Parkinsonism and its treatment

The cause of this chronic and progressive disease of the nervous system has been masked in mystery. The mist is now clearing up. There appears to be no doubt now that some environmental factor or factors are responsible for the slow degeneration in the brain which brings about the disease in the elderly people.


Factors which are thought to be responsible for parkinsonism

• Carbon monoxide poisoning.
• Intoxication by manganese and other heavy metals.
• Use of illicit drugs by drug addicts; methyl-phenyle-tetra-hydroxy pridine (MPTP) causes severe Parkinson's disease.
• Certain herbicidal sprays which are chemically similar to MPTP.
• Use of major tranquillizers such as phenothiazines can produce reversible symptoms of the disease.
• Certain virus infections of the brain.

There is increasing apprehension about the use of many chemical substances in industry and agriculture, the long-term toxic effects of which we hardly know. The lesson is that our contact with man-made chemicals should be minimum as we do not know which one is going to cause which disease in the long term.

Symptoms of parkinsonism

• Tremors in hands and fingers (pill-rolling) movements.
• Rigidity of muscles.
• Paucity of movement: short tottering steps, difficulty in getting started and in turning.
• Loss of balance.
• Handwriting becomes progressively smaller and gradually becomes illegible.
• Mask-like face of fixed expression; infrequent blinking.
• Excessive salivation.
• Speech is affected because patient cannot control muscles of speech; this may give rise to false impression of mental impairment.
• Intellectual deterioration occurs in advanced cases.


Treatment of parkinsonism

• Disease is progressive and there is no curative treatment.
• Symptoms can be controlled with atropine and synthetic atropine-like drugs which help reduce tremors. Replacement of depleted dopamine with levo- and carbi-dopa reduces stiffness and muscular rigidity, and facilitates movement.
• Surgical treatment (stereotaxic surgery) is not popular because of its destructive approach.

Prevention of parkinsonism

Role of tobacco: Almost the only known beneficial effect of tobacco is preventing or delaying the occurrence of Parkinson's disease in the elderly. In case you experience adverse symptoms of muscle stiffness and difficulty of walking on cessation of smoking and these symptoms disappear on resumption of smoking, it may be prudent to consult your physician regarding the desirability or otherwise of switching over to less harmful ways of smoking such as pipe in minimal quantity instead of complete abstinence.

Vitamin E has been reported to delay the effects of ageing and prevent such diseases as heart attacks and Parkinson's disease. It delays the appearance of tremors, rigidity of muscles and loss of balance and thus postpones the need for levodopa treatment. Vitamin E is found in nuts, seeds, whole grain, and vegetable and fish-liver oils. It can be taken in the form of capsules; 100 mg per day is sufficient for long-term use.

This article is republished at India Study Channel