What is Parkinson’s Disease?
Parkinson’s is a type of dementia, ranked as the second most common after Alzheimer’s disease.
Parkinson’s disease is the degeneration of brain cells in the brainstem, which is the part that produces a neurotransmitter called dopamine. Dopamine helps control body movements. When the chemical balance in the brain is disrupted, it causes abnormal movements.
Incidence Rate of Parkinson’s Disease
Parkinson’s patients are found at a rate of 1 person per 1,000 population. The ratio of men to women is 1.1:1, and Parkinson’s disease is usually found in patients aged 50 years and older.
Risk Factors for Parkinson’s Disease
- Elderly people
- Those who use certain psychiatric medications
- Those with a history of head injury
- Occupations at risk of head trauma, such as boxers and football players
- Genetics, found in a small portion
Movement-Related Symptoms
- Tremors that occur when at rest or during inactivity
- Muscle stiffness and slow movements
- Difficulty walking, short steps, and easy falls
Non-Movement-Related Symptoms
- Sleepwalking and frequent nightmares
- Chronic constipation
- Depression
- Soft and slow speech
- Severe cases may have difficulty swallowing and frequent choking
Impacts of Parkinson’s Disease
- Decreased quality of life due to difficulty moving, which may affect the ability to perform daily activities independently
- Increased risk of accidents such as falls, leading to injuries
- Psychological impact when unable to perform daily activities independently or socialize
- Social impact, including difficulty socializing, communication problems, and tremors affecting appearance
- Impact on family, requiring time to assist with care, which may increase family members’ anxiety
- Economic impact due to inability to work as before and the cost of care and treatment
Diagnosis of Parkinson’s Disease
- History taking, symptom examination, and neurological physical examination
- MRI Brain scan to differentiate from other diseases with similar symptoms
- PET Brain F-Dopa scan to assess brain function and dopamine abnormalities, which is not necessary for every case and may be considered selectively by the doctor
Treatment of Parkinson’s Disease
- Medication treatment
This is symptomatic treatment that replaces or balances dopamine in the brain but cannot restore degenerated brain cells. Regular doctor visits are necessary to adjust medication according to symptoms and daily activities.
Physical Therapy and Exercise for Parkinson’s Patients
It is essential to restore physical function, such as walking training, speech training, swallowing training, running, and cycling.
Surgical Treatment for Parkinson’s
After long-term medication, drug resistance may develop. If medication adjustment improves symptoms, medication treatment continues. If symptoms do not improve with medication, surgery with Deep Brain Stimulation (DBS) may be considered.
Deep Brain Stimulation (DBS) Surgery
Doctors consider DBS surgery when abnormal movement symptoms cannot be controlled with medication, medication effects wear off too quickly, there are medication-induced dyskinesias, or the patient experiences significant side effects from medication.
DBS surgery treats abnormal movements by electrically stimulating deep brain areas. The doctor drills two small holes in the skull and inserts wires into the brain, connected under the scalp down to the neck and chest, linked to an electronic device implanted in the chest that sends electrical impulses to stimulate the brain.
During surgery, after drilling the skull holes, the patient is initially sedated but remains awake during wire implantation so the doctor can test if electrical stimulation improves symptoms before closing the wound.
Advantages of DBS Surgery: The doctor can adjust the device after surgery to match the patient’s symptoms
- Care for Parkinson’s Patients
Besides medical treatment with medication, physical therapy, rehabilitation, or surgery, an essential part of care is home care. Family members play a crucial role in caregiving because Parkinson’s symptoms cause movement difficulties and depression, a psychological condition that affects daily life and social interaction. Care includes the following:
Preventing Accidents Due to Movement Difficulties and Loss of Balance, such as
- Choosing shoes with non-slip soles
- Keeping walkways free of obstacles
- Installing grab bars and ensuring non-slip bathroom floors
- Patients should walk according to doctor or physical therapist advice, such as lifting feet high, taking long steps, and walking slowly
- Regular exercise as recommended by doctors or physical therapists
- For severe swallowing problems, choose easy-to-chew foods, take small bites, and wait to swallow before the next bite
- Ensure patients take medication and attend regular doctor visits to evaluate symptoms and adjust medication or DBS device settings to match symptoms
- Family members should encourage patients, assist with transportation to medical appointments, rehabilitation, meal preparation, and creating a safe environment
Can Parkinson’s Disease Be Prevented?
Since the exact medical cause of Parkinson’s disease is still unclear, it is believed to be related to various risk factors that we can avoid to slow brain cell degeneration. Therefore, we should reduce risk factors by exercising regularly, getting enough rest, managing stress, avoiding exposure to toxic environments, and monitoring ourselves or family members for abnormal symptoms. If uncertain, consult a doctor because some symptoms may resemble Parkinson’s but could be more dangerous, allowing for early treatment.
