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Parkinsonís Disease



Parkinsonís Disease is a degenerative neurological disorder that affects approximately 500,000 people in the United States.  An estimated 50,000 new cases are reported each year.  It has garnered much attention in recent years due to the public disclosure of well known figures such as Muhammad Ali and Michael J. Fox to be sufferers of this disease.  Much research is currently underway to understand Parkinsonism.


Parkinsonís Disease affects the area in the brain called the substantia nigra.  This region produces the neurotransmitter called dopamine, the chemical messenger crucial for muscle movement.  Degeneration of the substantia nigra leads to decreased levels of dopamine.  A cardinal symptom associated with Parkinsonís Disease is the trembling of hands.  There are however other earlier symptoms associated with Parkinsonís Disease that are often ignored.  These include feeling unusually anxious, irritable, fatigued and have difficulty in sleeping.  As the disease progresses, patients may also experience increased and often times uncontrollable trembling, slurring of words, slowed movement (bradykinesia), stiff trunk and limbs, less facial expression, trouble swallowing, and problems with balance and coordination.   Reasoning ability is for the most part, unaffected.


Diagnosis for Parkinsonís Disease is made through careful observation by the physician.  There is no laboratory test that can definitively diagnose for Parkinsonís Disease.  There is also no cure for Parkinsonís Disease.  A common medication prescribed is levodopa, or L-dopa.  L-dopa is a precursor to dopamine.  The brain breaks down L-dopa to replenish the low levels of dopamine.  To some, the effects of this drug is almost immediate.  However, L-dopa does not reverse or stop the deterioration of the brain cells and increased dosage of L-dopa is eventually inevitable.  Regular exercise and a well-balanced diet is also strongly recommended.


The exact cause of Parkinsonís Disease is unknown but is believed to be multifactorial.  Genetics is strongly suspected in some cases, but it is generally thought that something must trigger it.  Parkinsonís may be triggered by chemicals in the environment or even viral infections.  It affects males more than females and has been found to occur in certain families, but a majority of cases are sporadic.  Families with high incidence of Parkinsonís Disease are strongly encouraged to undergo genetic counseling and a comprehensive pedigree analysis to rule out a genetic cause for this disease.  In families where Parkinsonís Disease only occurs in a specific gender, a new genetic test may be beneficial.  Preimplantation Genetic Diagnosis (PGD) tests for genetic abnormalities and can determine an embryoís gender prior to implantation.  This can significantly reduce the chance of having an affected child in these cases.  A genetic counselor should be consulted whether PGD will be beneficial.  PGD is also available for a variety of other hereditary disorders.



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Last modified: 06/09/04