What is Parkinson's disease? Symptoms, causes, and treatment
Parkinson's disease is one of the conditions of the nervous system often met among older adults, and it significantly affects the movement of the body. Although this condition cannot be cured completely, recognising and understanding the symptoms early helps the patient control them and have a better quality of life. This article will take you to a comprehensive understanding of Parkinson's disease, from the causes and the symptoms through to the approach to treatment and suitable care.
Getting to know Parkinson's disease
Let us first get to know Parkinson's disease at the outset. This condition has important characteristics of its own and clear risk groups. Knowing this information helps us watch for it and care for ourselves or those in our family in good time.
What is Parkinson's disease?
Parkinson's disease is a condition arising from an abnormality of the central nervous system, particularly in the part of the brain that controls the movement of the body. This condition arises from the gradual degeneration of the nerve cells in the part of the brain called the "Substantia Nigra", so that the production of the chemical called "dopamine" decreases. Dopamine has an important part in transmitting signals between nerve cells in order to control the movement of muscle. When there is not enough dopamine, the patient begins to have tremor, to move more slowly, and to find it harder to control balance. Parkinson's disease is usually found among older adults, particularly those aged from 60 years and over, but some patients begin to have symptoms from the age of 40-50 years, which is called "Young-Onset Parkinson's Disease". This condition is not contagious and is not a psychiatric condition, but a degenerative condition of the nervous system that greatly affects the quality of life of the patient and the family.
What is interesting is that medical studies find that patients with Parkinson's disease may have a slightly higher risk of stroke, although the two conditions have different mechanisms of arising. This connection arises from several factors, such as the problem of abnormal blood pressure in patients with Parkinson's, movement that has become limited, which brings a risk of blood clots, and shared risk factors such as increasing age, diabetes, and high blood pressure. Besides this, there is also a state called "Vascular Parkinsonism", which has symptoms similar to Parkinson's disease but arises from the blockage of small blood vessels in the brain at several points. Correct diagnosis and close care of the health of the blood vessels are therefore extremely important for patients with Parkinson's disease.
Is Parkinson's disease dangerous?
Although the danger of Parkinson's disease is not that it causes death directly, there are several dangers and complications to be careful of. The most important complication is falling, since the patient has problems of balance and movement. A fall may cause severe injury, such as a fractured hip or a fracture elsewhere, which may leave them bedbound and bring complications in its train, such as pneumonia or pressure sores. Besides this, in the later stage of the condition, the patient may have difficulty swallowing, which brings a risk of food or water going into the lungs, which may lead to pneumonia. Depression and problems of mental health, which are often found in patients, may also greatly affect quality of life and the will to continue treatment.
Who are the risk groups for Parkinson's disease?
Parkinson's disease is usually found in those aged over 60 years, and is found slightly more in men than in women. Besides age, other risk factors include a family history of Parkinson's disease, exposure to certain toxins such as pesticides, repeated injury to the head, and being male. But having these risk factors does not mean that the condition will certainly arise; it only increases the chance of it arising. Caring for your health on every side and avoiding the risk factors that can be controlled helps reduce the risk of the condition arising.
What are the symptoms of Parkinson's disease?
Knowing the symptoms of Parkinson's disease is important in making it possible to diagnose it and begin treatment in good time.
The warning signs and the early symptoms of Parkinson's disease
The early symptoms of Parkinson's disease are usually not severe and are easy to overlook. The warning signs that should be noticed include:
The general symptoms usually found in the first stage:
- Feeling more tired than usual
- Moving slightly more slowly
- Handwriting changing, becoming smaller or more cramped
- Losing the ability to smell
- Having problems sleeping
The particular symptoms that are clearly noticeable:
- Slight tremor of the fingers or of one hand while at rest
- The face looking less expressive than it used to
- The voice becoming quieter or less clear than before
- The symptoms usually beginning on one side of the body first
The 5 stages of Parkinson's disease:
Understanding the stages of Parkinson's disease helps the patient and the family prepare to meet the challenges better:
- Stage 1: there are only slight symptoms and they usually arise on one side of the body
- Stage 2: the symptoms begin to spread to both sides of the body
- Stage 3: the patient begins to have problems of balance and a risk of falling
- Stage 4: the symptoms become more severe and help is needed in daily activities
- Stage 5: the most severe stage; the patient may have to use a wheelchair or be bedbound
The 4 main symptoms of Parkinson's disease
As Parkinson's disease progresses, there are 4 main symptoms that are the particular characteristics of this condition:
1. Tremor at rest (Resting Tremor)
- It usually begins in one hand or in the fingers of one hand
- It is clearly noticeable when the patient sits or stands still
- The symptom decreases when movement begins
2. Rigidity of the muscle (Rigidity)
- It makes them feel tight and unable to move nimbly
- The muscle lacks flexibility
- There may be muscle pain alongside
3. Slowing of movement (Bradykinesia)
- It affects activities in daily life
- Walking, dressing, or doing housework takes longer
- The steps become shorter and the feet drag
4. Poor balance and abnormal posture (Postural Instability)
- It gives the patient a higher risk of falling
- The posture in standing and walking changes, usually with the head bowed
- Balance is unsteady, particularly when changing posture
Important observations:
- All 4 symptoms may not arise together in every patient
- The severity of each symptom differs from one individual to another
- The symptoms gradually become more severe according to the stage of the condition
- In the first stage there may be only slight tremor or slowing of movement
- When the condition progresses to stage 3-4, the patient will begin to meet problems of balance more
- A walking aid or help from a carer may be needed
Other symptoms not involving movement
Besides the symptoms of movement, patients with Parkinson's disease may also have other symptoms affecting their quality of life. These symptoms include depression and anxiety; problems of sleep, such as insomnia or not sleeping soundly; abnormality of the system of elimination, such as constipation or frequent urination; problems of memory and thinking, which may develop into dementia in some patients; problems of swallowing and excessive salivation; low blood pressure on standing up; and sweating abnormally much or little. These symptoms may arise before or after the symptoms of movement, and may significantly affect the patient's quality of life.
