Thursday, March 13, 2008

The symptoms of Parkinson's patients

Parkinson’s disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system, that affects the control of muscles, and so may affect movement, speech and posture. Parkinson’s disease belongs to a group of conditions called movement disorders. It is often characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia), and in extreme cases, a loss of physical movement (akinesia).The primary symptoms are due to excessive muscle contraction, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain.PD is both chronic, meaning it persists over a long period of time, and progressive. PD is the most common cause of parkinsonism, a group of similar symptoms. PD is also called “primary parkinsonism” or “idiopathic PD” (”idiopathic” meaning of no known cause). While most forms of parkinsonism are idiopathic, there are some cases where the symptoms may result from toxicity, drugs, genetic mutation, head trauma, or other medical disorders.
Symptoms of Parkinson’s disease have been known and treated since ancient times. However, it was not formally recognised and its symptoms documented until 1817 in An Essay on the Shaking Palsy by the British physician Dr. James Parkinson. Parkinson’s disease was then known as paralysis agitans. The underlying biochemical changes in the brain were identified in the 1950s, due largely to the work of Swedish scientist Arvid Carlsson who later went on to win a Nobel prize. L-dopa entered clinical practice in 1967[1], and the first study reporting improvements in patients with Parkinson’s disease resulting from treatment with L-dopa was published in 1968.Parkinson disease affects movement (motor symptoms). Typical other symptoms include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients’ symptoms may be quite dissimilar; progression is also distinctly individual. The disease can be difficult to diagnose accurately. Indeed, only 75% of clinical diagnoses of PD are confirmed at autopsy. Early signs and symptoms of PD 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 PD usually appear normal.
The worldwide prevalence of Parkinson’s disease is estimated to be 4 to 6 million people. There are over 1.7 million in China alone. The disease usually has a long, subtle onset, so diagnosis occurs most often after many years of subclinical disease. Prevalence estimates range from a low of 7 per 100,000 in Ethiopia to a high of 329.3 per 100,000 in Nebraska, U.S.A. (although that figure was arrived at using capture-recapture estimates), and 328.3 cases per 100,000 in the Parsi community in Bombay, India. The greatest prevalence of any country is the U.S.A., with between 100 and 250 cases per 100,000. In countries where Parkinson’s Disease is common, the average age at which symptoms begin is 55-60. Symptoms can occur at any age. In 1875, Henri Huchard (1844-1911) described the first case of juvenile Parkinson’s disease, who was a 3-year-old child who had all the clinical features of Parkinson’s disease. However, it is highly unusual for people under 30 to develop Parkinson’s Disease.It occurs in all parts of the world, but appears to be more common in people of European ancestry than in those of African ancestry. Those of East Asian ancestry have an intermediate risk. It is more common in rural than urban areas in developed countries, but the converse is true in poorer countries, leading Tanner to speculate about environmental causes .Men are more commonly affected than women. However, in many countries, especially Japan, women are affected far more commonly than men. There is a suggestion of increased prevalence in the California Hispanic population. About 2% of the population develops the disease some time during life.

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