Causes and Treatment of Parkinsons Disease - Essay Example

PARKINSON DISEASE EPIDEMIOLOGY and AETIOLOGY In today’s society, the prevalence and incidence of Parkinson’s disease continue to increase affectingboth males and females as the population ages. Stephen and company in their study (2003) pointed out that the rapid increase of incidence is over 60 years old with a small percentage of cases under 50. They further found out that its incidence varies by race and ethnicity. Throughout the world, it is estimated that about millions are affected. The disease is a slow degenerative disorder of the central nervous system impairing cognitive, motor and other bodily functions (Tortora 2008). Despite many studies conducted about the disease, the cause of it is unknown. However, it is known that the prevalence of the disease is caused with the interplay of genetics and environment. It is known that the mutation of genes in the family will likely to pass it on to the next generation. Factors like toxins, smoking, and vitamin E deficiency is shown to play a role in its prevalence too as the brain and the nervous systems are sensitive to their presence. PATHOPHYSIOLOGY The disease process involves the importance of the cerebral nuclei in regulating motor functions of the body. Normally, neurons that lead to the cerebral nuclei secrete dopamine. Dopamine inhibits the excitatory effects of acetylcholine produced by other neurons in the cerebral nuclei thus maintain balance. Output of the muscle which regulates signals from the nuclei is being restraint (Thibodeau & patton 2003). However, in the case of Parkinson disease, neurons that lead to the substantia nigra degenerate resulting to a decrease in dopamine amount being released. The patients will now have an imbalance between the brain chemicals dopamine and acetylcholine. Deficiency of dopamine and homovanillic acid and an excess of cholinergic neurotransmitters (Pearce 1978, pp 1664–1666) is evident. The excitatory effect is not controlled and the cerebral nuclei produces excessive signal affecting voluntary muscles to other parts of the body. This brings about complex network disorder including excitability, abnormal oscillatory activity, non- synchrony and reduced limbic and sensory functions (Wichmann 2008). Genes Environmental factors Impaired nuclei Reduced dopamine increased cholinergic neurotransmitter Tremor Rigidity Postural stooping bradykinesia Diagram showing pathophysiology of Parkinson SIGNS and SYMPTOMS On assessment, the patient may present several signs and symptoms. The most common is the tremor which is observed mainly on the upper limbs. This is characterised by back and forth movement or the “pin rolling”. Usually the patient experience “resting” tremor. The tremor however may disappear when the patient moves voluntarily and when he sleeps. Other symptoms include rigidity of cogwheel type which is due to stiffness and increased muscle tone (Miller & Stein 2000). What happens with rigidity is that the signal coming from the brain is disturbed thus the muscle remains tensed and contracted. As a result, the patient may feel pain when he moves. The muscle also becomes weak because the opposing muscle is relaxed with the same altered brain signal. The patient may also experience bradykinesia characterized by slow automatic movement (Stein & Miller 2000). Movement could be unpredictable. At one time the movement is easy but other times it could be difficult needing assistance. This makes simple activity like dressing or washing takes time for a patient. Stooped posture is also evident with Parkinson patients characterized by leaning forward and backward. Having this kind of instability may lead to impaired balance and coordination which might cause fall or bumps. As the disease progresses, the patient may also develop shuffling propulsive gait. He may also have the relaxed arm swinging while walking with bend trunk. Thus a Parkinson patient is said to resemble a car without a break (Hladysz n. d). All of the syndrome effect is a result of the overstimulation of the postural muscle of the neck trunk, and upper limbs. Other motor and muscle activity impairment may develop like swallowing, digestion and elimination. Aside from this, symptoms may still involve speech impairment. Speech could be monotonous and repetitive or even rapid. Depression is also present with the disorder as a result of the chemical