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Parkinsons

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In this paper I am going to discuss Parkinson’s disease. I will explore what the disease is, symptoms, treatment, and prognosis. Parkinson’s disease is a neurodegenerative disease of the central nervous system. It is present in mainly elderly patients (male and female) but there is an early onset in younger children if it is genetic. This disease occurs when nerve cells in the brain (substantia nigra) that produce dopamine are destroyed. It is unknown what causes these cells to die. Once the majority of nerve cells are lost, the brain cannot send the proper signals to the body to produce movements and motor control is affected. The symptoms then begin to appear which change a person’s life forever. The majority of symptoms in Parkinson’s disease are noticeable. However it is not until patients begin to show symptoms that they are diagnosed with the disease. Tremors at rest, inability to initiate movements or slow movements (Bradykinesia), slow speech, problems with balance, constipation, low blood pressure, and rigidity are some of the main symptoms that patients will begin to notice. These symptoms become worse over time if left untreated. The first initial treatment for Parkinson’s disease is L- Dopa therapy. It is used to cross the blood brain barrier where dopamine itself cannot in patients. This treatment is used to treat the symptoms of Parkinson’s disease but does not cure the disease. It can make the patient nauseous and become toxic after time. L- Dopa also does not treat mild tremors associated with Parkinson’s. After five years of daily treatment, a decline in L-Dopa efficiency may begin to occur. Dyskinesia is a side effect that can occur after L-Dopa treatment. Other long term side effects not associated with DA also develop. Choking, drooling, bowel dysfunctions, dementia, sleep disturbances, mood disorders, and postural instabilities are symptoms that can lead to a disability that leaves that patient bedridden. Deep brain stimulation (DBS) is usually given to a patient after they have had L-Dopa therapy. The patient usually undergoes L-Dopa therapy first because the deep brain stimulation surgical procedure is quite invasive. Deep brain stimulation is also more frequently used for patients with advanced Parkinson’s disease who suffer from severe bradykinesia or dyskinesia that was induced from L-Dopa treatment. Deep brain stimulation surgery is given to a patient who is under local anesthesia so that they can safely monitor the patient’s neurological functions and speech or voluntary movements. A craniotomy (drilling holes in the skull) is performed and electrodes are then placed above the substantia nigra and different currents are used until the degree of rigidity is found. A small generator is then implanted under the clavicle once there is strong signal strength. 3D scans are then used to make sure that the electrodes are in place. Depending on how severe Parkinson’s disease is in the patient depends on whether electrodes will be placed on both sides of the body. If a patient has symptoms on the left side of the body, then electrodes will be placed on the right side of the brain. The right side of the brain controls left side body movements, while the left side of the brain controls right body movements. However the majority of patients exhibit symptoms on both sides of the body. What deep brain stimulation does to the brain once electrically stimulated is still unknown. However it is safe, adjustable, and reversible. Deep brain stimulation is not consistently effective in reducing tremors or the non-DA symptoms of the disease. There are also long term side effects from deep brain stimulation which may lead to cognitive and psychiatric disorders.
The prognosis in Parkinson’s patients varies from patient to patient. If left untreated, it can lead to a deterioration of neurological functions and early death. There is currently no cure for Parkinson’s disease. The outcome of the patient varies on how they respond to medications and treatment.

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