Parkinson's Disease Information



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June 23, 2009

Parkinson's Disease Treatment

Although there is no cure for Parkinson's Disease, there are several measures that can be taken to improve a patient's quality of life. These measure include drug and surgical therapy. The other options available include making lifestyle changes, and employing physical and speech therapy.

One of the very first options suggested by doctors is medication. There are several drugs available. All with different roles.

  • Levodopa – The most commonly prescribed drug for Parkinson's Disease. Levodopa is a chemical that is able to cross the blood-brain barrier and be converted to dopamine in the brain. It is technically known as a 'precursor to dopamine.'
  • Segeline – It's an MAO-B inhibitor. MAO-B is an enzyme that degrades dopamine, therefore inhibiting this enzyme causes dopamine to have a longer lasting effect on the brain.
  • Anticholigernic medications – They block nerve impulses that control muscle movement. They also block acetylecholine, a neurotransmitter that helps to regulate muscle movement. Anticholigernics work best in patients who are over 70, where their main symptoms are tremors and drooling.

Most people manage Parkinson's Disease with medication. But in some cases severe symptoms can heavily reduce one's quality of life and sometimes the medication’s side effects are difficult to deal with. In situations like these, a surgical alternative may be sought. There are several surgical options available, these include:

  • Pallidotomy – This procedure involves making a lesion in the globus pallidus. That is, destroying some of the cells in a particular part of the brain that controlls movement. Pallidotomy has been found to reduce dyskenasias (involuntary movements) by 70%-90%.
  • Deep Brain Stimulation (DBS) – Involves implanting a small metal electrode into the brain. The electrode is then attatched to a pulse generator which is stored implanted in the chest subcutaneously (under the skin).It is believed that while DBS does not cure Parkinson's Disease, it may diminish drug induced symptoms. A programming device can be used to adjust the pulse generator. This is all done wirelessly. At this stage, only the physician keeps the device which controls the intensity of stimulation. The patient is given a device which determines whether the pace maker is on or off.
  • Thalamic stimulation
  • Pallidal stimulation
  • Subthalamic DBS

Just like any other surgery, there are risks. The major risk is bleeding in the brain that would cause a stroke. A stroke usually occurs during the surgery or a few hours after. The effect of the stroke can range anywhere from permanent brain damage to mild or permanent weakness and even death.

When an electrode is implanted it can become dislodged but it is relatively easy to locate using MRI or CT scans. Additional surgery will be required to replace the electrode, increasing the risk of having a stroke or getting an infection.

Side effects include:

  • Hallucinations
  • Apathy (unresponsiveness or indifference to social or emotional matters)
  • Edema (swelling) of the brain tissue
  • Hypersexuality
  • Compulsive gambling
  • Depression

Speech therapy has been found to be effective for some Parkinson's Disease patients. It is used to treat Dysarthrya (difficulty speaking) and Dysphagia (difficulty swallowing). The best way to get therapy that is specifically tailored for Parkinson's Disease patients is to visit an experienced speech pathologist.

Parkinson's Disease treatment has come a long way. New technologies and techniques are improving the quality of life of many Parkinson's Disease patients.

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