Parkinson’s Disease, the Shaking Palsy

By Dr. Gerard Muraida

Parkinson’s disease was first medically described as a neurological syndrome by English neurologist James Parkinson in 1817, in his publication An Essay on the Shaking Palsy. However, earlier descriptions have been noted in traditional Indian texts dating as far back as 1000 BC, and ancient Chinese sources also allude to conditions that suggest Parkinson’s. This month, which is national Parkinson’s Disease Awareness Month, the medical community focuses on sharing the latest information about this progressive central nervous system disorder that impacts more than half a million Americans annually.

Dr. Parkinson accurately mentioned the following symptoms in his essay, including: bowel issues, like constipation and incontinence; self-feeding difficulties (called dysphagia); drooling (called sialorrhea); sleep disturbance; and speech problems. Indeed, Parkinson’s disease remains a clinical diagnosis based on resting tremors, rigidity, and slowness of movement. Early in the disease, patients may feel anxious and have trouble sleeping. They may drag a foot while walking. The fingers of one hand may shake even when not doing anything.

In the brain, an area called the substantia nigra (black substance) contains dopamine-producing cells. Decreased dopamine leads to Parkinson’s disease.

Parkinson’s disease is more common in people older than 50, but sometimes it occurs in people in their 20s. It’s a little more common in men than in women. It usually develops very slowly.

Treatments have evolved over the last 50 years and include several medications aimed at preventing the brain’s dopamine levels from deteriorating. Novel non-medication treatments also exist, including deep brain stimulation. Plus, rest, decreased stress, eating a healthful diet and getting daily exercise assist in management of the disease.

A primary care practitioner can diagnose for Parkinson’s, but if there is some doubt, a neurologist can confirm the findings. Most individuals live long productive lives with Parkinson’s disease.

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