What is Parkinson’s disease?

It is a progressive disease which means it gradually becomes worse with time. It is a disease that affects the nervous system causing unintended or uncontrollable movements. It usually starts with tremors than the symptoms progress.

Parkinson symptoms

Rest tremor which means the tremor appears (or worsens) when the body part is not engaged in an activity
Bradykinesia which means generalized slowness of movement. This feature is present in 80% of patients at the onset of the disease and eventually seen in all patients
Rigidity is increased resistance to passive movement.it usually starts at one side and eventually progresses to the other side but stays asymmetric throughout the disease
Postural instability causes a feeling of imbalance and a tendency to fall with a significant risk of injury
Parkinson’s also causes non-motor symptoms like dementia and many other

Diagnosis

No specific test exists to diagnose Parkinson’s disease.so, This mainly depends on the medical history and the neurologic examination. The patient must have at least bradykinesia plus tremor or rigidity to consider diagnosing Parkinson’s disease.
No radiologic or blood tests can confirm the diagnosis.
MRI (magnetic resonance imaging) can be helpful in excluding other diseases but is not necessary.

Treatment

Medication: there are three main types of medication that are commonly used:

• levodopa
• dopamine agonists
• monoamine oxidase-B inhibitors

Levodopa

is the most common medication for patients with Parkinson’s disease. It passes the BBB (brain-blood barrier) and then turns into dopamine. Increasing the levels of dopamine using levodopa usually improves movement problems.

Dopamine agonists

it is similar to levodopa but milder because Dopamine agonists act as a substitute for dopamine in the brain

monoamine oxidase-B inhibitors

monoamine oxidase-B or MAO inhibitors like selegiline and rasagiline block the effects of an enzyme or brain substance that breaks down dopamine (monoamine oxidase-B), increasing dopamine levels.

Surgery

Most people with Parkinson’s disease are treated with medication, although a type of surgery is called deep brain stimulation.

Deep Brain Stimulation

Deep brain stimulation is a neurosurgical procedure that aims to implant electrodes and electrical stimulation to treat movement disorders like Parkinson’s disease and other motor diseases.
This is done by implanting one or more wires, called “leads,” inside the brain which is connected to a very small neurostimulator (electrical generator) injected under the person’s collarbone
What controls the stimulation in this technique is a pacemaker-like device placed under the skin of your upper chest. A wire that travels under your skin connects this device to the electrodes in your brain.
DBS interrupts the periodic signals that cause tremors and other movement symptoms.

Candidates for deep brain stimulation

• Patients under 70
• Good overall health
• Patients that have troublesome dyskinesias.
• Patients who fluctuate between “on” and “off” medication states

Side Effects That Can Happen After The Surgery

• Headache

• Seizure
• Confusion
• Hardware complications, such as an eroded lead wire
• Temporary pain and swelling at the implantation site
• Confusion and Difficulty concentrating
• Stroke
• Infection