What is Parkinson's disease?

Parkinson’s disease (PD) is a progressive degenerative disorder of the brain caused by the death or impairment of certain brain cells which control movement. Parkinson’s disease typically onsets after 60 years of age and is more common in men than in women.

 Symptoms are highly characteristic, although not exclusive of PD, and include: tremors in the hands, arms, legs, face and jaw, stiffness of the trunk, arms and legs, slowness of movement, and impaired balance and coordination. They usually begin slowly, and gradually get worse to the point that many patients eventually have difficulty walking, talking, swallowing, chewing and carrying out the simplest tasks. Other symptoms that can accompany Parkinson’s disease are depression, anxiety, constipation, urinary problems (incontinence or retention), dry or oily skin, excessive sweating, sleep problems, muscle cramps, and muscle or joint ache.

Parkinson's disease genetic factors

 Although it is known that Parkinson’s disease results from the death or impairment of certain brain cells responsible for producing dopamine (a brain chemical involved in the regulation of purposeful movement), the exact cause leading to their death or impairment still remains to be established. Both genetic and environmental factors have been implicated in the onset and progression of the disease, but currently the exact role of each of these factors (genes, toxins and certain viruses) and how they interplay with each other are still poorly understood.

 PD has no cure at the moment. But fortunately it is not a fatal disease and effective treatments* exist to relieve dramatically the symptoms. There are three main categories of medications used to treat PD symptoms: 1) drugs that work by increasing the brain levels of dopamine or by mimicking its action (e.g. dopamine precursors such as levodopa, MAO inhibitors, dopamine agonists); 2) drugs that work by affecting the levels of other brain chemicals involved in the control of movement (e.g. anticholinergic drugs); 3) medications used to control the non-motor symptoms of PD (e.g. antidepressants and anti-anxiety drugs).

 The effectiveness of levodopa (a dopamine precursor) in relieving the motor symptoms of PD is so high that it is considered as the cornerstone of PD treatment. However it is important to remember that levodopa cannot cure or stop the progression of the disease, but can only improve tremors, stiffness and slowness of movement, especially during the first stages of PD.

 Unfortunately long-term use of large doses of levodopa can lead to hallucinations, psychosis and involuntary movements such as twitches or muscle spasms. In addition patients can gradually become unresponsive to tolerable doses of levodopa, as the disease progresses. In all these cases (that is when levodopa begins to produce severe side effects or is no longer effective), surgical treatment should be considered. Currently, the most effective surgical treatment for Parkinson’s disease is deep brain stimulation, which involves the implantation of electrodes into specific parts of the brain in order to stimulate them in a way that prevents PD motor symptoms from occurring. Anyway, just as levodopa treatment, deep brain stimulation is not a cure, but only a method to relieve PD symptoms.

 Since Parkinson’s disease is a chronic condition that requires long-term treatment. In order to be covered in the event you may be suffering from Parkinson disease in the future, an appropriate international health insurance plan is advised.