PARKINSON’S DISEASES - What are they?
The term Parkinson’s disease is long established, and most people associate it with a disorder of the brain of unknown cause that results in tremor and difficulty in walking. Dr Parkinson however simply had to rely on his observation and as we are now able to take detailed images of the brain using MRI and CT and as we understand more about the biochemistry and the genomics of the way in which the body works it is clear that there are a number of different conditions all of which result in difficulty with movement and, to a greater and lesser degree, tremor.
Some people with these conditions are very disabled with tremor for others it is immobility combined with sudden blocking of movement when they are walking which means they are unable to take the next step that they want to take. There is an increased risk of dementia associated with these conditions, but it is not inevitable.
Why are Parkinson’s diseases important?
This is classified usually as a ‘movement disorder ‘and that expresses it very well. People affected find it difficult to carry out the movements they want to not because of muscle weakness or joint stiffness but because the part of the brain that decides to do something, for example to walk down the garden path, cannot communicate that effectively to the parts of the brain that can control the muscles and the coordination of the muscles that allow us to walk down the garden path without thinking.
For some people tremor is very disabling but this does not mean that if you notice tremor you are in the early stages of Parkinson’s disease. Tremor is very common, but the tremor of parkinson’s s very disabling it means that some people are unable to pour a cup of tea or drink a cup of tea.
why is it important to understand the condition ?
This is not normal ageing and it is not a preventable disease. There is nothing the person could have done to prevent it. Depression is understandably very common
Specialised services can make a great contribution but you may need to be firm about getting a referral
Can progession be slowed or reduced or reversed?
Fortunately there are now effective treatments for these conditions. These rarely result in what can be considered a cure but if the right treatment is prescribed, they can significantly reduce the symptoms from being disabling to being a nuisance.
What is also clear now is that becoming more active is effective at reducing the distressing symptoms. This may seem a paradox. The person has a movement disorder so it might be thought that rest is best but in fact the opposite is true. It is now clear that the brain can relearn lost skills and can gain new skills in what is called neuroplasticity because new links developed between the brain cells.
Many people with Parkinson’s dancing helpful in part because the music may stimulate the brain as well as the social factors involved in dancing either with other people with Parkinson’s disease or with a club or society whose main mission is dancing.screening
People are now also experimenting with boxing and it does seem that the focused movement of learning boxing skills is helpful not just whilst it is being done and whilst it strengthens the muscles but that when a person with Parkinson’s suddenly comes to a stop they can think about the boxing moves that they make and this seems to unblock the block.
What can be done?
Parkinson’s disease is common but very few general practitioners see enough people with Parkinson’s disease to develop the full range of skills that are required and therefore referral to a specialist service is of great importance. The specialist service maybe the neurology department or a geriatric medicine department and involves not only the consultant physicians but also specialist nurses and physiotherapists with a special interest in neurology disease in general and Parkinson’s disease in particular.
In addition Parkinson’s UK, the national charity for people with Parkinson’s and their family has a very good website websiteand local branches.