World Parkinson's disease Day 2019 April 11.
- PROF DR.M.A.ALEEM M.D., D.M.,(NEURO)
EMERITUS PROFESSOR OF NEUROLOGY
THE TAMILNUDU DR.M.G.R. MEDICAL UNIVERSITY
PAST PRESIDENT TAMILNADU PONDICHERY ASSOCIATION OF NEUROLOGISTS
FORMER OF VICE PRINCIPAL HOD& PROFESSOR OF NEUROLOGY KAPV GOVERNMENT MEDICAL COLLEGE& MGM GOVERNMENT HOSPITAL
CONSULTANT NEUROLOGIST AND EPILEPTOLOGIST (TRAINED AT INSTITUTION OF NEUROLOGY QUEEN`S SQUARE . LONDON.UK.) ABC HOSPITAL, ANNAMALAI NAGAR , TRICHY -620018
Parkinson's disease (PD) is a degenerative disorder of the central nervous system. It was first described in 1817 by James Parkinson, a British physician who published a paper on what he called "the shaking palsy."
The incidence and prevalence of PD increases with advancing age, being present in 1% of people over the age of 65 years.
Early-onset Parkinson's disease (EOPD) is defined as the onset of parkinsonian features before the age of 40 years. It accounts for 3-5% of all PD cases. It is classified into the 'juvenile' (occurring before the age of 21 years) and 'young-onset' PD (YOPD, occurring in the age range of 21- 40 years).
PD is twice as common in men than in women in most populations.A protective effect of female sex hormones is observed. The presence of gender - associated genetic mechanisms or/and gender -specific differences in exposure to environmental risk factors might explain this male preponderance.
It is estimated that 6.3 million people suffer from PD worldwide. The World Health Organization gives an "estimated crude prevalence" (the total number of existent cases each year, old and new) of 160 per 100,000, and an estimated incidence (the number of new cases each year) of 16-19 per 100,000.
The incidence of PD varies across the globe. However, this distribution may not be as simple as a geographical or ethnic factor. It is known that the PD is more prevalent in North America and Europe than in Asia and West Africa. However, research has been carried out to know the causes of PD and the use of medicinal plants for its treatment, prevention, and cure.
The Parsi community in Mumbai has the world's highest incidences of PD
A prevalence rate of 27/100,000 was reported in the southern part of India, and 16.1/100,000 from rural Bengal, in the eastern part of India.
Parkinson 's disease belongs to a group of conditions called movement disorders.
The four main symptoms are tremor or trembling in hands, arms, legs, jaw, or head; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance.
These symptoms usually begin gradually and worsen with time. As they become more pronounced, patients may have difficulty in walking, talking, or completing other simple tasks. Not everyone with one or more of these symptoms has PD, as the symptoms sometimes appear in other diseases as well.
Parkinson disease occurs when the nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine.
Dopamine is a chemical messenger responsible for transmitting signals between the substantia nigra and the next "relay station" of the brain, the corpus striatum, to produce smooth, purposeful movement. Loss of dopamine results in abnormal nerve firing patterns within the brain that cause impaired movement. Studies have shown that most Parkinson's patients have lost 60-80% or more of the dopamine-producing cells in the substantia nigra by the time the symptoms appear.
Recent studies have shown that people with PD also have loss of the nerve endings that produce the neurotransmitter norepinephrine. Norepinephrine, which is closely related to dopamine, is the main chemical messenger of the sympathetic nervous system, the part of the nervous system that controls many automatic functions of the body, such as pulse and blood pressure. The loss of norepinephrine might help explain several of the non-motor features seen in PD, including fatigue and abnormalities of blood pressure regulation.
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