Due to the gradually progressive nature of the disease and its various complications, falls are very common in Parkinson’s disease. By following some simple safety tips many of these falls and injuries may be prevented. The typical symptoms of Parkinson’s disease such as rigidity, impaired balance and slowness of movement all contribute to this tendency to fall. Bending forwards while walking with short shuffling steps, difficulty in maintaining balance while turning and freezing or stopping in mid step increase the chances of falling in a patient with Parkinson’s disease. Postural hypotension (sudden fall of blood pressure on standing) may occur as a side effect of medications, causing dizziness and increasing the risk of falling.
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Since Parkinson’s disease management depends mainly on oral medication, patient compliance or patient adherence to the medicines prescribed as well as not quitting the drugs altogether without informing the doctor is a very important issue. The absolute necessity of taking the medicines at proper times and in their prescribed doses cannot be overemphasized and should be clearly understood by the patient, family members or other caregivers. The dangers of quitting Parkinson’s disease drugs without informing the doctor also needs to be stressed.
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Although insomnia may not be the most debilitating of complaints in patients suffering from Parkinson’s disease, it can nonetheless cause much distress in Parkinson’s patients and the symptoms often aggravate as the disease progresses. Insomnia is the inability to get a good night’s sleep and may be due to :
- Sleep onset problem where the patient has difficulty in going off to sleep even though he/she may be extremely tired. This is most often associated with depression or anxiety states.
- Sleep maintenance difficulty where the patient goes off to sleep easily but wakes up frequently at night. This problem is faced very frequently by Parkinson’s disease patients and they may have abrupt and agitated arousal more than five times at night. This leads to tiredness and excessive daytime sleepiness.
- Excessive daytime sleepiness is caused by inability to sleep properly at night, most often due to waking up several times at night. Dopaminergic medication as part of Parkinson’s drug therapy also contributes to daytime sleepiness in Parkinson’s disease patients.
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A concussion usually occurs after severe head trauma and this may be a possibility in the end stages of Parkinson’s disease when patients are more prone to falls. Depending on the extent of the head trauma, a concussion may vary in its presentation and is often ignored after an injury, although the full effect may only be realized a day or two after the trauma. In terms of Parkinson’s disease, there is greater difficulty in identifying a possible concussion since some of the Parkinson’s disease symptoms may blur or mask the signs of a concussion.
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Bradykinesia is a Greek term meaning “slow movement” and was first coined by James Parkinson, after whom the disease has been named, as one of the cardinal features of Parkinson’s disease. However, it is now recognized that bradykinesia is not exclusive to Parkinson’s disease since it may be a manifestation of other neurological disorders or as a side effect of certain medications.
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Caring for a patient with Parkinson’s disease can be a difficult and stressful task for any caregiver, whether your are a loved one or a professional home attendant, and even the simplest tasks may require some planning and special consideration. Daily personal hygiene is one of the most important points to focus upon because Parkinson’s patients, especially in the end stages, are more prone to infections and complications, which could be prevented with a greater degree of fastidiousness on the part of both the patient and caregiver.
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Swine flu is a respiratory infection, with symptoms similar to that of the common flu and people living with Parkinson’s disease are at particular risk of developing severe symptoms if infected. Swine flu is caused by a new strain of influenza A virus, called the H1N1 virus. Normally, swine flu is a disease confined to pigs, and transmission to humans is rare, but the new strain has spread rapidly from pigs to humans. In this current pandemic, human-to-human transmission by direct contact (hand to mouth or nose) and by sneezing or coughing.
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Parkinson’s disease is a degenerative disease of the brain where there is progressive depletion of dopamine producing neurons in the substantia nigra, located in the brain. Stem cell therapy may possibly offer a solution as it aims at treating this disease by growing new cells to replace the older degenerated ones.
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The typical Parkinson’s gait develops over time as a result of the features of Parkinson’s disease such as bradykinesia (slowness of movement), loss of postural reflexes, and rigidity (increased tone). The gait of a person is his manner of walking and normally, a person will walk upright, with steady steps and even strides, and arms swinging by his sides. The distinctive gait of a person with Parkinson’s disease comprises of features such as stooped posture, slowness to start walking, short shuffling steps and a tendency to run with reduced arm swing. Levodopa is particularly helpful in improving Parkinson’s gait by helping to reduce bradykinesia and rigidity.
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In most newly diagnosed Parkinson’s patients, the anxiety revolves around the effect that the disease will have on daily functioning. However it should be noted that most Parkinson’s patients can quite comfortably manage with daily activities although there may be some level of difficulty. The symptoms in the initial stages of Parkinson’s disease may be mild, but in the last two stages of the disease or the “end stages”, the symptoms become such that the person becomes totally unable to function without help.
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