This progressive neurodegenerative disease results from the decrease of an important neurotransmitter—dopamine, in the brain, which is necessary for movement. Consequently, there is difficulty in initiating movement, with resting tremors and rigidity. According to research, this decrease in dopamine is due to loss in the part of the brain known as substantia nigra. Diagnosing Parkinson’s is a daunting task and a careful history and examination by a trained professional such as Best Neurologist in Lahore is needed.
What is the new diagnostic standard for Parkinson’s?
Previously, the gold-standard for the diagnosis of Parkinson’s was according to the Parkinson’s Disease Society Brain Bank’s checklist. However, recently the new criteria from the International Parkinson’s and Movement Disorder Society has come into practice. It offers a precise and early diagnosis, for better prognosis of the disease.
The criterion involves: assessing the age of the patient and the probability of them having Parkinson’s. This is followed by assessing patient score on Yahr and Hoehn scales, the walking speed of the patient, the genetic factors, the family history of the patient, the appearance of symptoms like loss of smell and dyskinesias. Following these, the healthcare provider performs investigations like the dopamine transporter scans and calculates the results of the factors.
Dopamine transporter scans use a radioactive drug to detect the dopamine producing cells in the brain. While this is not a conclusive investigation, it is used to support the diagnosis of Parkinson’s.
In Parkinson’s the score of the factors is between 75 and 99.7 percent. A score less than 75 percent is indicative of other disorders not relevant to Parkinson’s, while a score of 80 percent may indicate early Parkinson’s.
What are the stages of Parkinson’s?
With the progression of disease, the healthcare provider uses a scale to stage the symptoms.
Stage 1 involves slight changes in the facial expression, gait and posture. At this stage of disease, the patient is able to perform activities of daily living like usual.
Stage 2 involves more noticeable bilateral tremors while the patient finds it challenging to do regular activities.
Stage 3 is classed when the patient has problems with coordination and balance. This stage is when the falls are more likely and therefore the patient needs help while performing activities of daily living.
Stage 4 patients need full-time care as they cannot walk without support, and performing regular tasks is impossible.
Stage 5 is the most severe form of disease with complete reduction of movement. Such patients are on medication and even experience side-effects of the latter like hallucinations and confusion.
What is the treatment of Parkinson’s disease?
Parkinson’s is a disease that is not treated, but rather managed symptomatically to improve quality of life. The treatment options include medication, physiotherapy and in some cases, surgery.
In the early stage of Parkinson’s, no treatment is indicated as the symptoms are mild. Later on, patients are started on drugs such as levodopa, which are the mainstay of treatment. Other options are: MAO-B inhibitors, COMT-inhibitors and amantadine.
The goal of drugs is to mimic dopamine or stimulate its receptors indirectly. The treatment is tailored by the healthcare provider such Best Neurologist in Islamabad to minimize the side effects and maximize their benefit.