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    Default PARKINSON DISEASE-II..DIAGNOSIS,COPING UP ETC.,

    Dear all,
    Here is Part II of the post on Parkinson Disease.
    This gives information on:
    Diagnosis,
    Treatment,
    How to prevent,
    How to cope-up, and
    Prognosis. ( The likely course of a disease or ailment/ A forecast of the likely course of a disease or ailment.)
    Hoping people will understand something of this disease affecting normally aged citizens.
    Wishing everyone all the best,
    varadarajan


    What other conditions resemble Parkinson's disease?

    In its early stages, Parkinson's disease can resemble a number of other conditions with Parkinson-like symptoms known as Parkinsonism. These conditions include multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, Lewy body dementia, stroke, encephalitis (inflammation of the brain), and head trauma. Alzheimer's disease and primary lateral sclerosis can also be mistaken for Parkinson's disease. Other similar conditions include essential tremor, dystonic tremor, vascular Parkinsonism, and drug-induced Parkinsonism.

    How is Parkinson's disease diagnosed?

    An early and accurate diagnosis of Parkinson's disease is important in developing good treatment strategies to maintain a high quality of life for as long as possible. However, there is no test to diagnose Parkinson's disease with certainty (except after the individual has passed away). A diagnosis of Parkinson's disease - especially in the early phase - can be challenging due to similarities to related movement disorders and other conditions with Parkinson-like symptoms. Individuals may sometimes be misdiagnosed as having another disorder, and sometimes individuals with Parkinson-like symptoms may be inaccurately diagnosed as having Parkinson's disease. It is therefore important to re-evaluate individuals in the early phase on a regular basis to rule out other conditions that may be responsible for the symptoms.

    A neurologist who specializes in movement disorders will be able to make the most accurate diagnosis. An initial assessment is made based on medical history, a neurological exam, and the symptoms present. For the medical history, it is important to know whether other family members have Parkinson's disease, what types of medication have been or are being taken, and whether there was exposure to toxins or repeated head trauma in the past. A neurological exam may include an evaluation of coordination, walking, and fine motor tasks involving the hands.

    Several guidelines have been published to assist in the diagnosis of Parkinson's disease. These include the Hoehn and Yahr scale and the Unified Parkinson's Disease Rating Scale. Tests are used to measure mental capacity, behavior, mood, daily living activities, and motor function. They can be very helpful in the initial diagnosis, to rule out other disorders, as well as in monitoring the progression of the disease to make therapeutic adjustments. Brain scans and other laboratory tests are also sometimes carried out, mostly to detect other disorders resembling Parkinson's disease.

    The diagnosis of Parkinson's disease is more likely if:

    at least two of the three major symptoms are present (tremor at rest, muscle rigidity, and slowness);
    the onset of symptoms started on one side of the body;
    symptoms are not due to secondary causes such as medication or strokes in the area controlling movement; and
    symptoms are significantly improved with levodopa (see below).

    What is the treatment for Parkinson's disease?

    There is currently no treatment to cure Parkinson's disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.

    The most effective therapy for Parkinson's disease is levodopa (Sinemet), which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects (a shortened response to each dose, painful cramps, and involuntary movements), its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa (Sinemet), which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.

    In earlier stages of Parkinson's disease, substances that mimic the action of dopamine (dopamine agonists), and substances that reduce the breakdown of dopamine (monoamine oxidase type B (MAO-B) inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.

    For some individuals with advanced, virtually unmanageable motor symptoms, surgery may be an option. In deep brain stimulation (DBS), the surgeon implants electrodes to stimulate areas of the brain involved in movement. In another type of surgery, specific areas in the brain that cause Parkinson's symptoms are destroyed.

    An alternative approach currently being explored is the use of dopamine-producing cells derived from stem cells. While stem cell therapy has great potential, more research is required before such cells can become of therapeutic value in the treatment of Parkinson's disease.

    In addition to medication and surgery, general lifestyle changes (rest and exercise), physical therapy, occupational therapy, and speech therapy may be beneficial.

    How can people learn to cope with Parkinson's disease?

    Although Parkinson's disease progresses slowly, it will eventually affect every aspect of life - from social engagements, work, to basic routines. Accepting the gradual loss of independence can be difficult. Being well informed about the disease can reduce anxiety about what lies ahead. Many support groups offer valuable information for individuals with Parkinson's disease and their families on how to cope with the disorder. Local groups can provide emotional support as well as advice on where to find experienced doctors, therapists, and related information. It is also very important to stay in close contact with health care providers to monitor the progression of the disease and to adjust therapies to maintain the highest quality of living.

    Can Parkinson's disease be prevented?

    Scientists currently believe that Parkinson's disease is triggered through a complex combination of genetic susceptibility and exposure to environmental factors such as toxins, illness, and trauma. Since the exact causes are not known, Parkinson's disease is at present not preventable.

    What is the prognosis of Parkinson's disease?

    The severity of Parkinson's disease symptoms vary greatly from individual to individual and it is not possible to predict how quickly the disorder will progress. Parkinson's disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. There are many treatment options that can reduce some of the symptoms and can prolong the quality of life of an individual with Parkinson's disease.

    Parkinson's disease at a glance

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    Parkinson's disease is a neurodegenerative disorder which leads to progressive deterioration of motor function due to loss of dopamine-producing brain cells.
    Primary symptoms include tremor, stiffness, slowness, impaired balance, and later on a shuffling gait.
    Some secondary symptoms include anxiety, depression, and dementia.
    Most individuals with Parkinson's disease are diagnosed when they are 60 years old or older, but early-onset Parkinson's disease also occurs.
    With proper treatment, most individuals with Parkinson's disease can lead long, productive lives for many years after diagnosis.

    Last edited by R.Varadarajan; 16-08-2013 at 04:16 PM.

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