Author : Dr. Jakir Hossain Laskar, PhD
Parkinson’s Disease is a degenerative disorder in the nervous system that affects mostly on dopamine-secreting neurons in substantia nigra, a specific area of the brain. This neuro-degenerative illness affects the part of the brain which coordinates normal body movements. In the early stage of this progressive disease, patients experience noticeable tremor in just one hand, swing and walking, slurred speech, even stiffness or slowness of movement along with staggering gait.
Important Signs and Symptoms of Parkinson’s Disease
- Bradykinesia (Slowness of movement) – Parkinson’s Disease causes slowed physical movement in upper and lower extremities, making easy and simple tasks difficult and time-consuming. Steps of the patients become shorter when they walk; they feel difficulty to get out of bed or chair. They may drag their feet when they try to walk.
- Tremor – Shaking usually begins in a single limb, usually at hand, arm or fingers.
- Rigidity of Muscles – Muscular stiffness can occur at any part of the bogy which may be painful and limit the patient’s range of motion.
- Impaired Automatic Movements – Patients experience diminished ability to perform unconscious movements, including blinking of eyes, smiling and swinging of arms when they walk.
- Postural Instability and loss of Balance – Stooping postures with instable balance are common Parkinson Disease.
- Dystonia – Patients cannot move around and fail to make normal facial expressions because of the tension and rigidity in the muscles resulting in painful muscular cramps. Dystonia is a form of uncontrollable painful muscle spasm.
- Slurred Speech – Patients hesitate while talking. Speech become more of a monotone rather than with the natural inflections.
- Writing Disorganized – People with Parkinson Disease feel hard to write anything on paper and their writing may appear smaller.
Other Physical and Mental Symptoms of Parkinson’s Disease
- Anosmia (Loss of sense of smell) – The sense of smell of the patients is lost or changed unpleasantly.
- Neural Pain – Unpleasant sensations, like burning or numbness may occur sometimes.
- Incontinence of Urine – Patients are compelled to get up frequently to urinate during the night or they pass urine involuntarily.
- Constipation – Most Parkinson patients suffer in obstinate constipation.
- Hyperhidrosis – Excessive sweating affects the whole body in this condition.
- Erectile Dysfunction – Male patients suffer in impotency causing inability to sustain penile erection.
- Orgasmic Dysfunction – Women face difficulty to become sexually aroused and do not enjoy orgasm.
- Dysphagia (Difficulty swallowing) – Some patients cannot swallow foods easily leading to malnutrition and dehydration.
- Drooling – Excessive production of saliva in the mouth may occur.
- Insomnia – Sleeplessness at night results in excessive sleepiness in day-time. Some patients experience uncontrollable movement during sleep.
- Mental Depression and Anxiety – Feelings of uneasiness or fear and low mood can occur with mental confusion.
- Dementia – Mild cognitive impairment along with problems with activities which require planning and organization may occur with symptoms of memory loss.
- Psychosis – Hallucinations and delusions may occur in Parkinson patients as a non-motor symptom.
- Thought Blocking – In more advanced stage of Parkinson Disease, problems with thinking and finding of proper words are common.
- Change of Personality – This can cause impulse control disorders with other impulsive behaviors.
Types of Parkinson’s Disease
- Primary Parkinsonism – The majority of people around 80% suffer in this idiopathic type whose cause is unknown.
- Secondary Parkinsonism –
- Corticobasal Degeneration (CBD) – A type of Parkinsonism with progressive neuro-degenerative condition with numbness and loss of coordinated movement causing difficulties in dressing, writing, eating. etc.
- Drug-induced Parkinsonism – It is a form of Parkinson Disease which occurs after taking certain medicines. Some neuroleptic and antipsychotic drugs block the action of neurotransmitter dopamine causing staggering of gait and other movement disorders.
- Multiple System Atrophy (MSA) – This progressive neurological disease triggers over-production of a brain-protein called alpha synuclein which causes nerve cell degeneration and atrophy in several areas of the brain stem, cerebellum and basal ganglia. This nerve-cell degeneration can result movement disorders and other unconscious body functions.
- Progressive Supranuclear Palsy (PSP) – This neurodegenerative brain disease causes fronto-temporal dementia along with impairment of balance, speech and thought process.
