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Parkinson’s Disease

Parkinson’s disease (also known as Parkinson disease or Parkinson’s Disease) is a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills and speech.

History of Parkinson’s Disease

Symptoms of Parkinson’s disease have been known and treated since ancient times. However, it was not formally recognized and its symptoms were not documented until 1817, in An Essay on the Shaking Palsy. by the British physician James Parkinson. Parkinson’s disease was then known as paralysis agitans, the term “Parkinson’s disease” being coined later by Jean Martin Charcot. The underlying biochemical changes in  the brain were identified in the 1950’s, due largely to the work of Swedish scientist Arwid Carlsson, who later went on to win a Nobel prize.

What is Parkinson’s Disease?

Parkinson’s disease is a disorder that affects nerve cells, or neurons, in a part of the brain that controls muscle movement. In Parkinson’s, neurons that make a chemical called dopamine die or do not work properly. Dopamine normally sends signals that help coordinate your movements. Parkinson’s is a disease that causes a progressive loss of nerve cell function in the part of the brain that controls muscle movement. Progressive means that this disease’s effects get worse over time.

Symptoms of Parkinson’s Disease

Parkinson’s disease belongs to a group of conditions called movement disorders. The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia, normally caused by the insufficient formation and action of dopamine ,which is produced in the dopaminergic neurons of the brain. Secondary symptoms may include high level cognitive dysfunction and subtle language problems. Parkinson’s Disease is both chronic and progressive.

Early symptoms of Parkinson’s Disease are subtle and occur gradually. Affected people may feel mild tremors or have difficulty getting out of a chair.  They may notice that they speak too softly or that their handwriting is slow and looks cramped or small. They may lose track of a word or thought, or they may feel tired, irritable, or depressed for no apparent reason. This very early period may last a long time before the more classic and obvious symptoms appear.

Friends or family members may be the first to notice changes in someone with early Parkinson’s Disease. They may see that the person’s face lacks expression and animation (known as “masked face”) or that the person does not move an arm or leg normally. They also may notice that the person seems stiff, unsteady, or unusually slow.

As the disease progresses, the shaking or tremor that affects the majority of Parkinson’s patients may begin to interfere with daily activities. Patients may not be able to hold utensils steady or they may find that the shaking makes reading a newspaper difficult. Tremor is usually the symptom that causes people to seek medical help.

People with Parkinson’s Disease often develop a so-called Parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward (called festination), and reduced swinging of the arms. They also may have trouble initiating movement (start hesitation), and they may stop suddenly as they walk (freezing).

Parkinson’s Disease does not affect everyone the same way, and the rate of progression differs among patients.  Tremor is the major symptom for some patients, while for others; tremor is nonexistent or very minor.

Parkinson’s Disease symptoms often begin on one side of the body.   However, as it progresses, the disease eventually affects both sides.  Even after the disease involves both sides of the body, the symptoms are often less severe on one side than on the other.

The four primary symptoms of Parkinson’s Disease are:

A number of other symptoms may accompany Parkinson’s Disease. Some are minor; others are not. Many can be treated with medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms varies from person to person.

Cause of Parkinson’s Disease

The main causes could be graded under four headings:

  • Genetic
  • Toxins
  • Head injury
  • Drug induced

Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamineDopamine is a chemical messenger responsible for transmitting signals between the substantia nigra and the next “relay station” of the brain, the corpus striatum, to produce smooth, purposeful movement. Loss of dopamine results in abnormal nerve firing patterns within the brain that cause impaired movement. Studies have shown that most Parkinson’s patients have lost 60 to 80 percent or more of the dopamine-producing cells in the substantia nigra by the time symptoms appear.  Recent studies have shown that people with Parkinson’s Disease also have loss of the nerve endings that produce the neurotransmitter nor epinephrine. Nor epinephrine, which is closely related to dopamine, is the main chemical messenger of the sympathetic nervous system, the part of the nervous system that controls many automatic functions of the body, such as pulse and blood pressure. The loss of nor epinephrine might help explain several of the non-motor features seen in Parkinson’s Disease, including fatigue and abnormalities of blood pressure regulation.