imbalance in the brain. The patient usually does not connect with what is being talk about in times of conversation because of the defect in thinking, memory, and language. This is so because structural change in the brain may cause cognitive impairment (Beyer et al. 2007). MEDICAL TEST Diagnosing Parkinson’ disease is not easy. There are no standard reliable medical tests for it. CT-scan and magnetic resonance imaging are being used by medical practitioners but despite of the long adaptation of these technologies, it is surprisingly not considered to have a practical place in coming up with a diagnosis (Bradley 2006). However, most analysis revealed that its use is to eliminate the presence of tumor in the brain or strokes presenting the same signs and symptoms of Parkinson. A new diagnostic tool, positron emission tomography is gaining popularity in the diagnosis of the disease. It is to measure dopamine and atrophy in the substancia nigra of the brain (Dagher & Nagano 2007). The scan is preferred because of its sensitivity to dopamine cells. Another break through is the use of low cost DNA sequencing test that screen 17 genes introduced by Rubio and his group. However, this test is still young in its application. Contrary to expectations, a good history along with physical examination and assessing responsiveness of the patient to levodopa remains the strongest tool (Bardley 2006). RED FLAGS When caring for a Parkinson patient at home using alternative medicine, associated condition like dementia should warn the caregiver to bring the patient to a general practitioner. Dementia affects memory and thinking that may pose danger because the patient could not be able to care for herself anymore. Symptoms of it are agitation, memory problems, social withdrawal and difficulty in writing and reading. The attention of the physician is needed in this scenario as loss of memory may take the patient anywhere as he may have difficulty finding his way home. This may pose burden to caregivers and family members. Bringing the patient to a general practitioner may arrest further progression and at the same time caregivers and family members will be given additional measures to consider. ORTHODOX TREATMENT The main orthodox treatment for Parkinson disease is the use of levodopa, a drug employed 40 years ago. The employment of Levodopa rests on the belief that Parkinson is cause by reduced dopamine in which L-dopa may counter act by increasing its production. The drug may also relieve tremor, rigidity, and bradykinesia. However, there are side effects of the drug like nausea, vomiting, postural hypotension, and mental changes. Observation also reveals that patient can be in a “freezing attack” where their body become immobile for few minutes or seconds after medication. Care givers and patient should be cautioned for some of the contraindicated foods the patient must not take in while taking the drug. The patient should not take in vitamin B6 (pyridoxine) in combination with the drug. Foods rich in such vitamin like whole grain, bananas, liver, potatoes, and raw nuts must also be limited since it ruins the drug effectiveness. Further, the drug should not be combined with protein meals. Further, for the drug to really work, NADH, a co enzyme is needed. Patients who had been taking niacin which is one of the compositions of NADH are observed to have improved. Other alternative is home remedies that includes continuous bath. This is done by dipping the patient in a bath tub while water continuous to flow with 92 to 98 degrees room temperature. The temperature depends on the preference of the patient. Slight massage could be applied too and the treatment should be 5 to 6 times a week. The main goal of this therapy is maintain comfort of the patient as it is believed that discomforts may trigger attacks of symptoms. Exercise also proves helpful. Parkinson patients should be active to maintain good muscle tone and for optimum balance, coordination, and mobility. This corroborates with the study of Palmer and company (1986) where their 12 week program exercise showed that there is an improvement of patient’s gait, grip strength, tremor and motor coordination and other tasks requiring fine control after completing program. MAIN HOMEOPATHIC REMEDIES Homeopathic treatment comes in many forms. This treatment relies on the law pf physics and chemistry (www.holisticonline.com/Homeopathy). Choice