- Vascular Parkinsonism – Stroke symptoms appear suddenly in this type of arteriosclerotic Parkinsonism which usually affects more in the lower extremities. Restricted blood supply to the brain is occurred in this type usually more older people who have been suffering in diabetes, including symptoms of urinary incontinence, loss of memory and walking difficulties.
Causes of Parkinson’s Disease?
- Neurotransmitter Death – Dopamine is made from substansia nigra in the brain. If the dopaminergic neurons those are responsible for secreting dopamine start to die gradually, dopamine level decreases resulting to Parkinson symptoms.
- Gene Abnormality – Genes are, we know, our body’s instruction book. If our genetic code is changed anyway, our physical system starts working in a different way causing movement disorder, slowed movement, slurred speech, etc. Single genetic mutation in the LRRK2 gene is the greatest genetic cause of Parkinson Disease.
- Environmental Cause – Modern research indicates that some chemicals and metals show links with Parkinsonism. Chemicals used in farming, such as herbicides, insecticides and fungicides, and also metals used in factories, such as lead, manganese and trichloroethylene may trigger the disease.
- Previous Head Injury – If anyone had suffered serious head injury earlier with loss of consciousness, he or she may prone to suffer in Parkinson Disease late in life.
- Presence of Alpha-synuclein within Lewy Body – Some microscopic markers stay within our brain cells as clumps of specific substance called Lewy bodies. An important natural and widespread protein named alpha-synuclein is found within Lewy bodies can trigger the cause of the disease,
How is Parkinson’s Disease Diagnosed?
There is no specific test for the diagnosis of Parkinson Disease. Neurologists consider the disease based on the neurological and physical history. If necessary, doctors may suggest a scan called Dopamine Transporter Scan (DTS) which is a single-photon emission computerized tomography (SPECT) scan. Imaging tests, such as, Magnetic Resonance Imaging (MRI) Scan, Computed Tomography (CT) Scan, Ultrasound of the Brain, etc. are at times required for differential diagnosis or diagnostic conclusion.
Management of Parkinson’s Disease
- Neuro-protective Therapy – This therapy is considered to arrest the progression of the disease, so that the progressive nature of the disease is blocked or slowed down. MAO-B inhibitors in Allopathy and micro-dose 50-Millicimal Potency in Homeopathy can reverse the disease progression.
- Symptomatic Medication Therapy – Dopamine antagonists and peripheral decarboxylase inhibitor contribute the gold standard of the symptomatic treatment of Parkinson Disease.
- Supportive Psychotherapy – Parkinson patients with symptoms of mental depression and anxiety, psychosis, mood swing and other higher cognitive dysfunctions can be well-managed by psychotherapy techniques.
- Deep-Brain Stimulation (DBS) – It is a surgical procedure in which surgeons implant electrodes into a targeted area of our brain. Parkinson Disease symptoms may be reduced by this stimulation which sends electrical pulses to the patient’s neural system.
- Neuro-ablative Lesion Surgery – Parkinsonian neurological symptoms including rigidity and akinesia can be minimized through the destruction of a part of the brain called globus pallidus interna.
- Gait Training – Neurologists prescribe task-specific gait training for movement disorder and loss of physical balance.
- Physiotherapy – Flexibility, mobility and gait speed of Parkinson Disease can be improved through physiotherapy techniques along with range of motion exercise. Strengthening exercise is also effective for improvements in strength and motor functions with primary muscular weakness and slowness of movement.
- Speech Therapy – Parkinson patients suffer in speech disorder and voice impairment. Lee Silverman Voice Treatment (LSVT) is administered for the patients to correct slurred speech and to enhance vocal loudness.
- Occupational Therapy – This therapy is suggested to improve motor skills of the patients. They are encouraged to actively participate in their daily routine as much as possible to promote health and quality of life.
- Music Therapy – It is effective in patients with Parkinson Disease having emotional imbalance and bradykinesia. Symptoms can be minimized through choral singing, voice exercise along with rhythmic free body movements.