Parkinson’s Disease Diagnosis

A doctor may diagnose a person with Parkinson’s disease based on the patient’s symptoms, neurological examinations and medical history. No blood tests or x-rays can show whether a person has Parkinson’s disease. However, some kinds of x-rays can help the doctor make sure nothing else is causing symptoms. If symptoms go away or get better when the person takes a medicine called levodopa, it’s fairly certain that he or she has Parkinson’s disease.

The disease can be difficult to diagnose accurately. The  Unified disease rating scale  is the primary clinical tool used to assist in diagnosis and determine severity of Parkinson’s Disease. Indeed, only 75% of clinical diagnoses of Parkinson’s Disease are confirmed at autopsy. Early signs and symptoms of Parkinson’s Disease may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Usually doctors look for shuffling of feet and lack of swing in the arms. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. However, CT and MRI brain scans of people with Parkinson’s Disease usually appear normal.

The Unified Parkinson’s Disease Rating Scale (UParkinson’s DiseaseRS) is a rating scale used to follow the longitudinal course of Parkinson’s disease. It is made up of the following sections:

  • Mentation, behavior, and mood;
  • Activities of daily living;
  • Motor;
  • Complications of therapy;
  • Hoehn and Yahr Stage;

Hoehn and Yahr Staging of Parkinson’s Disease

Prognosis of Parkinson’s disease

Parkinson’s Disease is not by itself a fatal disease, but it does get worse with time.   The average life expectancy of a Parkinson’s Disease patient is generally the same as for people who do not have the disease.  However, in the late stages of the disease, Parkinson’s Disease may cause complications such as choking, pneumonia, and falls that can lead to death.  Fortunately, there are many treatment options available for people with Parkinson’s Disease.

The progression of symptoms in Parkinson’s Disease may take 20 years or more.  In some people, however, the disease progresses more quickly.  There is no way to predict what course the disease will take for an individual person.

Treatment of Parkinson’s Disease

Allopathic treatment–

There is no cure for Parkinson’s disease. But medicines can help control the symptoms of the disease. Some of the medicines used to treat Parkinson’s disease include carbidopa-levodopa (one brand name: Sinemet), bromocriptine (brand name: Parlodel), selegiline (one brand name: Eldepryl), pramipexole (brand name: Mirapex), ropinirole (brand name: Requip), and tolcapone (brand name: Tasmar).

Side effects of drugs used for Parkinson’s disease

The most common drugs used in the treatment are:L-dopa – It is the most widely used drug but also causes many side effects because only 1-5% of L-dopa enters dopaminergic neurons rest is metabolized to dopamine elsewhere.
Initially it causes complaints like:
Nausea
Vomiting
Reduced blood pressure
Restlessness
Drowsiness and sudden sleepLater it can complicate the condition even further and can cause:
Hallucinations
PsychosisYounger patients of Parkinson’s suffer more from its side effects as:
Dyskinesis
Painful ‘off’ dystonias
Tremors intensified

Dyskinesias, or involuntary movements such as twitching, twisting, and writhing, commonly develop in people who take large doses of levodopa over an extended period. These movements may be either mild or severe and either very rapid or very slow. The dose of levodopa is often reduced in order to lessen these drug-induced movements.

However, the Parkinson’s Disease symptoms often reappear even with lower doses of medication. Doctors and patients must work together closely to find a tolerable balance between the drug’s benefits and side effects.The period of effectiveness after each dose may begin to shorten, called the wearing-off effect. Another potential problem is referred to as the on-off effect — sudden, unpredictable changes in movement, from normal to Parkinson Ian movement and back again. These effects probably indicate that the patient’s response to the drug is changing or that the disease is progressing

Dopamine agonists – side effects includes
Somnolence
Hallucinations
Insomnia
Oedema
Less motor fluctuations
Dyskinesis (twisting / turning) movementsIn rare cases, they can cause compulsive behavior, such as an uncontrollable desire togamble, hyper sexuality, or compulsive shopping.  Bromocriptine can also causefibrosis, or a buildup of fibrous tissue, in the heart valves or the chest cavity.  Fibrosis usually goes away once the drugs are stopped.

