PARKINSON’S

DISEASE

26 November
2018
by: Katie Tiede
 Parkinson’s Disease

“Involuntary tremulous motion, with lessened muscular power, in parts not in action

and even when supported; with a propensity to bend the trunk forward, and to pass from a

walking to a running pace; the senses and intellects being uninjured,” (Parkinson, 1817).

Imagine living in a world where you are fully aware of your surroundings, mentally capable of

doing everything for yourself, but physically disabled and unable to care for oneself? Day-by-

day we take something as simple as walking or feeding ourselves for granted; the inability to

feel what it is like to have “The Shaky Palsy” (Parkinson, 1817). For those with Parkinson’s

Disease, they know this feeling all too well.

Parkinson’s Disease dates back for thousands of years, as depicted in early writings, but

it never really grew a name until James Parkinson wrote an essay in 1817 titled: An Essay on the

Shaky Palsy. Parkinson was a doctor from London who had noticed these different descriptions

of patients he observed in the streets near his home. With this essay, a surgeon named Jean-

Martin Charcot, was able to work even further on Parkinson’s work and finally give the disease

its name (Goetz, 2011).

As you read the first sentence to this paper, you may have been able to paint a mental

image of what Parkinson was trying to describe when he wrote his descriptive essay regarding

Parkinson’s Disease. With the disease, the whole body eventually becomes affected, but the

source of the problem is directed related to the brain. When a brain functions “normally”, we

can carry out day-to-day functions such as feeding oneself, walking, balance, and speaking,

among other tasks; someone who is diagnosed with Parkinson’s Disease, this is not the case for

them. In a Parkinson’s Diseased patient, the brain’s neurons become defective and are not able

to carry out their functions of producing the proper neurotransmitter, a brain chemical. The

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neurotransmitter specific to the disease is called dopamine, which is “a chemical messenger

responsible for transmitting signals between neurons” (Panchanan). With the loss of this

chemical, the signals being sent in the brain are improper, meaning they “fire” randomly

instead of meticulously.

To understand the signs/symptoms of the disease, one must understand what the role

of dopamine in the brain has to do with carrying out normal, functioning tasks. As mentioned

previously, dopamine is a neurotransmitter in the brain, a chemical messenger if you will, that

when found in normal levels in the brain allows for “smooth and purposeful movements”

(Parkinson’s Disease, 2018). Since a patient with Parkinson’s Disease has neurons depleted

which produce this chemical, the levels available in the brain for “firing” are significantly low. A

recent study suggests “most people with Parkinson’s have lost 60 to 80 percent or more of the

dopamine-producing cells,” (Parkinson’s, 2018). With this low level of dopamine, the body is no

longer able to produce smooth movements; much like with what James Parkinson described

when he wrote “involuntary tremulous motion” in his essay A Shaky Palsy. However, the

symptoms of the disease are not that simple, this is since the symptoms come in different

phases that progress overtime, often with a range of fifteen to twenty years (Parkinson’s

Disease, 2018).

Since the disease has different levels of symptoms, a lot of the times doctors may misdiagnose

a patient for a disorder with similar signs or have it dismissed due to normal aging; it is often

seen that “family members or close friends, or daily caretakes are more like to detect the

emergence of early symptoms in patients” (Parkinson’s Disease, 2018). As the disease

progresses, proper diagnosis is relevant to the care that is needed with Parkinson’s patients.

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The symptoms of the disease range from early, to primary and secondary motor, as well

as to primary and secondary non-motor; as the disease progresses the symptoms eventually

affect bilaterally, rather than unilaterally in the beginning stages. Some of the early symptoms

are often indirect, in which makes the disease difficult to diagnose. These early symptoms

include “mild tremors, posture difficultly, soft speech, slow handwriting, lack of limb

movement, abnormal facial expression, and depression” (Parkinson’s Disease, 2018). When it

comes to primary motor symptoms, a resting tremor is one of the most common signs, in which

“about 70% experience” (Parkinson’s Disease, 2018); bradykinesia is a common symptom with

this disease as well, in which “unplanned movements, decreases in the extent of movement, or

the slowing and loss of spontaneous and automatic movements” (Parkinson’s Disease, 2018)

occur, which also leads to balance and coordination issues. As the disease progresses,

secondary motor symptoms occur. These symptoms include difficulty swallowing and chewing,

which is from the brain’s control of the muscles in the mouth and throat, which prevent the

food from moving smoothly through the intestinal tract. Muscle cramps also occur, along with

sexual dysfunction and changes in speech.

