symptoms of parkinsons disease

The cause of Parkinson's disease are due to our loss of brain cells

2008-07-31T21:32:00.000-07:00

Sign and symptoms of a person with Parkinson disease can be not the same from a person to a person. Some person who develop Parkinson may have tremor as an early symptoms while some people may have balance problems. Age people above 65 are at high risk of develop Parkinson's disease as the muscle and the body systems are getting weak. People with Parkinson's disease develop stiffness, tremors and slow movement that can become worse over time.

The cause of Parkinson's disease are due to our loss of brain cells that produce a kind of chemical called dopamine. Dopamine is a like passenger boy in our brain that pass message from one brain to another. People with Parkinson's disease who are exposed to more of these Neurotoxins are likely to develop Parkinson;s disease.

Most of the early symptoms of Parkinson's disease are tremor which affects your whole body system to shake. The shaking always start in the hand first and slowly it will affects your legs, arms and even the heads and jaws. Your movement became slow. You will fell difficult in waking due to the stiffness of our limbs. Changes of your speech as you will notice your speech became soft. Problems of turning your head and body.

The symptoms of Parkinson disease are first to be notice are tremor

2008-05-14T23:49:00.000-07:00

The symptoms of Parkinson disease vary from each individual person and the stages that the patients experience. Parkinson diseases is a movement disorder cause by the shortage chemical transmitter in the brain. This cause by the loss of brain cell that produce a chemical called dopamine which result in passing messages from our brain to the muscles. People who are above sixty years of age are prone to the disease but the percentage is not very high. Parkinson disease are said to be inherited from family members. Others causes of Parkinson is the toxins in the environment that we are living in.

The symptoms of Parkinson disease are first to be notice are tremor in our hands, arms, legs or even heads. it will start in one side and later moved to both sides of the body. You will find movement very hard when you want to get up from your chair or moving to another side of the beds because your affected body ,arms and leg find it hard to move. others main symptoms are finding problems with balancing or walking, having stiff muscles and find movement very slow.

The doctor will diagnosed by asking you with question about your family history and the symptoms you are experience at the present. The doctor then will watch your movement and check your muscles strength and reflexes and also check your vision. The doctor will described a kinds of medicine for you to take with could control the symptoms and make the diseases to live with. The medicine most used are called Levodopa as is the best drug of controlling symptoms of Parkinson disease.

Treatment of Parkinsons Disease

2008-03-18T02:17:00.000-07:00

Parkinsons Disease is a neuromuscular condition and is cause by the changes in the basal ganglia of the brain result in slowing and weakening of voluntary movement, including those expressing emotion. At present it is said to have no complete cure despite many ongoing research. Medication to parkinsons patients depents on the amount of disruption the symptoms cause on the patients. The most effective treatment for parkinson disease patients is by a long shot is a drug called levodopa and is only effective in helping rigidity and bradykinesiabut is not so effective in helping patients with tremor or balance problems. Others medication used for treating Parkinsons disease include Coenzyme Q10, amantadine, anticholigernics, COMT inhibitors, selegiline, dopamine agonists,and carbidopa.

Physical therapy is necessary because it enables the patient to retain his mobility and control over his muscles in spite of the usual tremors and other physical symptoms of parkinsons disease.

Parkison's disease are associated with old age people

2007-11-30T01:15:00.000-08:00

Parkison's disease are associated with old age people and are said that this disease are brought down from relatives who had parkinsonian symptoms, it is suggested that a genetic factor may be involved. Parkinson's disease as most people refer as movement disorder. As peoples with this parkison's disease find themselves having trouble in walking and hand are very shaky. At present there is no cure for parkinson's disease patients and only drugs are used to control parkinson's disease.

The cause of parkinson's disease are old age, genetic factors,staying in a toxins enviroment, Trauma and carbon monoxide poisoning. The common symptoms and signs of parkinsons disease are having emotional and depression chandes. finding oneselves hard in swallowing, chewing and speaking. Others common causes are having urinary problems, Trembling of hands, legs and jaws. Having skin and sleep problems. Besides drug used to control parkinson's disease a kind of nutrition has been used in clinical study. This is widely used by parkinson patients to slow down its deterioration or partially treatment. Physical therapy can help strengthen and tone underused muscles, and give rigid muscles a better range of motion.