MAO-B inhibitors. These drugs inhibit the enzyme monoamine oxidase B, or MAO-B, which breaks down dopamine in the brain.  MAO-B inhibitors cause dopamine to accumulate in surviving nerve cells and reduce the symptoms of Parkinson’s Disease.  Selegiline, also called deprenyl, is an MAO-B inhibitor that is commonly used to treat Parkinson’s Disease. Studies supported by the NINDS have shown that selegiline can delay the need for levodopa therapy by up to a year or more. When selegiline is given with levodopa, it appears to enhance and prolong the response to levodopa and thus may reduce wearing-off fluctuations.

Selegiline is usually well-tolerated, although side effects may include

Nausea

Orthostatic hypotension,

Stomatitis

Insomnia.  It should not be taken with the antidepressant fluoxetine or the sedative mepiridine, because combining seligiline with these drugs can be harmful.

COMT inhibitors.  COMT stands for catechol-O-methyltransferase, another enzyme that helps to break down dopamine.  Two COMT inhibitors are approved to treat Parkinson’s Disease in the United States:  entacapone and tolcapone.  These drugs prolong the effects of levodopa by preventing the breakdown of dopamine. COMT inhibitors can decrease the duration of “off” periods, and they usually make it possible to reduce the person’s dose of levodopa.

The most common side effect is diarrhea.  The drugs may also cause nausea, sleep disturbances, dizziness, urine discoloration, abdominal pain, low blood pressure, or hallucinations.

Anticholinergics. These drugs, which include trihexyphenidyl, benztropine, and ethopropazine, decrease the activity of the neurotransmitter acetylcholine and help to reduce tremors and muscle rigidity.  Only about half the patients who receive anticholinergics are helped by it, usually for a brief period and with only a 30 percent improvement.  Side effects may include dry mouth, constipation, urinary retention, hallucinations, memory loss, blurred vision, and confusion.

Homeopathy Treatment & Homeopathic Remedies for Parkinson’s Disease

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptability) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica sectionNone of these medicines should be taken without professional advice.Reportorial rubric:

Murphy: Diseases: Paralysis-agitans.
Clarke: Paralysis agitans.
Boericke: Nervous system: Paralysis-Type – agitans

Homeopathic Remedies

Mercurius

Weakness of limbs, trembling of extremities, especially hands. Paralytic agitans. Lacerating pain in joints. Cold and clammy sweat on limbsOily perspiration.Tremors everywhere in body. Weakness with trembling from least exertion. All symptoms are aggravated at night, warmth of bed, Damp, cold, rainy weather and during perspiration. Complaints increase during sweating and rest. All symptoms always associated with weariness, prostration and trembling.
Slow in answering questions. Memory weakened and loss of will power. Skin alwaysmoist and freely perspiring. Itching worse warmth of bed

Zincum-Metallicum

Violent trembling (twitching) of the whole body especially after emotions. Twitching in children. Chorea.  Paralysis of hands and feet. Trembling of hands while writing. Lameness, weakness, trembling and twitching of various muscles. Feet in continued motion, cannot keep still. Worse touch, between 5-7 pm., after dinner, better eating, discharges.

Rhus-tox

When the tremors start with pain which is relieved by motion. There is stiffness of the parts affected. Numbness and formication, after overwork and exposure. Paralysis; trembling after exertion. Limbs stiff and paralysed.All joints hot and painful. Crawling and tingling sensation in the tips of fingers. Worse during sleep, cold, wet rainy weather and after rain, night, during rest, drenching and when lying on back or right side. Better warm, dry weather, motion, walking, change of position, rubbing, stretching out limbs.

Gelsemium

Centers its action on nervous system, causing various degrees of motor paralysis…Dizziness, drowsiness, dullness and trembling are the hallmark of this remedy. Trembling ranks the highest in this remedy, weakness and paralysis, especially of the muscles of the head. Paralysis of various groups of muscles like eyes, throat, chest, sphincters and extremities. Head remedy for tremors. Mind sluggish and muscular system relaxed. Staggering gait. Loss of power of muscular control. Cramps in muscles of forearm. Excessive trembling and weakness of all limbs. Worse by dampness, excitement, bad news. Better by bending forwards, profuse urination, continued motion and open air.

