Everything You Need to Know About Parkinson’s (Part 2)

While not directly fatal, the numerous complications caused by Parkinson’s Disease (PD), a neurodegenerative condition caused by dangerously low levels of dopamine in the brain, such as balance issues and depression, can often be a cause of death. However, these complications can mostly be avoided with the right treatment in order to lead a healthy, productive life.

Complications:

• Severe depression, anxiety, and/or fear requiring separate medicinal treatment.
• Dementia and other cognitive difficulties in advanced-stage PD patients.
• Swallowing difficulties and constant drooling caused by saliva accumulation in the mouth due to slowed swallowing.
• Insomnia, interrupted sleep, rising early and sleeping throughout the day, or acting out one’s dreams while sleeping.
• Difficulty urinating or urinary incontinence.
• Chronic and severe constipation.

Treatment:

Although incurable, a wide variety of treatment options for effective symptom control, physical therapy for balance issues, speech language therapy for speech problems, and certain lifestyle changes can help improve an individual’s quality of life:

1- Medication:

• Carbidopa-Levodopa, the most effective Parkinson’s medication, is a combination of the natural chemical Levodopa that converts to dopamine, and carbidopa, which acts as a guard against Levodopa’s early conversion, as well as reducing its side effects like nausea and lightheadedness. However, high doses may cause Dyskinesia (involuntary movements).
• Dopamine Agonists, despite being longer-lasting, are less effective than Levodopa as they simply imitate dopamine’s function. However, their side-effects are much more severe, i.e. hallucinations, compulsive behaviour, and drowsiness.
• MAO-B inhibitors prevent dopamine breakdown by restraining the action of MAO-B enzymes. However, these inhibitors cannot be used alongside carbidopa-levodopa and most antidepressants, as they amplify their side-effects and cause serious reactions.
• Catechol-O-methyltransferase (COMT) inhibitors act as an accompaniment to levodopa by blocking enzymes like MAO-B inhibitors do. However, as they enhance levodopa’s effectiveness, COMT inhibitors may increase the risk of dyskinesis.
• Amantadine can either be prescribed during early stages for short-term symptom relief, or be used alongside carbidopa-levodopa in later stages for dyskinesis control. Its side effects include hallucinations, swollen ankles, and purple spots or smears on the skin.

2- Deep Brain Stimulation (DBS):

People with advanced-stage Parkinson’s disease and unstable responses to levodopa such as severe bouts of dyskinesia, extreme muscle rigidity and slowed movement may also opt for DBS. It works to control such symptoms via electric pulses sent from a generator to electrodes surgically implanted near the collarbone and in the brain, respectively. However, the procedure presents a risk of infections, stroke, or brain hemorrhage, and is unsuitable for those unresponsive to levodopa.

3- Lifestyle Changes:

• A Healthy, All-Inclusive Diet can help soften the effects of certain symptoms, such as high fibre foods and fluids for constipation, omega-3 fatty acids, etc.
• Exercise not only relieves stress and depression, but can also aid in balance and flexibility improvement. Examples include walking, swimming, and dancing.
• Avoid Balance-Related Falls by moving slowly, making a U-turn when turning around, avoiding walking while carrying something, not walking backwards, striking your heels instead of your toes on the floor, and looking forward instead of down while walking.
• Yearly Flu Vaccines every autumn can aid the now-vulnerable immune system, along with a one-time vaccination against pneumococcal pneumonia-a serious chest infection.
• Emotional Support from close family and friends can help a patient in overcoming the depression, hopelessness, and frustration caused by increasing difficulty in performing regular tasks. Support groups comprised of fellow PD sufferers, and supportive psychological counselling may also benefit some individuals.

A Parkinson’s diagnosis does not have to be majorly life-altering. By recognizing the signs early-on, and with the right treatment, a large number of individuals can lead fulfilling lives. If you or a loved one displays symptoms of Parkinson’s, consult with your doctor immediately. You can also book an appointment with a top Neurologist in Islamabad, Lahore and Karachi through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your neural concerns.