World Parkinsons disease day April 11th

Dr. Joshua Caleb .K Consultant Neurologis, KIMS Saveera, Ananthapur.

Parkinson's disease was first described by James Parkinson in his publication "An essay on shaking palsy" in the year 1817.

In memory of his birthday April 11th is celebrated as world Parkinson's disease day, to create awareness among people to make them recognise the disease early and get treated. This disease is due to depletion of a chemical called dopamine in a part of brain called substantial Nigra due to degeneration of cells producing dopamine.

Parkinson's disease gets manifested very often after the age of 60 years, the characteristic clinical features of the disease are Temor, Rigidity, Akinesia (or Bradykinesia) and Postural instability. Which is remembered as acronym TRAP.

Patients with this disease will have shaking of hands (tremor), tightness of the body (Rigidity), slowness of all their activities (Akinesia or Bradykinesia) and tendency to fall (postural instability), as this disease gets manifested after 60 years very often it is attributed to aging process and gets neglected with early recognition and treatment patient can resume to his normal activities and become independent for nearly 10 more years.

to get recognised early it is necessary to see a Neurophysician who is expert in diagnosing this disease and treat instead of neglecting such patients , very often they do better with medication itself , some patients may need a surgical treatment called deep brain stimulation (DBS).

There are new medication options available in recent days for advanced Parkinson's disease like intra jujunal levodopa gel (IJLJ) Apo morphine injections which are very helpful.

It is advisable for all PD patients to do regular exercise to keep them physically active for long years.

Sometimes these symptoms can be due to some other causes like using psychiatric medication, medications used to treat gastritis or normal pressure hydrocephalus or due to heavy metal exposure where the disease can be cured with appropriate treatment.

In less than 20 % patients the disease will be manifested before 40 years which is called young onset Parkinson's disease (YOPD).

Sometimes it is familial due to genetic inheritance.

There is another group of diseases called parkinsonism plus syndromes, where patient will have rapid progression of disease and along with TRAP symptoms they will have other symptoms like frequent falls, swallowing difficulty, giddiness, urinary urgency, sleep disturbances, memory disturbances, hallucinations etc., this group of patients require special attention and care as they develop different complications from the early stages of disease itself.

Parkinson's disease is a disabling disease but with early recognition and prompt treatment patient can lead near normal life.