Parkinson's disease (PD) belongs to a group of conditions called motor system disorders. It is the result of the loss of dopamine-producing brain cells

The disease occurs when certain nerve cells, or neurons, die or become impaired. Normally, these neurons produce dopamine, which is a chemical messenger responsible for transmitting signals within the brain. Loss of dopamine causes the nerve cells to fire out of control, leaving patients unable to direct or control their movement in a normal manner.

“There is a lack of awareness in [Australia’s] health and general community of the challenges and needs of those suffering from this complex and disabling condition,” according to the Deloitte 2011 Access Economics report, Living With Parkinson’s Disease: Challenges and positive steps for the future.

The three types of Parkinson's disease are grouped by age of onset and are as follows:

    • Juvenile onset - The incidence of this type is rare, but the age of onset can happen before 21 years.

    • Young onset This occurs between 21 to 40 years of age.

    • Adult onset - It is the most common type and the average age is approximately at 60.



Risk factors


When it comes to Parkinson’s disease, the risks and causes are relatively unknown. However, several factors appear to play a role:

    • Sex – In Australia and the rest of the world, men appear to be more likely to develop it than women.

    • Environmental triggersThere is concern that prolonged exposure to toxins such as pesticides and herbicides may put you at a slightly increased risk of Parkinson's disease.

    • Age - PD usually starts in middle or late life, and case studies indicate that risks increase with age, but, although rare, it is not uncommon for young adults to also experience it.

    • Heredity – Researchers have singled out specific genetic mutations that can cause PD. However, it is proven that these mutations are quite rare, except in extreme case where many family members have Parkinson’s.



Prevalence


Although a large part of PD sufferers are alder, some individuals are diagnosed as young as 30 years old. The Deloitte report offers these figures for Australia:

    • At least one in every 350 people in Australia lives with PD.

    • Parkinson’s disease is more prevalent among males (54 percent) than with females (48 percent).

    • Over 80 percent of PWP are aged over 65 years.

    • More than 2 000 people with Parkinson’s disease in 2011 are aged in their 30s and 40s.

    • More than 12 000 people of working age (15 to 64 years old) are estimated to be living with PD.



Symptoms


This disease is considered the second most common neurological condition in Australia, and yet it continues to be least understood in terms of causes. Early symptoms are subtle and occur gradually, but the four primary symptoms of Parkinson's are listed as:

    • Tremors or trembling in hands, arms, legs, jaw, and face

    • Rigidity or stiffness of the limbs and trunk

    • Slowness of movement and postural instability

    • Impaired balance and coordination



Patients may also have difficulty walking, talking, or completing other simple tasks. The disease is both chronic and progressive.

Diagnosis


Because PD is one of several neurologic movement disorders that produce similar symptoms, it is vital that you consult a specialist who is familiar with the array of other disorders that can often mirror the symptoms of Parkinson’s.

Since there precise science to diagnosing tests available to diagnose the PD, making the diagnosis has become quite difficult, but specialists will almost certainly use one or more of the following tests:

    • Computed Tomography (CT) - With this method, computers and X-rays are used to create images of the body’s internal workings, including the brain and looks for signs of diseases like Parkinson's.

    • Magnetic Resonance Imaging (MRI) - is a test that produces very clear pictures, or images, of the human body without the use of X-rays. Instead, MRI uses a large magnet, radio waves, and a computer to produce these images.

    • Positron Emission Topography (PET scan) - It is used to gauge the activity and function of brain regions that are involved in movement.



Doctors may also give patients Levodopa (a medication that the brain converts to dopamine) and the resulting relief of motor impairment is usually able to confirm diagnosis.

Treatment


As there is no existing cure for this disease, and understanding the available treatments and options is pivotal to managing the symptoms and maintaining the affected person’s overall functional capacity and quality of life. Some of the standard treatments include:

    • Medications commonly used to increase the dopamine levels to try and slow down the disease’s progression.

    • Lifestyle modifications are often recommended to help control motor symptoms in the early stages of the disease.



Surgical treatment options


Surgical treatment options are available for patients with severe motor symptoms and they include:

    • Pallidotomy - This procedure destroys a small part of the brain, called the globus pallidus, which becomes overactive in Parkinson’s patients and causes poor motor function. This surgery may help relieve tremors and stiffness.

    • Thalamotomy - Here the aim is to permanently erase tremor and other involuntary movements by destroying a tiny area of the brain called the thalamus, which controls some involuntary movements.

    • Deep brain stimulation - It involves implanting a surgical device (known as a brain pacemaker) usually under the skin near the collarbone, that delivers tiny electrical signals to the areas of the brain that control movement.



There are also a range of relatively novel approaches, physical therapy or muscle-strengthening exercises that you can ask your specialist about. The median time, according to the Deloitte report, from onset to death is 12.2 years in Australia, but there are exceptional cases of patients living with Parkinson’s disease for well over 20 years.