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Diagnosis and Treatment of Parkinson's Disease

Parkinson's disease (PD) is a complex neurodegenerative disorder of the brain that has a great impact on a person's ability to move. Other than producing movement symptoms, it also brings about non-movement symptoms like losing the sense of smell, lack of or difficulty in sleeping, memory loss and trouble in comprehension, mood swings and depression.

The treatment of Parkinson's are directed to manage only the presenting symptoms of the disease, and it depends on a patient basis. Not all Parkinson's disease patients are alike. But before we discuss the treatment regimen, let us give emphasis on Parkinson's disease diagnosis. We've mentioned in the previous article that we currently don't have a biomarker examination that would easily pinpoint us to diagnosing Parkinson's disease. It's more complicated to analyze Parkinson's in its early stages.

There have been numerous medical journals published on Parkinson's disease guidelines, like that from the Canadian Neurological Sciences Federation that directs healthcare providers, patients, families, relatives, friends, and carers on everything that they need to know about the disease, which elicits a standard of care to people with Parkinson's disease.

Diagnosis of Parkinson's disease

It is important to distinguish Parkinson's disease from other neurological condition that causes Parkinsonian syndrome (Dementia with Lewy Bodies or Vascular Dementia). Remember that Parkinsonism or Parkinsonian syndrome is a movement symptom complex comprised of bradykinesia (slow movement) resting tremor, and rigidity of limbs. This is done through a thorough medical history and neurological exam will be performed.

Upon checkup, the doctor will be able to diagnose Parkinson's based on the symptoms presented and based on the patient's medical history. Genetics is accountable for most Parkinson's disease cases. Meaning if your family has a positive history of the disease, there's an increased risk of you developing Parkinson's. The doctor will ask when the symptoms started and how long this has been going on. It's important for your doctor to know if you're taking antipsychotic and anti-vomiting medications because the side effects of the said drugs cause symptoms similar to that of Parkinson's. The neurological examination is basically a physical exam. Your doctor will test your sense of smell, pull or tag on your limbs to check if there's resistance, you will be asked to stand from a sitting position to see if there's rigidity, you will be asked to walk across the room to see if there's positive shuffling gait. Lastly, your doctor will do a challenge test, where you will be given Parkinson's disease medications, and if you respond well to it, then it is 100% sure that you do have Parkinson's disease.

Treatment of Parkinson's disease

The traditional method to treat Parkinson's disease symptoms is to improve the dopamine levels. The drug of choice for managing Parkinson's disease symptoms is levodopa. Other medications like carbidopa, COMT (catechol- o-methyltransferase inhibitor), and MAO-B (monoamine oxidase B). These medications are usually given with levodopa to prevent its early breakdown, prevent side effects like nausea and vomiting, and enhance and prolong the desirable effects of the medicines.

When the symptoms don't go well with the medications, or if the effects start to wear off, a Parkinson's patient becomes a candidate for DBS (Deep Brain Stimulation). It is a surgical procedure where an electrode wire is placed inside a specific area in the brain that regulates s impulse to remove tremors and improves movement. DBS gives a chance for the Parkinson's disease patients to have autonomy and to experience the quality of life they once had.

The cure is yet to be discovered, recent studies show a promising horizon for patients with Parkinson's disease. Just like in December 2015, the revolutionary stem cell therapy for Parkinson's has reached Australia and the trial is underway.

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