The causes of Parkinson's disease
Although there has already been a great deal of research on Parkinson's disease, the real cause of this condition is still not definitely known. But doctors have identified the main factors involved in the arising of this condition, most of which involve the working of the brain and factors both inside and outside the body.
The decrease of dopamine in the brain
The main cause of the symptoms of Parkinson's disease is the decrease of dopamine in the brain. When the nerve cells in the Substantia Nigra part of the brain degenerate or die, the production of dopamine decreases accordingly. Dopamine is a neurotransmitter with an important part in transmitting signals in order to control the movement of the body. When the level of dopamine decreases by about 60-80%, the patient begins to have clearly noticeable symptoms of the condition. Although the cause of the degeneration of these nerve cells is still not definitely known, it is believed to involve several factors working together.
Genetic and environmental factors
Although most cases of Parkinson's disease are not inherited directly, researchers have found certain genes involved in the condition, particularly where it begins to arise at a young age. Environmental factors also have an important part. Exposure to certain toxins, such as pesticides, heavy metals, or industrial chemicals, may increase the risk of the condition arising, and repeated injury to the head may be a risk factor as well. Overall, Parkinson's disease probably arises from several factors working together, both genetic and environmental.
The approach to treating Parkinson's disease
Although Parkinson's disease cannot be cured completely, there are several approaches to treatment that can help relieve the symptoms and improve the patient's quality of life effectively. The treatment emphasises controlling the symptoms and helping the patient carry on daily life with quality.
Physiotherapy and occupational therapy
Physiotherapy has an important part in helping patients with Parkinson's disease maintain the strength of the muscle, flexibility, and the capacity for movement. The physiotherapist will design a programme of exercise suited to each individual, such as walking, stretching, balance training, and training the strength of the muscle. Besides this, occupational therapy also helps the patient carry out daily activities more effectively, such as dressing, eating, or doing housework.
Treatment with medication to control the symptoms
Treatment with medication is the main approach to managing the symptoms of Parkinson's disease. The medicine most widely used is Levodopa, which is converted into dopamine in the brain. It is usually used together with Carbidopa to increase its effectiveness and reduce side effects. Besides this there are other groups of medicine, such as Dopamine agonists, MAO-B inhibitors, and COMT inhibitors. The doctor will choose the medicine suited to each individual, taking into account the symptoms, the age, and the side effects that may arise.
Treatment with Botulinum Toxin (Botox)
Injection of Botox, or botulinum toxin, is another option in treating some symptoms of Parkinson's disease, particularly where the patient has particular symptoms that ordinary medicines cannot control well enough. Botox works by inhibiting the release of the neurotransmitter that makes the muscle contract. The medicine takes effect about 1 -2 weeks after the injection, with the result that the muscle relaxes and the symptoms related to the tightness of the muscle are reduced. The effect of the medicine gradually wears off within 3-6 months, and it may have to be injected again as necessary.
Deep Brain Stimulation surgery (Deep Brain Stimulation: DBS)
For patients whose symptoms cannot be controlled well with medication, deep brain stimulation surgery may be an option. This method involves implanting electrodes into the brain and connecting them to an electrical stimulator implanted under the skin. The device sends an electric current to help reduce tremor, rigidity, and slowness of movement. Although it does not cure the condition completely, it helps control the symptoms better and may reduce the amount of medication needed.
