What is Parkinson’s disease?

Parkinson’s disease is a disease of the central nervous system (brain) that progressively causes movement abnormalities such as tremors. Parkinson’s disease is explained by the loss of cells in a part of the brain that is called the substance black. It also causes stiffness or slowing down of the movement. It is one of the most common neurological pathologies in the world. It evolves differently from one patient to another.

Parkinson’s disease affects about 1% of over 60s and 3% of over 80s. 20% of patients are under 60 years of age at diagnosis. Men have almost the same risk of being touched as women. Since Parkinson’s disease causes a physical disability, it considerably reduces the autonomy of people with Parkinson’s because of, for example, difficulty in getting around and a reduction in the speed with which daily life is performed. It also has repercussions on the patient’s entourage.

Causes of Parkinson’s disease

Although Parkinson’s disease was first described in 1817 by the English physician James Parkinson, and significant efforts have been made by research, its causes are not yet determined. Many hypotheses exist, some have already been invalidated as an infectious cause by a bacterium or a virus or an autoimmune cause. However, two of them hold the attention of researchers: heredity and the environment.

-The hereditary factor: There are indeed rare genetic forms of this disease. But it would only concern a few families. About 11% of patients had another case in the family.

Environmental factors: Apart from the genetic factor, the environment seems to play an important role in the onset of Parkinson’s disease. Exposure to certain environmental factors and toxins can be one of the causes of Parkinson’s disease. These toxins destroy the dopaminergic neurons, the loss of which leads to Parkinson’s disease. The main environmental factors are: some pesticides, some heavy metals, manganese, carbon monoxide, carbon disulphide, etc …

The most plausible hypothesis today to explain the occurrence of Parkinson’s disease in the majority of patients is a combination of predisposing environmental and genetic factors. Genetic fragility would lead to the destruction and decrease of dopaminergic neurons and would be aggravated by the presence of environmental toxins.


Symptoms of Parkinson’s disease

The symptoms of Parkinson’s disease vary a lot from person to person. Similarly, the disease does not progress at the same rate in everyone. The first criterion for diagnosing Parkinson’s disease is the presence of at least two of the three main symptoms of the disease. These three great symptoms can occur together or one of them can dominate the others. These are: slowness to initiate movement (akinesia), specific muscle stiffness and resting tremor. Other symptoms of Parkinson’s disease are:

-Depression and anxiety: The proportion of people with depression is much higher in Parkinson’s disease than the average. This is explained by the difficulties related to the symptoms, the modification of the relations with the entourage, the apprehension of the evolution. In the same way, the external circumstances often accentuate the anxiety: the fact of being alone at home, for example, or on the contrary being in town. The practice of a physical activity such as yoga will be very beneficial to you.

-The trampling or freezing: Difficulties with walking are characterized by a dragging leg, phases of trampling or episodes of abrupt acceleration of the march. Most of the time, these difficulties appear after several years of evolution and are resistant to drug treatments.

Swallowing disorders: More than 50% of sick people have difficulty swallowing. This especially affects people in the advanced stages of the disease. The automatic movements of chewing are slow, and less effective. Pieces that are too hard, too big or too dry can get stuck in the throat. It is therefore necessary to cut the food very finely and to coat with a creamy sauce or a fluid vegetable puree

The diagnosis

The diagnosis of Parkinson’s disease is usually difficult to establish. Indeed, the symptoms appear gradually, and they are not specific to the disease. To eliminate another disease causing Parkinson’s disease, your doctor will need to combine several clinical signs and perform some tests. These are: brain imaging, CT or MRI, and a blood test. Generally, an initial improvement of the symptoms under treatment is a strong argument in favor of the diagnosis of Parkinson’s disease.

Parkinson’s disease and end of life

Palliative care is very important for people with Parkinson’s disease, because the more the disease progresses, the less they are able to use dopamine replacement drugs, which causes a significant decline in motor function. In addition, in the advanced stages of the disease, people with the disease begin to develop complications associated with the disease. These complications can manifest themselves in various forms such as: decline in cognitive functions, dementia, mood disorders (such as depression or anxiety), dysfunction of the autonomic nervous system (such as a drop in blood pressure or swallowing problems), and sleep disorders. Pain can also be a big problem. Pain is often underestimated and can affect the quality of life of people with Parkinson’s disease, reducing their ability to participate in physical activities and caregivers to provide the necessary care.

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