DEFINITION

Parkinson's Disease is a chronic, degenerative disease of the brain which affects the voluntary control of the body.

DESCRIPTION

Parkinson's Disease usually affects people in middle to late life. Parkinson's Disease is most common in the elderly (over 65).Both sexes are equally affected.

CAUSE

Parkinson's Disease occurs when particular cells in the brain die. These cells are important for the control of muscles and patterns of movement. What causes these cells to die is unknown.

SIGNS AND SYMPTOMS

Loss of nerve cells in a particular part of the brain causes a decrease in the voluntary control of body movements. This is because the loss of these nerve cells reduces the amount of a chemical messenger called dopamine, which is necessary for smooth, controlled movements of the body. Symptoms appear when about 70% of these dopamine-containing cells stop functioning normally. Symptoms vary greatly between sufferers of Parkinson's disease.

- The main symptoms of Parkinson's Disease include tremor, stiffness, and rigidity of muscles and slowness of movement. Tremor is worse at rest and stops during sleep. - Loss of energy, tiredness, and pain may also occur. - Everyday activities, such as writing and rising from a bed or chair, can become difficult. The patient may walk quickly with small, shuffling steps to avoid overbalancing. Swinging of the arms is reduced while walking. - Muscular rigidity can cause a mask-like appearance of the face, with a fixed expression, widened eyes and infrequent blinking. Speech and swallowing can be affected. - In advanced cases, mental function may be impaired. A depressed mood is common. - The disease may affect one limb, one side of the body or the whole body. Signs and symptoms begin gradually and become progressively worse over a number of years. Symptoms and signs can become worse if the patient is anxious or tired.

TREATMENT OPTIONS

In no way is this information intended to replace the advice of a medical practitioner. Always see your Doctor for diagnosis and advice. Medical treatment involves taking medication that controls the symptoms of Parkinson's disease. These drugs do not slow the progression of the disease. The primary treatment is a drug called L-dopa (levadopa). L-dopa becomes less effective over time (5-7 years). L-dopa may be combined with other drugs to make it more effective.

There is no optimum drug treatment for Parkinson's and each patient is treated on an individual basis. This is because each person has different symptoms, a different rate of disease progression, a different lifestyle and different responses to the drugs available to treat Parkinson's disease. All of these factors will affect the timing, type, dose and combinations of medication. As the disease progresses, the individual medication programme may need to be reviewed and altered.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice. 1) Follow the Diet Hints. 2) Stop smoking. Ask your Pharmacist for suggestions. 3) If the diet is inadequate, consider some supplements. Note that vitamin B6 can lower the effectiveness of levodopa. Therefore, it is advisable to take B group vitamins a few hours before or after a dose of levodopa. 4) Antioxidants may assist in maintaining general health and wellbeing. Antioxidants include vitamins A, C and E, selenium and coenzyme Q10 (ubiquinone). Cranberry juice or a cranberry supplement can help prevent urinary tract infections and also act as a urinary deodoriser, particularly if incontinence is a problem.

DIET HINTS

Always follow the advice of your Dietitian or Doctor. A normal, healthy eating pattern and regular exercise are recommended during the early stages of Parkinson's Disease. The dietary intake of calcium should be sufficient to prevent osteoporosis developing. Adequate intake of fluids and fibre can help manage any constipation that develops. Dietary modification may be necessary once medication for Parkinson's Disease is started. Please see the Parkinson's Disease Diet topic on theHealthpoint for more information.

VITAMINS/MINERALS/HERBS

If the diet is inadequate, nutritional supplements may be of benefit. Always consult your health care professional for advice on dosages and interactions, particularly if you are currently taking medications for Parkinson's Disease. - Vitamin E is an antioxidant that may neutralise toxins in the body and the brain. The recommended daily allowance of vitamin E is 15 IU for males and 12 IU for females. - Calcium supplements may be required if dietary intake is inadequate. Calcium is essential for maintaining bone strength. The recommended daily intake of calcium is 1000 to 1500 mg. - Vitamin D supplements may be necessary if sun exposure is inadequate. Supplements of 200 to 400 IU per day are recommended in these cases. - Iron supplements may be necessary to prevent anaemia if dietary intake is inadequate. The recommended daily allowance of iron is 10 mg. Iron supplements can interfere with levodopa therapy. If iron supplements are necessary, your Doctor will advise you when to take them during the day. - Vitamin B complex may assist with brain function and enzyme activity. Pyridoxine (vitamin B6) deficiency may occur in patients with Parkinson's Disease who are receiving levodopa treatment. These patients should only receive moderate doses of vitamin B6, as it may interfere with the effectiveness of levodopa. - Linseed oil and fish oil may be beneficial in maintaining cell membranes.