Parkinson’s Disease – More Common Than You Might Think

January 29, 2023 at 8:41 p.m.


My wife was recently diagnosed with Parkinson’s disease (PD) and, unfortunately, I have been witness to most of its symptoms and treatment. The first may be falling.  My wife fell several times before I began connecting the occurrence with some underlying pathology. I suspected Parkinson’s as the cause and did some research about it.  According to what I later read, she was well in the process by then.  

The Discovery

I learned that the disease was named after a physician, Dr. James Parkinson, who lived many years ago. He was born April 11, 1755, in a small village west of London. Much of his life was spent there. He was likely the first doctor to describe the symptoms, features and presentation of the disease that now bears his name. (An honor rarely bestowed during the discoverer’s lifetime.)

His description of PD was included in an essay, “An Essay on the Shaking Palsy,” and published 200 years ago. He wrote the essay when he was 62 years old and that work remains relevant today; a testament to Parkinson’s insight and powers of observation. His essay relied on information compiled from the literature together with meticulous clinical observations of his own patients. It is important to note that as neurological diseases were little known and the study of scientific medicine was in its infancy, Parkinson was working in “uncharted territory.”

As the medical discipline of neurology evolved over succeeding centuries, researchers continued to acknowledge Parkinson’s groundbreaking and meticulous contribution to describing what is today a major and baffling neurological disease. According to a recent book, Parkinson’s most important words in defining the disease were characteristic of his perceptive abilities and accuracy.

He wrote: “Shaking Palsy consists of involuntary tremulous motion, with lessened muscular power, in parts (limbs) not in action and even when supported; with a propensity to bend the trunk forward, and to pass from a walking to a running pace; the senses and intellects being uninjured.”

As a younger man, Parkinson was eager to gain medical knowledge and determined to increase his skills. Three evenings a week he walked three miles from his home town to Leicester Square, in London, to attend lectures at the medical society. However, Parkinson had other interests besides medicine. He was also well known for his political and social views and his contribution to the emerging field of geology. He was a founding member of the Geological Society. A number of fossil species he discovered still bear his name and his most substantial work was a magnificently illustrated three volume treatise on fossils. By the time he died in 1824, Parkinson’s reputation was primarily that of a paleontologist and geologist, and less known as a physician.

Symptoms

Parkinson’s symptoms vary from person to person and change overtime. Three telltale signs help doctors make a diagnosis:  slowness of movement (bradykinesia), tremor and rigidity.  Bradykinesia plus either tremor or rigidity must be present for a Parkinson’s diagnosis to be considered.  Other symptoms are related to these movement challenges: changes in walking, loss of sense of smell, difficulty in turning, festination or shuffling (quick, small involuntary steps forward), retropulsion (quick, small, involuntary steps backward, freezing episodes (an inability to perform a movement, or a feeling that your feet are stuck to the ground), micrographia (small, cramped handwriting), speech and swallowing changes.  Another movement symptom, postural instability (trouble with balance and falls) is often mentioned, but it does not occur until later in the disease progression.

If You Have The Disease

Work with your doctor to create a plan to stay healthy. This might include:

• A referral to a neurologist, a doctor who specializes in the brain.

• Care from an occupational therapist, physical therapist or speech therapist.

• Meeting with a medical social worker to talk about how Parkinson's will affect your life.

• Start a regular exercise program to delay further symptoms.

• Talk with family and friends who can provide you with the support you need.

Incidence

Both men and women can contract Parkinson’s. It can affect almost 50% more males than females. One definite risk factor for the development is old age.  Although the majority of the people having PD first develop the disorder at almost age 60 while about 5 to 10% of the people develop early onset that starts at about age 50. Early onset is usually but not always due to hereditary reasons because of some mutations in specific genes.  Most of the experts characterize PD as a movement disorder that mainly affects the nervous system. Almost one million people only in the United States suffer from PD and the experts predict that the number might rise to 1.2 million in the next decade.  

