Parkinson's disease
Long-term degenerative neurological disorder / From Wikipedia, the free encyclopedia
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Parkinson's disease (PD), or simply Parkinson's, is a chronic degenerative disorder of the central nervous system that affects both the motor system and non-motor systems. The symptoms usually emerge slowly, and as the disease progresses, non-motor symptoms become more common. Early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Problems may also arise with cognition, behaviour, sleep, and sensory systems. Parkinson's disease dementia is common in advanced stages.
Parkinson's disease | |
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Other names | Parkinson disease, idiopathic or primary parkinsonism, hypokinetic rigid syndrome, paralysis agitans, shaking palsy |
Specialty | Neurology |
Symptoms | Rigidity, slowness of movement, tremor, difficulty walking[1] |
Complications | Dementia, depression, anxiety,[2] eating problems, and sleep problems |
Usual onset | Age over 60[1][3] |
Causes | Unknown[4] |
Risk factors | Pesticide exposure, head injuries[4] |
Diagnostic method | Based on symptoms[1] |
Differential diagnosis | Dementia with Lewy bodies, progressive supranuclear palsy, essential tremor, antipsychotic use[5] |
Treatment | Medications, surgery[1] |
Medication | L-DOPA, dopamine agonists[2] |
Frequency | 6.2 million (2015)[6] |
Deaths | 117,400 (2015)[7] |
Named after | James Parkinson |
The motor symptoms of the disease result from the nerve cell death in the substantia nigra, a midbrain region that supplies dopamine to the basal ganglia. The cause of this cell death is poorly understood but involves the aggregation of the protein alpha-synuclein into Lewy bodies within the neurons. Collectively, the main motor symptoms are known as parkinsonism. Contributing factors include a combination of genetic and environmental factors. Those with an affected family member are at an increased risk of getting the disease, with certain genes known to be inheritable risk factors. Environmental risks include exposure to pesticides and prior head injuries; a history of exposure to trichloroethylene is also suspected.
Diagnosis of Parkinson's disease is mainly based on symptoms, usually motor-related. PD typically occurs in people over the age of 60, of whom about one percent are affected. In those younger than 50, it is termed early-onset PD. The average post-diagnosis life expectancy is 7–15 years. No cure for PD is known, and treatment aims to mitigate symptoms. Initial treatment typically includes L-DOPA, MAO-B inhibitors, or dopamine agonists. As the disease progresses, these medications become less effective and produce a side effect marked by involuntary muscle movements. Diet and certain forms of rehabilitation have shown some effectiveness at improving symptoms. Surgery to place microelectrodes for deep brain stimulation has been used to reduce severe motor symptoms where drugs are ineffective. Evidence for treatments for the non-movement-related symptoms of PD, such as sleep disturbances and emotional problems, is less strong.
The disease is named after English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy, in 1817. Public awareness campaigns include World Parkinson's Day and the use of a red tulip symbolizes Parkinson's awareness. People with PD who have increased the public's awareness of the condition include boxer Muhammad Ali and actor Michael J. Fox.