10 Things You Should Know About Parkinson’s Disease
by Juan Osorio
Parkinson’s disease (PD) is a disease of the basal ganglia characterized by slowness in the initiation and execution of movement, increase muscle tone, tremor at rest, and impaired postural reflexes. It is named after James Parkinson, who, in 1817, wrote a classic essay on “shaking palsy” a disease whose cause is still unknown.
1. There is no cure for Parkinson’s disease.
2. The diagnosis of Parkinson’s disease increases with age, with the peak onset in the 70s and is more common in men by a ratio of 3:2
3. Symptoms of Parkinson’s disease do not occur until 80% of neurons in the substantia nigra are lost. The substantia nigra is located in the midbrain and controls voluntary movement, produces dopamine, and regulates moods. The dopamine cells begin to die therefore messages from the brain to the body are decreased and leave the person unable to control movements normally.
4. The classic manifestations of Parkinson’s disease often include tremor, rigidity, and bradykinesia which are often called the triad.
A. Tremor, often the first sign may be minimal initially therefore the patient is the only one who notices it. The tremor can affect handwriting and is described as “pill rolling” because the thumb and forefinger appear to move in a rotary fashion as if rolling a pill.
B. Rigidity, the second sign, is the increased resistance to passive motion when the limbs are moved through their range of motion. The rigidity is caused by sustained muscle contraction and elicits a complaint of muscle soreness; feeling tired and achy; pain in the head, upper body, spine, or legs.
C. Bradykinesia, the final sign of the triad is particularly evident in the loss of automatic movements. They include blinking of the eyelids, swinging of the arms while walking, swallowing of saliva, self expression with facial and hand movements, and minor movement of postural adjustment.
5. Genetic factors associated with Parkinson’s disease include 13 genes; environmental factors include exposures
to chemicals such as carbon monoxide and manganese; and the use of illicit drugs such as amphetamine and methamphetamine can also cause Parkinson’s disease.
6. Exercise can limit decreased mobility, such as muscle atrophy, contractures, and constipation. The American Parkinson Disease Association publishes booklets and videotapes that provide helpful exercises. A physical therapist or occupational therapist may be consulted to design a personal exercise program for the patient. Exercise will not halt the progress but will enhance the patient’s functional ability.
7. Diet is a major importance to patients with Parkinson’s disease because malnutrition and constipation can be serious consequences of inadequate nutrition. Patients should eat foods that are easily chewed and swallowed and should allow
themselves ample time for eating to avoid frustration and encourage independence. Patients are advised to limit their protein intake if they are on levodopa.
8. Parkinson’s can be treated with drug therapy that aims at correcting an imbalance of neurotransmitters within the central nervous system. Each patient must be evaluated to determine which medication is best for them. Some drug classes
include; Dopamine Agonists, Anticholinergics, MAO-B inhibitors and Carbidopa/Levodopa. Levodopa is the most effective and is being used in 70 to 80 percent of all Parkinson’s patients.
9. Parkinson’s disease can be treated surgically through deep brain stimulation (DBS). This involves placing an electrode in the thalamus, globus pallidus, or subthalamic nucleus and connecting it to a generator placed in the upper chest. The device delivers a specific current to the brain to improve motor function. This procedure is reversible if needed.
10. Parkinson’s disease interesting opinions: Adolf Hitler is said to have had the disease, people who smoke and drink are less likely to develop the disease, and Japan is the only country in the world that has more women than men with Parkinson’s disease.
PDF founder William Black. Parkinson’s Disease Foundation
American Parkinson Disease Association 135 Parkinson Avenue Staten Island, NY 10305-1425
Medical Surgical Nursing 7th Edition Vol. 2 pages 1549-1553
Sharon Lewis, RN, PhD, FAAN
Margaret Heitkemper, RN, PhD, FAAN
Shannon Dirksen, RN, PhD
Patricia O’Brien, APRN-BC, MA, MSN
Lind Bucher, RN, DNSc
Written by Juan Osorio, anatomy and physiology student.