The youngest patients diagnoses with parkinson disease is 23 years old.

2007-10-02T22:07:00.000-07:00

The condition in diagnosed of Parkinson's disease by the appearance of motor symptoms, which include resting tremor, muscular rigidity, stooped posture and slowness or difficulty in movement. Other non- motor symptoms like sweating, facials flushing, pain and fatique may also be present. Most of the symptoms of parkinson;s disease are due to deficiency of dopamine caused by the loss of dopamine producing cells in the brains.

Parkinson's disease despite slowing down the patients with proper treatment can enjoy a good quality of life and perform tasks, drive and also playing game. While parkinsom's disease mostly effects the early people, people who is mostly above sixty years of age.About five percentage of people above age of forty and above are diagnoses with parkinson disease. The youngest patients diagnoses with parkinson disease in Malaysia is 23 years old.

Parkinson's disease is not symptomatic of the aging process

2007-10-02T21:39:00.000-07:00

Parkinson's disease is not symptomatic of the aging process. Under recognition or under diagnosis of the symptoms of parkinson's disease (PD) is hampering early identification and treatment of the disease. This is due to the major symptoms of the disease, slowness of movement, trembling of the hands and body stiffness, being taken for sign of sging. It is pity that symptom of PD are easily mistaken for signs of aging as the disease is easily treatable with availability of very effective medications that will enable patients to enjoy an extent quality life.

Under diagnosis was also compounded by the difficulty in diagnosising PD due to its non specific and subtle early symptoms, which are often mistaken for drepression. PD is a chronic, progression disorder of the nervous system, which cause increasing and devastating disability over time.

Parkinson disease affects the movement of the body

2007-09-27T00:57:00.000-07:00

Parkinson disease affects the movement of the body and the symptom always begins on one side of our body and later it will affect the other side of our body. It is a degenerative disorder of the central of our nervous which occur when our nerve cells in area of our brain known as subtantia nigra die or become impaired. Parkinson disease most people preffer as old age disease as it always begins around the age of sixty and its affect men more than women.

The symptoms of parkinson disease include disorders of mood, behavior, thinking, and sensation. Other symptoms associated with Parkinson's disease are Shaking (muscle tremor), it is mostly the first symptons Parkinson's disease. Poor balance due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Parkinson's disease patient needs daily exercises, good food nutrition and medication. Medication can help patients manage walking problem. It is advisabe not to leave the patients alone most of the time as it needs support. It is encourage to joint support groups service where most of the PD patients and peoples to help with the daily exercises.

Stem cells therapies to treat Parkinson.s disease 2

2007-07-25T01:31:00.000-07:00

Adults stem cell can be isolated from bone marrow, the liver, muscle, the brain, fat and other tissues. These cell can provide fewer different types od differentiated cells. Though so far stem cells have not cure any condition, doctors have successfully used them in blood and marrow transplants for more than thirty years. These transplants are used in the treatments of leukaemai and lymphoma to sustain life after chemotherapy and radition.

Experimentally they are used to replaced a defective immune systems in some inherited immune disorders, and to replace an immune system turned against itself, such as in some autoimmune disorders.

In future stem cells might be used to replace disease cells. If stem cells could be directed differentiate into specific cell types, they could treat Parkinson's disease, spinal cords injuries, burns, Alzheimer's arthritis, disorders of bone development and other conditions.

Stem cells therapies to treat Parkinson.s disease

2007-07-25T00:46:00.000-07:00

Stem-cell research is a new frontier in medicine. REsearchers are seeking ways to create stem-cell based therapies to treat or cure illnesses such as Parkinson's disease, Alzheimer's, diabetes, heart disease and spinal cord injuries. But the real world application, if they occur are years away.

