Diseases > Parkinson and Parkinsonisms
It is a chronic incapacitating disease that is very prevalent in Europe and the United States
It´s most important symptom is general slowness. It is estimated that from the age of 65, between 1% and 2% of the population suffer from this disease.
Also known as Parkinson´s Disease, it is a chronic, progressive, and degenerative condition due to the lack of a substance called dopamine in the brainstem, that leads to affected patients exhibiting three basic symptoms: tremors, rigidity, and general slowness.
Parkinson's disease can start from the second decade of life up to the end of life, with peak prevalence between the fifth and sixth decades. It can be said that the idea that Parkinson's disease is exclusive to old age is a myth, since there may be infantile and juvenile parkinsonism.
Symptoms usually begin slowly and progressively. Sometimes the first symptom is a depressive state, difficulty in turning over in bed, writing, or putting on shoes. In other circumstances, it is the patient's relatives who notice that they perform all activities a little slower than usual: more time used when showering, walking, writing, etc.
The cause of the death of dopamine-producing brain stem neurons is not exactly known. There are indications of environmental and genetic factors that could play an important role in this regard; nevertheless, in many patients no determining factor is found.
The life expectancy of a patient affected by Parkinson's disease is the same as that of the rest of the population if treated appropriately; however, the quality of life decreases as the disease progresses. Quality of life will also depend on how the patient has been treated: aggressive treatments with high doses of l-dopa will involve complications in a short period of time, most of the time impossible to control with drugs, which will lead to an early need for Parkinson's surgery. Conservative treatments in the early stages with dopaminergic agonists or COMT inhibitors will delay the onset of these complications, although it is thought that from 20% to 30% of patients will be surgical candidates.
Parkinson's Disease was described in 1817 by a physician named James Parkinson, to whom it owes its name. At first, Dr. Parkinson called it paralysis agitans, a term that defines the symptoms of the disease-- that is, the association of slowness with abnormal movements.
In 1967 Dr. Cotzias took the next important step in the history of this disease: he realized that by giving l-dopa (a drug) to patients, they improved significantly because of the lack of dopamine in their brains. Five years later, however, this medicine disappointed the scientists a bit, as the improvement experienced was accompanied by complications: mental disorders, loss of drug efficacy, and uncontrollable abnormal movements. For this reason, there has been a shift towards functional Parkinson's surgery.
In recent years, advances in the treatment of Parkinson's have occurred in the surgical field and with the creation of new drugs that improve the condition of the patient without as many complications: dopamine agonists, COMT inhibitors and others.