Argentum Nitricum

It is complimentary to Gelsemium. Memory impaired; easily excited and angered; flatulence and greenish diarrhea.Inco-ordination, loss of control and imbalance with trembling and general debility. Paralysis with mental and abdominal symptoms. Rigidity of calves. Walks and stands unsteadily. Numbness of body. Specially arms.

Agaricus Muscarius

Trembling, itching and jerking, stiffness of muscles; itching of skin over the affected parts and extreme sensitiveness of the spine. Cannot bear touchJerking and trembling are strong indications. Chorea and twitching ceases during sleep. Paralysis of lower limbs with spasmodic conditions of arms. Numbness of legs on crossing them. Paralytic pain in left arm followed by palpitation. Stiffness all over with pain over hips.

Cocculus

Head trembles while eating and when it is raised higher. Knees sink down from weakness. Totters while walking with tendency to fall on one side. Cracking of the knee when moving. Lameness worse by bending. Trembling and pain in limbs. One-sided paralysis worse after sleep. Intensely painful, paralytic drawing. Limbs straightened out and painful when flexed.
It shows special affinity for light haired females especially during pregnancy.

Lathyrus

Tremors of the upper extremities with paralytic weakness of the lower limbs. Feels as if limbs are hard and contracted; limbs feel heavy. Feels as if floor is irregular and is obliged to keep his eyes on the ground to guide his feet. Affects the lateral and anterior columns of cord. Does not produce pain. Reflexes always increased. Lateral sclerosis and Infantile paralysis. Finger tips numb. Tremuloustottering gait. Excessive rigidity of legs with spastic gait. Knees knock against each other while walking. Cannot extend or cross legs when siting.Stiff and lame ankles.

Physostigma

Marked fibrillary tremors and spasms of the muscles, worse from motion or application of cold water. Palpitation and fluttering of the heart felt throughout the body. Depresses the motor and reflex activity of the cord and causes the loss of sensibility to pain, muscle weakness and paralysis.  Paralysis and tremors, chorea. Meningeal irritation with rigidity of muscles. Pain in right popliteal space. Burning and tingling in spine. Hands and feet numb with sudden jerking of limbs on going to sleep. Crampy pain in limbs.

Ambra Grisea

Tremors with numbness, limbs go to sleep on the slightest movement, coldness and stiffness of limbs. The finger nails become brittle and are shriveled. Cramps in hands and fingers. Worse grasping anything. Cramps in legs. Extreme nervous hypersensitiveness. Dread of people and desire to be alone. Music causes weeping. One sided complains call for it.

Heloderma

Trembling along nerves in limbs. Tired feeling, very weak and nervous, fainting, numb sensation. It causes locomotor ataxia. The eyes become more prominent and corneal opacities visible. Very depressed and sensation as if would fall on right side. Sensationas if walking on sponge. As if the feet were swollen. When walking, lifts feet higher than usual and puts down heel hard. Stretching relieves pains in muscles and limbs.

Mag-phos

Trembling; shaking of hands, involuntary. Paralysis agitans. Cramps in calves, feet very tender. Twitching, Chorea, cramps. Numbness of finger tips. Worse right side, cold, touch, night. Better warmth, bending double, pressure and friction.

Bufo Rana

Special action on nervous system. Painful paralysis. Pain in loins, numbness and cramps. Staggering gait. Feels as if a peg is driven into joints. Worse—Warm room. Better bathing or cold air. Putting feet in cold water.

Tarentula

Remarkable nervous phenomena. Chorea, extreme restlessness and Paralysis agitans. Must keep in constant motion even though walking aggravates. Numbness of legs with twitching and jerking. Extraordinary contractions and movements.

Plumbum Metalicum

Paralytic agitans. Paralysis of single muscles. Cannot raise or lift anything. Extension is difficult. Paralysis from over-exertion of extensor muscles in piano players. Wrist drop. Loss of patellar reflex. Pain in right big toe at night. Hands and feet cold. Infantile paralysis and neuritis.

Conium

Heavy, weary and paralyzed limbs. Trembling and unsteady hands. Muscular weakness especially of lower extremities. Perspiration of hands. Putting feet on chair relieves.Ascending paralysis ending in death by failure of respiration. Worse by lying down, turning or rising in bed, cold, exertion. Better by darkness, limbs hanging down, motion, pressure.