Stem cells are difference from other cells in the body. When most cells divide, they produce two identical dauther cells, not so with stem cells, Some stem cells become specialised for example cells of the skin or heart muscle and some remains stem cells, replenishing the stem cell pool. Because some stem cells change into specialised cells, researchers believe they may be useful in repairing tissues damaged by disease, aging or injury. Sten cells are not all the same. Different stem cells can be derived from embryos, umbilical- cord blood and the plancenta and adult tissues.

Embryonic stem cells come from human eggs fertilised in vitro out of the body as part of infertility treatment. Some Embroyos may remains after a women become pregnant, and are provided for research with the concent of the donors. Embryonic stem cells can differentiate into any type of cell in the body.

No two patients will have the same symptoms or Prognosis.

2007-06-26T02:07:00.000-07:00

The symptoms of parkinsons disease, besides being similar to those of aging, are also like those of other ailments like stroke and Alzheimers. In fact the three conditions can be present in the same patients, in which case the symptoms will overlap. There are no specific tests to detect the onset of parkinson disease. Neurologists are best able to diagnoise PD.

Medicals doctors says a lot of the symptoms appear as someone ages, but they might not be due to parkinsons diseases, hence the confusion. Also no two patients will have the same symptoms or Prognosis. In addition, the symptoms can change from hour to hour, from day to day and from year to year. But there are some symptoms which are not normally found in normal aging,. The most well known are the uncontrolled tremors in the hands or feet, stiffness of the limbs, slowness of movement and diffculty with balance

The doctors also say onlt a small percentage of patients suffer from dementa. The symptoms progressively worsen as the disease advance. PD sufferers usually lose the battle due to complications,chiefly lung infection.

nicotine prevention of Parkinson’s disease

2007-05-18T01:44:00.000-07:00

Parkinson's disease occurs when brain cells that produce dopamine, an important chemical messenger die. People don't get Parkinson's disease until approximatley 80% to 90% of the dopamine-producing cells are dead. Nicotine is believed to protect these cells against damage

Survey finds that nicotine is now showing great promise in medical research in terms of prevention of Parkinson’s disease. Peoples who smoke will less get Parkinson's disease from people who don't smoke at all. Research also found that people who suffer from Parkinson’s disease and after smoking cigarettes or taking nicotine gum or using nicotine patches find movement difficulties less severe.

Coffee drinkers, lesser risk of getting Parkinson's Disease

2007-04-16T22:58:00.000-07:00

The symptoms of parkinsons disease is difficulties in walking, uncontrollable shaking of our hand and body and other coordination issues and its affects one-half of our body and slowly it will moved to the other parts of the body. The parkinsons patient will have no muscle control in its body and it can affect the face and also the lager musles of the body. Man are at the higher risk of develop parkinsons disease then women. At present there is said to have no cure to the disease but it slow with a long shot of drug called levodopa to control the disease.

Coffee drinkers are said to have a lesser risk of getting Parkinson's Disease as caffeine seems to have a protective result against Parkinson's Disease. Cigaretters smokers are also seems to have a protective result against Parkinson's Disease and also can prevent for developing Parkinson's Disease. Old age people will likely to get Parkinson's Disease due to lack of excercise and the often used of the brain.

Tai Chi for Parkinson disease

2007-03-12T01:41:00.000-07:00

Tai Chi is being recommended by some medical institutions. Physicians at the Mayo Clinic recommend Tai Chi for Parkinson’s therapy as Tai Chi movement’s helping to reduce the gradual loss of balance that Parkinson’s patient sufferers. Tai Chi movements rotate the human body when you practiced for a long time and its also good in helping people with disabilities. The Parkinson’s Society of Canada recommends Tai Chi for Parkinson’s patients

An older man with advanced Parkinson’s disease attended tai chi night classes for many months. With tai chi movement that is taught to him, he is able to do his daily excerise without any supports which he is using a walking stick for the beginning to do his tai chi excerise.

Old ages are higher risk of developing Parkinson's Disease

2007-02-01T19:56:00.000-08:00

Men appear to be at greater risk of developing Parkinson's Disease than women. At present there is no cure for the disease. The symptoms of parkinsons disease is difficulties in walking, uncontrollable shaking of our hand and body and sometimes leads to other symptoms, such as depression or anxiety, problems with chewing and swallowing, and speech changes. Some people may have problems with urination or constipation. Others may have trouble sleeping or problems with skin that is too oily or too dry.

