Parkinson's disease (PD) is a chronic (persistent) disorder of part of the brain. It is named after the doctor who first described it. It mainly affects the way the brain co-ordinates the movements of the muscles in various parts of the body. PD mainly develops in people over the age of 50. It becomes more common with increasing age. About 5 in 1000 people in their 60s and about 20 in 1000 people in their 80s have PD. It affects both men and women. Rarely, it develops in people under the age of 50. PD is not usually inherited, and it can affect anyone.

Signs and Symptoms

People with idiopathic Parkinson's disease may develop several symptoms over time, but they typically develop the primary symptoms bradykinesia, tremor, rigidity, and parkinsonian gait.Most people with Parkinson's do not develop all of the symptoms associated with the disease

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Bradykinesia is slowness in voluntary movement. It produces difficulty initiating movement as well as difficulty completing movement once it is in progress.

Tremors in the hands, fingers, forearm, or foot tend to occur when the limb is at rest but not when performing tasks.

Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson's.

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? Difficulty swallowing (dysphagia)?saliva and food that collects in the mouth or back of the throat may cause choking, coughing, or drooling

? Excessive salivation (hypersalivation)

? Excessive sweating (hyperhidrosis)

? Loss of bladder and/or bowel control

? Loss of intellectual capacity (dementia)?late in the disease

? Psychosocial: anxiety, depression, isolation

Causes

A small part of the brain called the substantia nigra is mainly affected. This area of the brain sends messages down nerves in the spinal cord to help control the muscles of the body. Messages are passed between brain cells, nerves, and muscles by chemicals called neurotransmitters. Dopamine is the main neurotransmitter that is made by the brain cells in the substantia nigra. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain causes nerve messages to the muscles to become slowed and abnormal.

Diagnosis

Parkinson's disease is just one of several neurologic movement disorders that produce similar symptoms.It is important that the physician you are seeing has experience with all of the different disorders that can masquerade as Parkinson's disease.

Diagnostic Tests

Unfortunately, there is no diagnostic test that can confirm Parkinson's disease. Laboratory testing of the blood of patients with the symptoms typical of Parkinson's only rarely uncovers any abnormality.

Treatment

There is no cure for PD, and no treatment prevents the disease from progressing. However, treatments can usually ease symptoms.

?At first, you may not need any treatment when the symptoms are mild. A specialist may simply see you every now and then to monitor how the disease is progressing.

?A drug that eases symptoms is usually started when symptoms become troublesome.

?Therapies such as physiotherapy, occupational therapy and speech therapy may also be useful as the disease progresses.

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