Treatment

There is no exact cause of Parkinson’s disease that affects the nervous system but the symptoms of the brain disorder might be because of the low dopamine levels. According to the experts, the mechanism of how Parkinson’s disease develops is still unknown but exposure to certain environmental factors and genetic mutations can be the cause of Parkinson’s disease.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

My wife was recently diagnosed with Parkinson’s disease (PD) and, unfortunately, I have been witness to most of its symptoms and treatment. The first may be falling.  My wife fell several times before I began connecting the occurrence with some underlying pathology. I suspected Parkinson’s as the cause and did some research about it.  According to what I later read, she was well in the process by then.  

The Discovery

I learned that the disease was named after a physician, Dr. James Parkinson, who lived many years ago. He was born April 11, 1755, in a small village west of London. Much of his life was spent there. He was likely the first doctor to describe the symptoms, features and presentation of the disease that now bears his name. (An honor rarely bestowed during the discoverer’s lifetime.)

His description of PD was included in an essay, “An Essay on the Shaking Palsy,” and published 200 years ago. He wrote the essay when he was 62 years old and that work remains relevant today; a testament to Parkinson’s insight and powers of observation. His essay relied on information compiled from the literature together with meticulous clinical observations of his own patients. It is important to note that as neurological diseases were little known and the study of scientific medicine was in its infancy, Parkinson was working in “uncharted territory.”

As the medical discipline of neurology evolved over succeeding centuries, researchers continued to acknowledge Parkinson’s groundbreaking and meticulous contribution to describing what is today a major and baffling neurological disease. According to a recent book, Parkinson’s most important words in defining the disease were characteristic of his perceptive abilities and accuracy.

He wrote: “Shaking Palsy consists of involuntary tremulous motion, with lessened muscular power, in parts (limbs) not in action and even when supported; with a propensity to bend the trunk forward, and to pass from a walking to a running pace; the senses and intellects being uninjured.”

As a younger man, Parkinson was eager to gain medical knowledge and determined to increase his skills. Three evenings a week he walked three miles from his home town to Leicester Square, in London, to attend lectures at the medical society. However, Parkinson had other interests besides medicine. He was also well known for his political and social views and his contribution to the emerging field of geology. He was a founding member of the Geological Society. A number of fossil species he discovered still bear his name and his most substantial work was a magnificently illustrated three volume treatise on fossils. By the time he died in 1824, Parkinson’s reputation was primarily that of a paleontologist and geologist, and less known as a physician.

Symptoms

Parkinson’s symptoms vary from person to person and change overtime. Three telltale signs help doctors make a diagnosis:  slowness of movement (bradykinesia), tremor and rigidity.  Bradykinesia plus either tremor or rigidity must be present for a Parkinson’s diagnosis to be considered.  Other symptoms are related to these movement challenges: changes in walking, loss of sense of smell, difficulty in turning, festination or shuffling (quick, small involuntary steps forward), retropulsion (quick, small, involuntary steps backward, freezing episodes (an inability to perform a movement, or a feeling that your feet are stuck to the ground), micrographia (small, cramped handwriting), speech and swallowing changes.  Another movement symptom, postural instability (trouble with balance and falls) is often mentioned, but it does not occur until later in the disease progression.

If You Have The Disease

Work with your doctor to create a plan to stay healthy. This might include:

• A referral to a neurologist, a doctor who specializes in the brain.

• Care from an occupational therapist, physical therapist or speech therapist.

• Meeting with a medical social worker to talk about how Parkinson's will affect your life.

• Start a regular exercise program to delay further symptoms.

• Talk with family and friends who can provide you with the support you need.

Incidence

Both men and women can contract Parkinson’s. It can affect almost 50% more males than females. One definite risk factor for the development is old age.  Although the majority of the people having PD first develop the disorder at almost age 60 while about 5 to 10% of the people develop early onset that starts at about age 50. Early onset is usually but not always due to hereditary reasons because of some mutations in specific genes.  Most of the experts characterize PD as a movement disorder that mainly affects the nervous system. Almost one million people only in the United States suffer from PD and the experts predict that the number might rise to 1.2 million in the next decade.  

Treatment

There is no exact cause of Parkinson’s disease that affects the nervous system but the symptoms of the brain disorder might be because of the low dopamine levels. According to the experts, the mechanism of how Parkinson’s disease develops is still unknown but exposure to certain environmental factors and genetic mutations can be the cause of Parkinson’s disease.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

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