Parkinson's disease (PD) is a neurological condition that worsens with time and mostly affects movement. It usually starts off as a barely perceptible tremor in one hand and continues to include stiffness, a slowing of movement, and issues with balance. For the condition to be adequately managed and the quality of life for those affected to be improved, early detection is essential. However, given there is no definite test to diagnose Parkinson's disease, making the diagnosis might be difficult.
The medical history, symptoms, and results of physical and neurological exams are the main factors used to make a diagnosis. Given that Parkinson's disease does not now have a cure, treatment focuses on symptom management.
Diagnosing Parkinson’s disease
A comprehensive evaluation of the patient's medical history and a full discussion of their symptoms are necessary for the initial diagnosis of Parkinson's disease, says Dr Aditya Gupta, director of neurosurgery and Cyberknife at Artemis hospital Gurugram.
He says that tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability are typical symptoms. It is also possible to take into account non-motor symptoms like sadness, sleep difficulties, and cognitive alterations. The beginning, course, and intensity of these symptoms will be questioned by the physician.
Neurological examination
The nervous system's functioning is evaluated by a neurological examination, says Dr Gupta adding that this include assessing balance, coordination, muscle strength, and reflexes. Parkinson's disease may be indicated by tremors, rigidity in the muscles, and slow movements throughout these tests.
An essential diagnostic tool is the patient's reaction to Parkinson's medicine, especially levodopa. Dopamine levels in the brain are raised by levodopa, and a marked improvement in symptoms following treatment provides compelling evidence for the diagnosis of Parkinson's disease.
Imaging tests
Certain imaging procedures, such as MRIs, CT scans, and DaTscans, can help rule out other disorders that may cause similar symptoms, even though no imaging test can definitively identify Parkinson's disease. When there is doubt, a DaTscan can help support a Parkinson's diagnosis by visualising the brain's dopamine system.
Treatment options for Parkinson’s disease
Medications
The principal means of treating Parkinson's symptoms is medication. The most popular medications consist of the following.
Levodopa: This drug works best to manage symptoms when taken in combination with carbidopa, says Dr Gupta.
Drugs: like pramipexole and ropinirole are examples of dopamine agonists, which mimic the effects of dopamine in the brain, suggests Dr Gupta.
MAO-B inhibitors: These drugs, which include selegiline and rasagine, prevent the breakdown of dopamine in the brain.
COMT inhibitors: These work similarly to entacapone in prolonging the effects of levodopa by inhibiting an enzyme responsible for dopamine breakdown.
Deep brain stimulation (DBS)
Dr Gupta says that the alternative for advanced Parkinson's disease patients is surgery with DBS. It entails inserting electrodes into predetermined brain regions, linking them to a generator inserted into the chest. This device helps lessen discomfort by electrically stimulating the brain.
Physical therapy and exercise
Enhancing balance, flexibility, and mobility can be achieved with physical therapy. Frequent exercise that is customised for each person's capabilities can also greatly enhance quality of life and delay the onset of symptoms.
Lifestyle modifications
Occupational therapy, speech therapy, and dietary modifications can all help with symptom management. To improve general health and well-being, one should follow disciplined routines, consume a balanced diet, and stay well-hydrated.
A study of the patient's medical history, a neurological examination, the patient's response to medicine, and imaging tests are used to rule out other illnesses in the diagnosis of Parkinson's disease. For patients to maintain their independence and general well-being, an extensive treatment plan and an early diagnosis are essential.
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