Parkinson’s disease is the world’s second most common neuro-degenerative disease, It is a life altering disease but not life threatening and with good medical care they can have normal life span. It is named after the person who first described in 1817 (James Parkinson) as shaking palsy because of its triad of symptoms resting limb tremor (shaking), bradykinesia (slowness of movement) and rigidity (stiffness) and it is his birthday which is celebrated as “World Parkinson’s Day”, to boost awareness about the ailment. The Parkinson’s disease is expected to double from 4.6 million (2005) to 9.3 million (2030) and this bulk of growth in the next 20 years will be in countries with rapidly growing economies especially Asia.
Prevalence of the Parkinson’s disease in India is considered to be about 60-100 per a population of one hundred thousand, while in the Western countries it is 116-197. In India the disease is showing an increasing trend due to an increase in the population of elderly people.
The Parkinson’s disease occurs when certain nerve cells in the substance called the Substantia Nigra, die or become impaired. These cells produces a chemical, which allows smooth, coordinated function of the body’s muscles and movement. When approximately 80% of the dopamine-producing cells are damaged, it results in the Parkinson disease. In many cases the symptoms just don’t show up, while in few the doctors identify when approached for some other disease. It has been proven that at least 25 per cent of the disease is not diagnosed even in neurology clinics. But even in those who have obvious symptoms, the disease is not treated. Caretakers of elderly assume tremors, slowness and forgetfulness as all part of the aging process. Disease affects both men and women in almost equal numbers. It shows no social, ethnic, economic or geographic boundaries. While the condition usually develops after the age of 65, 15% of those diagnosed are under 50 years. The number of new cases increases with age: One in every hundred over the age 65 years has Parkinson’s disease .One in ten over the age of eighty have the disease.
The reason for the nerve cell deterioration is not known, a combination of genetic and environmental factors are responsible for the onset of Parkinson’s Disease. A genetic mutation in the Parkin gene causes the accumulation of defective protein, which leads to the death of the dopamine-producing neurons. Several environmental factors such as heavy metals and pesticides have also been implicated.
The process of making a Parkinson’s Disease diagnosis can be difficult. There is no X-ray or blood test that can confirm PD. A physician arrives at the diagnosis only after a thorough examination.
People suspected of having PD should consider seeking the care of a neurosurgeon / neurologist who specializes in Parkinson disease, (it is the neurologist who is most important as there are many diseases that mimic Parkinson’s disease and such disease do not respond to treatment).
Currently there is no permanent cure available for PD as it is a progressive disease. Any form of medical or surgical treatment can improve the quality of life only for a certain period.The surgery is performed when patient reaches a stage when drugs start having side effects. Various surgeries are available including destruction of tissue permanently (PALLIDOTOMY) and a reversible procedure called DBS (deep brain stimulation) procedures.The aim of the treatment therefore is to help the patient maintain the quality of their life by minimizing disability and controlling of the drugs. The improvement in quality of life is so dramatic and magical that the surgical options(DBS),which are available during the short duration of the disease works wonders for many patients. Optimal treatment is therefore individualized and is best left to the discretion of the doctor (Neurologist) who is treating the patient. These management options are now available in Yashoda Hospital.