Parkinson's Disease

April is Parkinson Awareness Month and presents an important opportunity for all residents of Anguilla to become better informed about this neurological disorder. In many countries, including Anguilla, people are reluctant to talk about Parkinson’s disease and it appears to be a deep, dark secret for sufferers.

What is Parkinson’s disease?
Parkinson’s disease is a disorder of the brain that affects the transmission of messages to the muscles. It is characterized by tremor, stiffness of the muscles, and difficulty in initiating movements. It occurs most often in later life, but can also affect younger people. Men face almost twice the risk of developing the condition. Parkinson’s disease is a progressive disease, which means that it normally worsens over time. It usually, but not always, develops slowly.

What causes Parkinson’s Disease?
The causes of Parkinson’s disease are largely unknown and, while there are treatments, we have yet to find a cure. The symptoms range from mild sleep disturbance to debilitating tremors that can affect all aspects life.

What are the symptoms of Parkinson’s Disease?
Patients’ individual symptoms may be quite dissimilar and progression of the disease is also distinctly individual.
Symptoms may include the following:
• Tremor or involuntary movements - One or both hands or limbs may exhibit an involuntary trembling, which lessens when the person is using the affected part. Involuntary movements of the hand are common, and the person may seem to be “rolling” something between the fingers.
• Rigidity of muscles; slowness of body movement - Posture may be stiff or stooped, with diminished movement of the arms and legs.
• Shuffling gait - The person may take small, cautious steps, or may alternate slow steps with rapid ones.
• Loss of facial mobility - The person’s face may seem to be expressionless.
• Speech difficulties - Speech may be slow and expressionless, and the voice a low-pitched monotone.
• Impaired balance - The person may have difficulty balancing or sitting up straight.
• Deteriorating handwriting - The person’s writing becomes cramped, smaller and more difficult to read.

How is Parkinson’s disease diagnosed?
At present, there are no laboratory tests that can confirm the diagnosis of Parkinson’s disease. In order to arrive at a diagnosis, the physician takes a family and health history from the person, and performs a thorough physical and neurological examination, observing the person’s movements and muscle function. The physician will also rule out other disorders that can cause similar symptoms. Early diagnosis of Parkinson’s disease is important so that appropriate treatment can begin.
Management of Parkinson’s Disease
For now, there is no cure for Parkinson’s disease. But with early diagnosis and an effective plan of treatment, the symptoms of the disease can often be controlled or lessened. Treatment varies widely for each individual, and may include:
• Medication therapy - A number of drugs can help control the symptoms of Parkinson’s disease. The choice of correct drug or drugs, the dosage, the method of taking medication, and the risk of side effects of drugs vary from person to person, requiring careful physician supervision.
• Rehabilitative therapy - Physical, occupational and speech therapists can assess the person’s abilities and needs, and provide exercises to help maintain the highest possible range of motion, muscle tone, balance and flexibility, and communication ability.
• Lifestyle alterations - Exercise helps maintain muscle tone and strength. Diet is important for nutrition, for maintaining an appropriate weight and because protein level may be a factor in the person’s condition. Rest and stress reduction are also important.
Support groups and counselling should be available to help the person and family members deal with the social and emotional impact of Parkinson’s disease.

Conclusion
Parkinson’s disease affects many individuals in Anguilla, but very often individuals with this disease have to suffer in silence as the disease is under-diagnosed and individuals with the disease or their family members are often too embarrassed to talk about the illness and seldom seek medical or professional help. Individuals with this illness should be encouraged to see their health care professional and can receive some help to cope with this degenerative disorder.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.