Treatment with modern medical technology at PYONG Clinic
At PYONG Rehabilitation Clinic we have brought technology of world standard into use in rehabilitating patients with Parkinson's disease, the technologies that stand out being:
- Gait training with the Exoskeleton robot (Robotic Exoskeleton Gait Training), which helps train the patient's walking and balance effectively. The system helps support the weight and control the movement of the legs, so that the patient can train walking safely and more effectively
- Stimulation of the brain with a magnetic field (Transcranial Magnetic Stimulation: TMS) and stimulation of the brain with a direct electric current (Transcranial Direct Current Stimulation: tDCS). These technologies help stimulate the working of the brain in the area that controls movement, and can help improve the symptoms of patients with Parkinson's disease effectively
- Training the movement of the hand with a robot with an AR system (Robotic AR-Integrated Hand Neurorehabilitation), which helps patients with a problem of controlling the hand and fingers train the skills of movement enjoyably and effectively through games and various activities
- Stimulation with a magnetic field over the muscle (Peripheral Magnetic Stimulation: PMS), which helps increase the strength of the muscle and reduce the tightness of muscle arising from Parkinson's disease
- Analysis and training of the brain waves (Brain Wave Analysis and Training), which helps the doctor assess the working of the brain and design a plan of treatment suited to each individual patient precisely
Self-care and changes of habit
Self-care is no less important than medical treatment. Exercising regularly helps maintain strength and reduce depression. Eating food of nutritional value, particularly food high in fibre, drinking water, and resting enough are also important. Adjusting the environment in the home to be safe helps reduce the risk of falling. Besides this, taking part in social activities and doing activities you like also helps maintain mental health very well.
Caring for patients with Parkinson's disease
Caring for patients with Parkinson's disease depends on the cooperation of the doctor, the family, and the carers. Understanding and giving suitable support helps the patient have a better quality of life.
Advice for patients and families
Studying and gaining knowledge about Parkinson's disease helps you meet various situations better. Communicating openly between patient and family is important. Appointments with the doctor should be kept consistently and the advice followed strictly. Joining a support group helps you exchange experience and receive encouragement. Carers should look after their own health as well, finding time to rest and doing relaxing activities to prevent burnout.
Managing the challenges in daily life
The patient should plan and manage their time appropriately, doing the activities that need most concentration during the period when the medicine is working, dividing tasks into small steps, and giving themselves more time. Using aids such as a walking stick helps make activities easier. Adjusting the environment in the home, such as arranging the furniture so that it is convenient to walk, fitting handrails, and using enough light, increases safety. Keeping a positive attitude and focusing on what can still be done helps you be happier with life.
Frequently asked questions about Parkinson's disease
When Parkinson's disease is discussed, there are usually several questions that patients and families wonder about. Receiving a clear answer helps you understand and manage the condition better.
Can Parkinson's disease be cured completely?
At present Parkinson's disease still cannot be cured completely, since it is a condition arising from the degeneration of nerve cells in the brain, which cannot be restored. However, present treatment can control the symptoms well, particularly in the first stage. Medication and the various therapies help the patient have a good quality of life and carry out daily activities almost normally. Suitable treatment and correct self-care help slow the progress of the condition and maintain the capacity to carry out activities for as long as possible.
Is this condition inherited?
Most cases of Parkinson's disease (85-90%) are not inherited directly. However, about 10-15% of patients have a family history of this condition, particularly where it begins to arise at a young age (before the age of 50 years). Having a direct relative with Parkinson's disease increases the risk only slightly, from about 1-2% in the general population to 3-4%. So even with a family history, it does not mean that the condition will certainly arise.
When should a doctor be seen?
A doctor should be seen without delay when you notice symptoms that may indicate Parkinson's disease, including tremor of the hand or fingers at rest, moving more slowly than usual, rigidity of the muscle, poor balance, a face without expression, a changed way of walking, handwriting becoming smaller or more cramped, or a voice that is quiet and unclear. Diagnosis and beginning treatment early help control the symptoms well and slow the progress of the condition. Do not hesitate to consult a doctor when you have doubts about your own health.
Summary
Parkinson's disease is a condition arising from an abnormality of the nervous system, affecting the movement and the quality of life of the patient. Although this condition cannot be cured completely, suitable treatment can help control the symptoms and improve quality of life greatly. Understanding the symptoms, the causes, and the approach to treatment, together with suitable self-care, helps the patient and the family manage the condition better.
At PYONG Rehabilitation Clinic we are committed to offering treatment and rehabilitation for patients with Parkinson's disease with the most modern medical technology, under the care of a team of physicians in rehabilitation medicine and specialist physicians in the field of neurology (specialist physicians in conditions of the brain and the nervous system), together with a multidisciplinary team of high expertise. We use the principles "Curated by Experts" and "Best in Class Technology" in designing a plan of treatment suited to the individual, combining diagnosis and the management of medication with advanced rehabilitation technology, so that the patient receives comprehensive care and can return to living with quality.