all depends on the targeted symptoms to improve. Among them are Mercurius, Zincum Metallicum, Rhus Toxicodendron. Mercurius Mercurius is derived from the element mercury with a long history of medicinal use. It has been adapted during the early times of Chinese and Hindu civilization. Today, it used to treat symptoms of Parkinson but it is being diluted first with milk sugar (www.herbs2000.com). This remedy controls symptoms like excessive hand trembling and stammering. The patient’s skin feels moist and can frequently sweat. It becomes worst when the person is perspiring. These symptoms become worst during cold weather. The patient may also experience joint pain and could have difficulty when speaking. Over all symptoms could be aggravated during night time including itching ( Hill 2010). Zincum Metallicum This homeopathic remedy is sometimes referred to as “zinc” which is mineral found in sulphur. For homeopaths, this is an energy source for the nervous system (/www.natural-healing-guide.com). This covers symptoms like violent trembling affecting the whole body. This is evidently observed when the patient is in an emotional state. Extremities may be paralyzed while feet will continuously tremble. Because of trembling, writing could be difficult. The symptoms becomes worst when touch and during the early part of the evening. However the patient may feel better after a meal (Hill 2010). Rhus Toxicodendron Rhus Toxicodendron is recommended for patients having hot and painful joints when moving. This type of homeopathic remedy produces symptoms like tingling or crawling sensation in the finger tips. Trembling and numbing after exertion is also present but the person may feel better when moving around like stretching and walking. ADJUNCTIVE ADVICE Other alternative ways a patient may benefit from is lifestyle change like diet. Change in the diet is essential for this disorder. It is recommended that the patient has to eat more of raw organically grown foods. More emphasis is placed on raw nuts, seeds, sprouts, raw fruits and vegetables. Low protein diet is also suggested. Hyperketogenic diet is found to be beneficial too. An important finding consuming this type of diet where they replaced unsaturated fats to saturated fats reveals an improvement of participant’s rating scale (Vanitallie et al.2005). Although Parkinson disorder is impossible to eliminate, its presence and progression could be combated with the full understanding of its pathophysiology to plan for a more effective treatment as its effect is too much to ignore. References Beyer, M et al. 2007, A magnetic resonance imaging study of patients with Parkinsons disease with mild cognitive impairment and dementia using voxel‐based morphometry, Journal of Neurosurgical Psychiatry. 78(3): 254–259. Bradley, H 2006, Differential diagnosis of Parkinson disease: A new blood test, Clinical medicine & research, 4 (4) 246-247. Dagher, A & Nagano S 2007, Functional and anatomical magnetic resonance imaging in Parkinsons disease, Mol Imaging Biology, 9(4):234-42. Hill, C 2010, Homeopathic treatment for Parkinson disease, Viewed 2 December 2010, www.ehow.com/way_5459353_homeopathic-treatments-parkinsons-disease.html Hladysz, H n.d, Parkinson diseases: partially solved puzzle, Viewed 1 December 2010, www.a-renewedhealth.com/Health & Product info/Health_ Infomation/parkinson_disease.htm). Palmer, S, Webster, d, Bestivins, R, & Dickinson G1986, Exercise therapy for Parkinsons disease. Arch Phys Med Rehabil, Volume 67(10):741-5. Pearce, J 1987, Aetiology and natural history of Parkinson’s disease, British Medical journal. Vol. 16; 2(6153): 1664–1666. Stein, A & Miller, J 2000. NCLEX Review, Thomson learning, Australia Stephen, K et al. 2003, Incidence of Parkinson’s Disease: Variation by Age, Gender, and Race/Ethnicity. American Journal of Epidemiology. 157 (11): 1015-1022. Tortora, G 2008, Principles of Anatomy and Physiology, Wiley; 12 edition. ISBN-13: 978- 0470565100. Vanitallie, TB, Nonas, C Di Rocco A, Heymsfield, Sb 2005, Treatment of Parkinson disease with diet-induced hyperketonemia: a feasibility study, Neurology, 22;64(4):728-30. Wichmann, G 2008, Pathophysiology of Parkinson. Journal of clinical pathology. 03.017. Viewed 1 December 2010, onlinelibrary.wiley.com/doi/10.1111/j.1749- 6632.2003.tb07477.x/abstract. Homeopathy mercurius 2010, www.herbs2000.com/homeopathy/merc.htm, viewed 2 December,2010. Read More