Discus The Pathophysiology, Diagnosis and Management of Parkinson’s Disease

This paper shall discuss the pathophysiology, diagnosis and management of Parkinson’s disease.

  • Pathophysiology of Parkinson’s disease

Parkinson’s disease refers to a form of degenerative disorder, which affects the central nervous system (Ronken and Scharrenburg 2002). A nineteenth century English doctor, James Parkinson, coined the name, after he wrote the first description that shed light on the disease. In most cases, Parkinson’s disease affects elderly people in society (Tuite, Fernandez, Thomas and Ruekert 2009). Some other studies have associated Parkinson’s disease with smokers over the age of 50 (Tuite eta al 2009).

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The most common manifestations of this disease are uncoordinated movements and dementia. The loss of movement and poor coordination are often caused by the death of cells at the mid-brain. The manifestation of the disease usually takes the form of multiple factors that are all related to the challenges of body movement and coordination (Fisher, Memo, Stocchi and Hanin 2007). In many cases, lack of body control is caused by the severe depletion of the mid-brain cells. This partly involves the control of body movements and the state of physical balance. People with Parkinson’s disease suffer from mid brain cells that have been damaged through splitting. These cells produce dopamine, although the cause for splitting is yet unknown. The dead cells are the cause of Parkinson’s disease, yet no precise explanation pinpoints to a singular cause (Olanow, Stocchi and Lang 2011). Available explanations are usually in the form of various processes of aging, wear and tear, and the normal attrition processes (Olanow et al 2011). Primarily, the disease is caused by the accumulation of certain proteins into some special neurons and the insufficient production of some special cells that control the movement processes of the body (Ronken and Van Scharrenburg 2002).

 

  • Diagnosis of Parkinson’s disease

In most cases, Parkinson’s disease victims present signs of rigidity, poor gait balance, and shaking. Few studies have investigated the distribution of this disease across the gender divide (Adler and Ahlskog 2000). However, trends have indicated a possibility of high degrees of susceptibility among men than women (Willow 2006). Individuals’ lifestyle also accentuate risks for Parkinson’s disease (Willow 2006). However, it is not clear whether lifestyle factors are part of the high incidences of the disease. Nevertheless, several studies link the disease to a multiplicity of personality and the environmental factors (Ebadi and Pfeiffer 2004). Some studies have concluded that the major causes of other lifestyle diseases, such as hypertension and dementia, are also related to the condition (Ebadi and Pfeiffer 2004). This is contrary to some studies linking genetic predisposition to the disease (Ebadi and Pfeiffer 2004).

 

According to available surveys, Parkinson’s disease tends to affect urban areas more than rural areas (Calne and Calne, 2001). In addition, more developed countries tend to report a higher prevalence of the disease than the developing countries (Grosset, Fernandez and Okun 2009). These findings suggest that demographics and genetics are potential risk factors to Parkinson’s affliction.

 

Besides environmental and genetic factors, some scholars point out that exposure to certain chemical substances, such as those contained in the pesticides, is one of the risk factors of Parkinson’s disease (Factor and Weiner 2007). It is in line with this contention that some scholars have argued that the occurrence and prevalence of Parkinson’s disease is usually environmentally determined (Ronken and Van Scharrenburg 2002). Pollution is regarded as one of the causative agents of Parkinson’s disease, with studies indicating that Parkinson’s disease is common polluted environments, such as the urban centres, than in the rural areas (Duvoisin and Sage 2001). The relative degree of exposure to environmental pollutants correlates with high disease incidence.

 

In summary, the available literature would suggest that Parkinson’s disease has a multifactor etiology, with genetics and environmental factors linked to the incidence and prevalence of the disease.

 

  • Management of Parkinson’s Disease

The manifestation of Parkinson’s disease is such that the symptoms of uncoordinated movements are more pronounced as the individual progresses in age (Simuni and Pahwa 2009). It is partly because of this reason that the medications used are sometimes combined for the purposes of achieving appropriate levels of efficiency.

 

Normally, the task of managing and treating of the disease takes the form of multiple approaches. Notably, the treatment process involves the alleviation of some of the symptoms of the disease (Adler and Ahlskog 2000). There are no treatment therapies known to cure the disease completely, because, the splitting of the mid-brain cells cannot be stopped by any known medication or surgical therapies. The kind of treatment given is considered in light of the occupational status of a Parkinson’s disease patient and other demographic variables such as age and health status (Adler and Ahlskog 2000). Occasional adjustment in the form of treatment is usually considered at different stages of the patient’s progress. This is done in a bid to balance between the changes in the manifestation of the disease and the treatment methods to be adopted in the process (Bunting-Perry and Vernon 2007).

