In today’s world, brain and nervous system problems are common. These neurological disorders include Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, epilepsy, and stroke. These types of disorders can affect memory and ability to perform daily activities. In this paper, we will be taking a closer look into Parkinson’s disease (PD), a movement disorder that has personally affected a close member of my family. In 1817, a doctor from London by the name of James Parkinson wrote a paper titled An Essay On the Shaking Palsy.
In the essay, Parkinson observed 3 of his patients and 3 people off of the street. He goes on to write about the three main symptoms he observed which were described as postural instability, rigidity, and tremors. Parkinson believed that the disease developed because of a problem in the brain’s medulla region. At the time it was published, it received little to no attention from the medical community. That is until 1861 when French neurologist Jean-Martin Charcot and his team brought light to his work, distinguished the disease from other conditions and dubbed it “Parkinson’s disease.
“. For years, doctors could not find ways to treat Parkinson’s disease effectively. In the late 1800s drugs like morphine, arsenic & cannabis were given to patients to treat the tremor symptoms. Going forward to the 1950s, neurosurgeons actually began to perform surgery on the basal ganglia of the brain. This lead to some improvementsin the symptoms associated with Parkinson’s disease but also lead to death in about 10% of patients, so it was considered a risky procedure (McCoy, Parkinson’s Disease Then and Now.
) Before continuing to how we treat Parkinson’s disease today, let’s talk about how the disease works. To understand how it works, we need to know how our neurons affect our body’s movement and how Parkinson’s disease effects the brain. Movement in our bodies is controlled by complex chains of neurons that are located in the deep parts of our brains called the basal ganglia and substantia nigra. The substantia nigra has neurons that produce neurotransmitter dopamine and is also in charge of relaying messages that come from the striatum, back and forth from the brain to the spinal cord. The basal ganglia works with the cerebellum to ensure that movement is carried out smooth and fluidly. For reasons still unknown, Parkinson’s disease is when the dopamine-producing nerve cells of the substantia nigra begin to die off. When not enough dopamine is produced, parts of the basal ganglia are either over or under stimulated. The main symptoms of Parkinson’s disease, tremor and stiffness, occur when the nerve cells fire andthere isn’t enough dopamine to transmit messages. The body tries to compensate for the lack of dopamine by producing high levels of glutamate. Something to note about the disease is that it’s progressive. It gets worse with age and can lead to other neurological complications such as dementia. It’s estimated that roughly 50 to 80 percent of patients will experience PD Dementia. The PD Dementia usually begins to show/take effect anywhere from 5-15 years after the initial diagnosis of Parkinson’s. (Mayfield Brain & Spine,”Parkinson’s Disease (PD)) So now moving on to the treatment of Parkinson’s disease today, things are still tricky. PD varies between patients. When it comes to medications, there are two main routes. The first being Sinemet, which is a combination of levodopa and carbidopa. Levodopa is converted to dopamine in the brain. Carbidopa helps prevent the breakdown of levodopa before it can reach the brain and take effect.( RXList, Sinemet ) And then there are drugs like selegiline and rasagiline that conserves dopamine in the brain by blockingthe breakdown action of MAO-B. These medications are often taken in combination with one another in order to provide treatment. The downside to using the medications are the side effects. Not only can the drugs worsen the symptoms of the disease, it also can lead to sleepiness, confusion and hallucinations. Another thing to note is that medications will only have therapeutic effect for roughly 5-10 years before becoming ineffective. Moving on to Surgical options, the main one being Deep Brain Stimulation (DBS). During the procedure,surgeons implant a pacemaker-like device that sends electrical signals to brain areas responsible for body movement. Electrodes are placed in certain areas on the brain depending on the patients symptoms. The electrodes are placed on the sides of the brain and are connected to the device via a cable that runs from the skull, down the neck and on the chest. The benefits of the surgery the devices settings can be changed over time to accommodate the patients symptoms. It also causes no damage to the brain tissue,which leads to the possibility of one day becoming reversible. There are two other surgical options called pallidotomy and thalamotomy, which use high frequency energy currents to permanently destroy cells in specific areas of the brain.( Mayfield Brain & Spine, “Parkinson’s Disease(PD)” ) In conclusion, Parkinson’s is a serious condition that usually begins to show between ages 55-70. There are approximately 60,000 new cases of Parkinson’s every year in the U. S alone. Roughly 10,000,000 people worldwide are effected by the disease. With no known cure and limited treatment options, The Centers for Disease Control and Prevention (CDC) rated complications from PD as the 14th cause of death in the United States. (Parkinson’s Foundation, “What is Parkinson’s?)Works CitedMayfield Brain & Spine. Parkinson’s Disease (PD). Posture & Body Mechanics, Mayfield Brain & Spine, www.mayfieldclinic.com/PE-PD.htm.McCoy, Krisha. Parkinson’s Disease Then and Now. Stroke Center – EverydayHealth.com, Ziff Davis, LLC, 27 Apr. 2016, www.everydayhealth.com/parkinsons-disease/history-of-parkinsons-disease.aspx.Sinemet (Carbidopa-Levodopa) Patient Information: Side Effects and Drug Images at RxList. RxList, www.rxlist.com/sinemet-drug/patient-images-side-effects.htm.What Is Parkinson’s? Parkinson’s Foundation, 17 Oct. 2018, www.parkinson.org/understanding-parkinsons/what-is-parkinsons.
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