The prognosis for a patient with Parkinson’s Disease is about the same as someone who

does not have the disease, however, due to the nature of the disease it is not definitive of the

length of time a person will live once diagnosed; this is because medications and treatments

can help slow the progression. Another reason it is unknown is because the average age of

onset is sixty years, but “in rare cases, parkinsonian symptoms may appear in people before the

age of twenty”. Also, “In the late stages, Parkinson’s Disease may no longer respond to

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medications and can become associated with serious complications such as choking,

pneumonia, and falls” (Parkinson’s Disease, 2018).

Although there is no cure for Parkinson’s Disease currently, there are medications and

surgeries that are available to help patients’ motor symptoms improve. Along with the

symptoms, medications prescribed for these patients occur in three different categories;

increasing the level of dopamine in the brain, easing some symptoms, and limiting non-motor

symptoms. Among one of the most common therapies for dopamine increasing medications, is

Levodopa/Carbidopa. With this medication, it tricks the brain into making more dopamine,

which in turn will reduce the tremors and other motor symptoms. The treatment route for

patients who have Parkinson’s Disease is based on the symptoms that the patient is exhibiting

and how much those symptoms are causing a disfunction in their lives. As the disease

progresses to its later stages, medications do not tend to work much at treating the symptoms,

in which surgery may be an option; these brain surgeries include those that would limit the

tremors.

Non-scientifically, during the early stages of developing the disease, diet could play a

role in how the medications one is prescribed to slow symptoms, are absorbed in the body.

Doctors often suggest exercise and physical therapy to maintain mobility for as long as possible,

along with speech therapy to work on swallowing and speech; this however is not proven to be

supported, but it is a hopeful agent for those who would like to continue to function as

normally as possible in society. Patients may also find refuge in support groups, in which they

are amongst those who are going through the same physical changes; experience speaks

volumes to those who may be at the earlier stages in the disease.

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 Parkinson’s Disease

As research continues, scientists develop a better understanding of what causes

Parkinson’s Disease, looking for common genes among those who inherit it genetically. At this

time since there is no cure, treatment continues to be based on treating the symptoms and

done on a case-by-case basis since every patient is different. Much cannot be said on how one

can prevent the disease itself, since research is never-ending on the exact cause of why these

neurons die, limiting the amount of dopamine available for proper “firing” in the brain. For

those who have worked in healthcare, it is not uncommon to have taken care of someone who

has Parkinson’s Disease; although you may not have known it due to the nature of medications

that are able to limit the main symptoms of the disease. Since the disease progresses slowly,

people affected with it are hopeful; hopeful that one day their symptoms will be depleted, and

their life can return to “normal”; hopeful that they will not be wheelchair bound with mental

capacity still high. There is much to be said about not being able to care for yourself physically,

while being mentally stable. How would your life be changed if you woke up one day with “The

Shaky Palsy”?

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Works Cited
Goetz, C. G. (2011, September 01). The History of Parkinson's Disease: Early Clinical

Descriptions and Neurological Therapies. Retrieved October 20, 2018, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234454/

Panchanan Maiti, Jayeeta Manna, & Gary L. Dunbar. (2017, October 25). Current understanding

of the molecular mechanisms in Parkinson's disease: Targets for potential treatments.

Retrieved September 12, 2018, from

https://translationalneurodegeneration.biomedcentral.com/articles/10.1186/s40035-

017-0099-z

Parkinson, J. (2002). Neuropsychiatry Classics (2nd ed., Vol. 14, Spring 2002). Retrieved October

20, 2018, from http://viartis.net/parkinsons.disease/shaking.palsy.pdf

Parkinson's Disease: Hope Through Research. (n.d.). Retrieved September 20, 2018, from

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-

Research/Parkinsons-Disease-Hope-Through-Research#What is Parkinsons

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