 

Some of the treatment therapies of the disease may not be appropriate to people with other medical conditions, such as hypertension and kidney problems. Furthermore, the kind of medication used for the management of some aspects of Parkinson’s disease could have adverse side effects, which may affect the healing process of the patient. Usually, the treatment strategies are designed in ways that seek to address movement-related problems of the patient. The nature of treatment is also designed to match the degree of severity of the disease (Weiner and Shulman 2006). At the early stages when symptoms begin to manifest themselves, the treatment methods often entails the use of levodopa. The popularity of levodopa derives from its efficiency in treating the obvious symptoms of the disease. In many cases, levodopa is preferred due to its efficacy against stiffness, difficulties in movement, and general pain of body parts. The drug has also proved to be efficient in facilitating walking and muscle control (Weiner and Shulman 2006). Another benefit related to the use of Levodopa is the ability to restore body balance for people with severe cases of Parkinson’s disease.

 

According to research studies conducted on the treatment processes of Parkinson’s disease, the major objective and the degree of efficiency of Levodopa therapy is tied on the ability of the treatment to delay motor fluctuations in the victim, which usually begins five to ten years after the treatment process (Weiner and Shulman 2006). According to available studies, the manifestation of Parkinson’s disease has often tended to relate to the various issues associated with the question of longevity. On this matter, analysts have probed the comparative advantages of levodopa over dopamine agonists (Ronken and Van Scharrenburg 2002). Studies conducted in developed and developing worlds give evidence that levodopa has a higher comparative advantage than dopamine agonists with particular regard to side effects (Weiner and Shulman 2006). The choice of using levodopa over the dopamine agonists is usually based on evidence that the usage of dopamine agonists attracts multiple side effects. Dopamine agonists are associated with hallucinations and, in some cases, sleep disruptions. Usually, sleep disruptions begin to manifest themselves as the victim becomes increasingly dependent on the drugs for the purpose of composure. In the course of treatment, the dopamine agonists may lose their levels of efficiency and may require the support of levodopa medication to handle them effectively (Weiner and Shulman 2006).

 

Generally, the most appropriate remedies for addressing Parkinson’s disease relates to the fact of the changing nature of the disease, in terms of manifestation and prevalence across the world. The treatment processes are usually meant to slow down the process of cell-degeneration (Weiner and Shulman 2006). Other medications have been developed to handle the complications that often result from the disease in its late stages.

 

  • Lifestyle Approaches to Management of Parkinson’s disease

Alternative perspectives have suggested that the treatment and management of Parkinson’s disease could be handled through changes in the lifestyle of the affected parties (cite). In this regard, some medical analysts have sought to place the issue of diet as a fundamental element in managing the sickness (Weiner and Shulman 2006).

 

In the usual cases, some of the issues that relate to the concept of the disease are primarily based on variations or levels that it could be affected by changes in diet. Surveys conducted on the relationship between Parkinson’s disease and lifestyle indicate that people who practice healthy lifestyles are less likely to incur the risk of the disease as compared to people who expose themselves to potentially hazardous eating habits (Bunting-Perry and Vernon 2007). For instance, people on low-sugar and low-fat diets are less prone to the risk of infection as compared to people who consume junk and sugary foodstuffs (Bunting-Perry and Vernon 2007). This explanation has often been adduced to explain variations in the prevalence of the disease between the developed western regions and places like Saudi Arabia. For instance, in the United States, the consumption of sugary foods and junk is higher than in Saudi Arabia where the social lives of the population are largely determined by the strict code of Islamism. This argument has been extended to encompass the social lives of people between the two countries as a reason for explaining factors behind the variations in the prevalence of the disease. Similarly, drug use and alcoholism are some of the social habits that often expose people to the perils of Parkinson’s disease (Foltynie, Lewis and Barker 2003, p. 55).

