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Parkinsons Disease - Medical Malpractice
Parkinson's disease is a nerve disorder that causes tremors and shaking of the body, problems with walking, difficulty moving and incoordination. It most often occurs in men and women over the age of fifty but can occur in individuals somewhat younger than that. It becomes a relatively common disorder when a person is elderly. Parkinson's disease in younger people most commonly comes from a hereditary form of the disorder and runs in a person's family. Parkinson's disease is quite rare in children.
Parkinson's disease is caused by a lack of the dopamine producing cells in the brain. The end result is low dopamine, which is a neurotransmitter that controls movement and personality. The dopamine messages cannot get to the body and the result is muscles and nerves that do not work. No one knows why these dopamine producing cells do not work and why they waste away. People who have Parkinson's disease are said to have "parkinsonism". There can be causes of secondary Parkinsonism as well, such as the use of certain antipsychotic medications.
The main symptoms of Parkinson's disease tend to come on gradually and worsen as the disease progresses. Symptoms you should be looking out for include the loss of automatic movements, such as blinking movements. Constipation occurs as does difficulty swallowing. The person can drool excessively, and there can be a problem with walking and balance. There can be a mask-like face with lack of expression in it. Muscles can hurt or ache. Movement in general is slowed and there can be tremors, particularly noticeable in the hands as a "pill rolling tremor", specific to Parkinson's disease. The tremor is worse with rest and goes away with movement of the hands or arms. The person can have problems getting into or out of a chair due to coordination and strength problems. Small hand movements become difficult to do so that writing becomes really small and shaky. Eating becomes a problem as the disease progresses.
The speech in Parkinson's disease becomes softer and the individual speaks in a monotone voice. There are related symptoms, such as anxiety and stress-related symptoms, confusion, depression, Parkinson's dementia, fainting spells, hallucinations and loss of memory. The disease can mimic Alzheimer's dementia in some cases.
Doctors need to do a complete history and physical examination in order to detect the presence of Parkinson's disease. The doctor looks for stiff and jerky movements, difficulty starting voluntary movement, atrophy of the muscles, heart rate variability, and Parkinsonian tremors. The reflexes tend to be normal and a CT scan of the brain may show evidence of atrophy of the dopamine-secreting areas of the brain.
Parkinson's disease cannot be cured but its symptoms can be managed with medication and physical therapy. The mainstay of medical treatment is the giving of dopamine in the form of L-dopa. This is a precursor to regular dopamine and replaces some of the lost dopamine in the body.
Each type of medication for Parkinson's disease has different half-lives. The goal is to keep the medication in the system for as long as possible to control the symptoms. Sometimes the sensitivity to L-dopa wears off and the individual needs to have a temporary drug holiday. This is often done in a hospital system.
Physical therapy involves strengthening the muscles and providing ways to teach the person how to improve coordination. It may involve teaching them the use of a walker or a cane.
The medications used to treat Parkinson's disease include Levodopa, Mirapex, Seligiline, Amantadine and Entacapone, to prevent the breakdown of L-dopa. There are side effects of these medications including hallucinations, nausea, diarrhoea, vomiting, and delirium. If these side effects occur, the dosage needs to be reduced.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here