Diet Tips by Dr. Jakir Hossain Laskar for Patients with Parkinson’s Disease
- Eat plenty of anti-oxidant enriched fresh fruits and vegetables which will help to heal inflammation and purify the patient’s body detoxication pathways. Antioxidants are available in vegetables, such as okra, bell-peppers, artichokes, etc. Fruits like, blueberries, grapes, pears, apples and walnuts, hazelnuts, dark chocolate, kidney beans, lentils, avocado, etc. are rich source of antioxidants. These antioxidants clear out harmful and toxic free radicals from the body which cause oxidative stress.
- Homocysteine, which is a toxic amino acid, is responsible for the progression of the Parkinson symptoms. So, eat nutrients like, zinc, folic acid, vitamin B-6, vitamin B-12 and tri-methyl-glycerin (TMG) which can reduce homocysteine. Also, these nutrients help produce dopamine which is very beneficial for Parkinson symptoms.
- Omega-3-fatty acid has anti-inflammatory and mood-boosting properties which are beneficial for neuro-inflammation of Parkinson patients. Dietary source of this acid is from fish like, sardines, herring, salmon, mackerel, pomfret, etc.
- Take sufficient amount of vitamin D supplement as it can enhance brain-derived neuro-trophic factor (BDNF) which may help reduce many Parkinson symptoms.
Which Foods to Avoid for Parkinson’s Patients?
- Dairy products, such as, milk, cheese, yogurt decrease the level of serum uric acid and act as a risk factor for Parkinson disease. Neurotoxins, polychlorinated biphenyls, pesticides are found in many dairy products which may increase movement disorders and speech impairments.
- Patients who consume red meat and processed meat may be prone to pose a higher risk of Parkinson disease. Frequent intake of processed meat increases intracellular iron concentration and hydroxy radical production which may cause mitochondrial damage in the nerve cells.
- Saturated or unsaturated animal fats should not be eaten patients with Parkinsonism. Though, they can eat healthier fats, like monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) which has neuroprotective and anti-inflammatory properties and can reduce oxidative stress.
- Parkinson patients suffering in constipation need to take increased fiber. They should eat nutritious whole grains, such as, oats, barley, brown rice, wild rice, whole wheat, bulgur, air-popped popcorn, etc. They should not be eaten pasta, cereals, enriched bread and snacks food. A sugar-rich diet including pastries, frozen desserts, pancake syrup, jam and jelly, pie also are not permitted for Parkinson patients.
Tips for Caregivers of Parkinson’s Patients
- You must not do everything for your loved one; let him or her participate to complete daily activities. Patients should be allowed to perform many actions on their own hands, such as, dressing, combing, drinking, etc.
- One of the family members has to keep ample time throughout the day to support the patient. If no family member with much time is available, hire an expert nurse to assist the patient in providing care.
- Try to know disease-related information and learn as much as you can about the care options of your loved one’s disease, so that you can serve the patient better.
- Patients with movement disorders face difficulty to perform daily responsibilities like dressing, cleaning, cooking, shopping, etc. and they feel embarrassed. You as a family member should step in to help perform his or her tasks.
- Appoint a physical therapist who can help the patient in movement skills. You as a family member can also help him do exercise which will help dopamine utilization in the brain. Fitness achieved through exercise programs improves motor coordination, strength, balance, memory and quality of life. If necessary, also appoint a speech therapist who can teach them vocal exercises to enhance the strength and volume of the voice.
- And finally, the rewarding aspect of caregiving with Parkinson patients is to maintain a good relationship and communication requiring for a significant level of care. Foster good relation with your loved one; it will help him or her overcome stress and depression. Mind you, your love and affection, your concern, your depth of care and all other services to your beloved one are beyond measure.
Homeopathic Treatment of Parkinson’s Patients?
In the beginning, I usually prescribe Medorrhinum, Natrum Sulphuricum, Zincum Metalicum higher potencies. Along with these constitutional remedies, Kalmia Latifolia 200 is administered frequently as a complementary medicine. As therapeutic remedies, I use Eriodictyon Glutinosum Q (Mother Tincture), Oenantha Crocata Q, Absinthium Q, Strychninum Sulph 6x (Trituration), Ferrum Cyanatum 3x, etc. Some Parkinson’s patients having early and moderate stages are cured by homeopathic medicines; rest can be well-managed to great extent. But none of these homeopathic medicines for Parkinson’s Disease should be taken without professional advice from a consultant Homeopath in Neuro-Psychiatry.
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