People who abuse alcohol are more likely to get affected by the disease than people who do not consume. Studies have linked alcoholism to the destruction of certain brain cells and the general impairment of the body’s central nervous system (Fisher et al. 2007). Usually alcoholism often exposes victims to nervous conditions due to the chemical substances used in making some of the alcoholic beverages. Another lifestyle factor relates to the levels of physical activity. According to the available evidence, people whose lifestyles involve some significant levels of exercises or activities are less likely to suffer from Parkinson’s disease as compared to individuals with a sedentary kind of lifestyle (Bunting-Perry and Vernon 2007).

 

The comparisons often made with regard to lifestyle matters have attracted debates from various scholars particularly concerning the question of genetics and its contribution to the prevalence of Parkinson’s disease (Weiner and Shulman 2006). For instance, in the United States, the prevalence of Parkinson’s disease is often associated with baby boomers that have achieved certain levels of financial security and live out their lives in sedentary lifestyles (Bunting-Perry and Vernon 2007). However, the emergence and prevalence of this disease affects people across all races, traditions, and cultures.

 

Research has also shown that the disease carries strong elements of a global phenomenon and may not necessarily be defined within one specific manifestation (Mouradian 2001, p. 111). Moreover, the exposure to stressful conditions has also been cited as a major factor that contributes to the prevalence of the disease (Mouradian 2001). Persons who are engaged in stressful professions are more likely to develop symptoms of Parkinson’s disease at some level of their career growth.

 

The above factors raise important concerns over the treatment and management of the disease. In treatment, combining medicines is meant to serve a complementary purpose, where one medicine complements the deficiencies of the other. However, some cases have been cited where the reliance on stronger medications builds a level where the side effects become even more pronounced (Mouradian 2001). It is because of this reason that the management and treatment of this condition is usually provided under the guidance of competent healthcare personnel. Like other conditions such as diabetes and hypertension, Parkinson’s disease can be handled through proper management and practice of healthy living practices. While such an approach may defy complete healing, nonetheless, the quality of life of the victims can improve significantly through proper care.

References

Adler, C, H and Ahlskog, J, E 2000, Parkinson’s Disease and Movement Disorders: Diagnosis and Treatment Guidelines for the Practicing Physician, Springer, New York.

Bunting-Perry, L, K and Vernon, G, M 2007, Comprehensive Nursing Care for Parkinson’s Disease, Springer Publishing Company, New York.

Calne, D, B and Calne, S, M 2001, Parkinson’s disease, New York, Lippincott Williams & Wilkins, New York.

Duvoisin, R, C and Sage, J 2001, Parkinson’s Disease: A Guide for Patient and Family, Lippincott Williams & Wilkins, New York.

Ebadi, M and Pfeiffer, R, F 2004, Parkinson’s Disease, Taylor & Francis, New York.

Factor, S and Weiner, W 2007, Parkinson’s Disease: Diagnosis & Clinical Management : Second Edition, Demos Medical Publishing, London.

Fisher, A, Memo, M, Stocchi, F and Hanin, I 2007, Advances in Alzheimer’s and Parkinson’s Disease: Insights, Progress, and Perspectives, Springer, New York.

Foltynie, T, Lewis, S and Barker, R, A 2003, Parkinson’s Disease: Your Questions Answered, New York, Elsevier Health Sciences.

Grosset, D, Fernandez, H and Okun, M 2009, Parkinson’s Disease: Clinican’s Desk Reference, Manson Publishing, New York.

Mouradian, M, M 2001, Parkinson’s Disease: Methods and Protocols, Springer, New York.

Olanow, C, W, Stocchi, F and Lang, A 2011, Parkinson’s Disease: Non-Motor and Non-Dopaminergic Features, John Wiley & Sons, New York.

Ronken, E, and Scharrenburg, E, R 2002, Parkinson’s Disease, IOS Press, New York.

Ronken, E., and Van Scharrenburg, G. J. (2002). Parkinson’s Disease. Oxford: IOS Press.

Simuni, T and Pahwa, R 2009, Parkinson’s Disease, Oxford University Press, Oxford.

Tuite, P, Fernandez, H, Thomas, C and Ruekert, L 2009, Parkinson’s Disease: A Guide to Patient Care, Springer Publishing Company, New York.

Weiner, W. J., and Shulman, L. M. (2006). Parkinson’s Disease: A Complete Guide for Patients and Families. Maryland: Johns Hopkins University Press.

Willow, M, J 2006, Parkinson’s Disease: New Research, Nova Publishers, New York.

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