifically, tremors are seen in a limb that is at rest; and it could resemble a pill rolling motion or an oscillation of the arm (Parkinson Disease, 2009). Rigidity is another characteristic of this disease, and connotes an enhancement in the resistance exhibited, when an external attempt is made to move the patient’s joint. Such resistance could be either fluid or in fits and starts. A simple test of rigidity is to have some person flex and extend the previously relaxed wrists of the patient. It can be exhibited to a much greater extent by initiating voluntary movement in the other limb (Parkinson Disease, 2009). Another symptom is that of Bradykinesia, which denotes slowness of movement, reduction in unplanned movements and a diminution in the extent of movement. It is also exhibited as small handwriting or micrographia, decreased facial expression, soft speech and a reduced rate of blinking (Parkinson Disease, 2009). Parkinson’s disease defies diagnosis by means of any single test. A number of tests have to be performed, in order to eliminate conditions that result in symptoms that are akin to those of this ailment. Some of these tests are blood tests to ensure that the condition is not on account of hypothyroidism, which leads to slow movements. Another line of approach is to employ brain imaging techniques like magnetic resonance imaging, positron emission tomography and single photon emission computed tomography. These methods can be utilized to preclude cerebral stroke and brain tumors, whose symptoms are similar to that of Parkinson’s disease (Parkinson Disease, 2009). Another line of diagnostic approach to this disease is to document the medical history of the blood relations of the patient. This technique enables the physician to establish any genetic proclivity to this ailment, if present. Furthermore, a careful and protracted perusal of the patient’s movements makes it possible to detect movements that are native to this ailment. A diagnosis of Parkinson’s disease is returned by a physician, whenever there are at least two of the principal symptoms associated with this disease. However, one of these symptoms has to necessarily be that of bradykinesia or tremor (Parkinson Disease, 2009). Allopathy boasts of no cure for Parkinson’s disease, and at best offers management of the symptoms. The chief method of treatment is based on medication that attempts to assuage the symptoms. The symptoms of this disease arise from the gradual deterioration of middle brain’s nerve cells. The outcome of this degeneration is dopamine deficiency. The latter is essential for movements that are smooth and controlled (Parkinson's disease - treatment, 2009). This disease affects around a million Americans. Although it is predominant in the older men and women, it has been known to affect some of the younger citizens. In addition, it has been predicted by experts that the increasing longevity of the people of the world, the number of victims of this disease will increase. It is usually treated with the drug levodopa, which is transformed in the brain into dopamine. In this manner, the shortfall in dopamine is artificially made good. Unfortunately, levodopa has no effect on the changes to the brain, engendered by Parkinson’s disease. Furthermore, levodopa has side effects in some patients (Moore, 2001). However, some new drugs have been developed, which have proved to be more effective. Medication in this disease belongs to one of the categories, mentioned below. Levodopa or therapy that is founded on the replacement of the depleted dopamine. The employment of dopamine agonists, which replicate dopamine functionality. COMT inhibitors that block the enzyme COMT and thereby prevent the disintegration of levodopa in the intestine. This results in a greater amount to reach the brain. In addition, anticholinergics are used, which block acetylcholine’s effects and thereby increase dopamine levels. Similarly, amantadine therapy is also employed, which increases the transmission of dopamine. Finally, MAO type B inhibitors are utilized in therapy, which have the important property of disallowing dopamine metabolism in the brain (Parkinson's disease - treatment, 2009). Furthermore, the symptoms of Parkinsonism can be alleviated to a considerable extent by neurosurgery. There are three methods of neurosurgery that are frequently employed and they are; first, thalamotomy, wherein a lesion is effected on a portion of the brain, in order to reduce some types of tremor. Second, pallidotomy, in which dyskinesias or wriggling movements are mitigated by means of a lesion on some other part of the brain. Third, deep brain stimulation, which effects control over specific symptoms, by means of an electronic stimulator. In this method, the lesion is created by the electrical impulse. This lesion prevents the transmission of abnormal signals in the brain. The term brain pacemaker has frequently been given to this stimulator (Parkinson's disease - treatment, 2009). List of References Lieberman, A. (n.d.). Parkinson Disease. Retrieved October 5, 2009, from Microsoft® Encarta® Online Encyclopedia 2009: http://encarta.msn.com/encyclopedia_761568892_4/Parkinson_Disease.html#howtocite Moore, C. (2001, December 24). Parkinson's steps out of shadows. Cox News Service . Parkinson Disease. (2009). Retrieved October 5, 2009, from MSN Encarta: http://encarta.msn.com/encyclopedia_761568892_3/Parkinson_Disease.html#s10 Parkinson Disease. (2009). Retrieved October 5, 2009, from emedicinehealth: http://www.emedicinehealth.com/parkinson_disease/page3_em.htm Parkinson's disease - treatment. (2009, April). Retrieved October 5, 2009, from better health: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Parkinsons_disease_treatment Samii, A., Nutt, J. G., & Ransom, B. R. (29 May 2004). Parkinson's disease. The Lancet , Vol. 363, Issue 9423, pp. 1783 – 1793. What Causes Parkinson's? (n.d.). Retrieved October 5, 2009, from http://www.pdf.org/en/causes What Causes Parkinson's? (2009). Retrieved October 5, 2009, from Parkinson's Disease Foundation: http://www.pdf.org/en/causes Wolpow, E. (May 2009). Tremors. Harvard Health Letter , Vol. 34, Issue 7, p. 7. Read More