The cause for developing the Parkinson's disease is the widespread damage of the dopamine-producing cells in a person's brain. Long shot of drug called levodopa is used for the disease and it is so effective that many patients forgot they are suffering from the disease as they continue to lead their lives as normal.

Understanding symptoms of parkinsons disease

2006-11-21T23:28:00.000-08:00

Parkinson's disease is known to have no cure and long shot of drug levodopa is one of the most effective treatment for the symptoms of Parkinson's Disease today. This disease affects millions of people of the world everyday. To understand Parkinson's disease for those who live with this illness in their daily life is quite important. First you must understanding what the disease is. The symptoms of parkinsons disease is difficulties in walking, uncontrollable shaking of our hand and body and other coordination issues.

Parkinson's affects one-half of our body and can travel to the other side of our body. THE patient will have no muscle control in its body. Stiff muscles, poor balance is the result. The muscle issues can affect the face and also the larger muscles of the body. The patient will show no sign of emotion in their face. The results will not being able to smile, swallow or speak as they used to be. Finding themself difficult in writing, buttoning a shirt and short, holding or even brushing its teeth.

Parkinson's Disease affects men more than women

2006-10-29T22:30:00.000-08:00

The primary cause for developing the Parkinson's disease is the widespread damage of the dopamine-producing cells in a person's brain. Once the rate of damage rise up to more then 70% the risk against Parkinson's disease is inescapable and death occurs usually as a result of secondary complications such as infection.

Parkinson's Disease affects generally elder adults, about 1 in every 100 of the known cases are diagnosed in people over the age of 60. Parkinson's Disease is known to affect about 3% of the population over the age of 65. With present statistics and the probable aging of the population, authorities think that that percentage will double in the next 45 years.

Men appear to be at greater risk of developing Parkinson's Disease than women. Men have to deal with about double the risk of developing Parkinson's Disease as women in any age group. Parkinson's Disease seems to growth more quickly in men than women according to one study.

Sadly, for patients with Parkinsons today, there is no real way out, and it's best to try and remain as active and involved as possible in the normal daily routine to keep up morale, and keep the patient interested in life. People with one or more close relatives who have Parkinson's Disease have an increased risk of developing the disease themselves.

Caffeine and nicotine show lesser risk in developing Parkinson's Disease

2006-10-19T21:43:00.000-07:00

Men appear to be at greater risk of developing Parkinson's Disease than women. Men have to deal with about double the risk of developing Parkinson's Disease as women in any age group. Scientists think that estrogens may play a function in protecting the body from the chemical changes that occur in Parkinson's Disease. As most women who've had estrogen replacement therapy have a lower rate of Parkinson's Disease than other women their age.
Parkinson's Disease seems to growth more quickly in men than women and the symptoms present also found a difference in some way according to one study, Men are more prone to rigidity and tremor, and women more at danger from gait disturbance and shuffling.

Caffeine also seems to have a protective result against Parkinson's Disease. A study show people who commonly drank coffee ran a lesser risk of developing Parkinson's Disease than other men who don't drink coffee. The more coffee they consumed, the lower the risk of developing Parkinson's Disease.

Cigarette smokers are less risk to get Parkinson's disease and also smoking believed to prevent and also provide relief for suffers of Parkinson's Disease as its has nicotine. Nicotine is now showing great promise in medical research in terms of both prevention of Parkinson’s disease. Smoking is of course harmful to health, so it is adviceable no one should take it up to prevent or alleviate the disease.

Study show that Intravenous glutathione injections have been shown to produce amazing and rapid results, in patients with Parkinson's disease. Following even a single dosage of intravenous glutathione, many of the symptoms of Parkinson's disease rapidly improve, often in as little as 20 minutes.

Learn the symptom of Parkinsons disease

2006-10-08T23:07:00.000-07:00

Parkinson's disease is a progressive disorder of the central nervous system .
There are primary levels of Parkinson's disease and secondary levels. Not everyone with the disease experiences all of the symptoms and the progression of the disease is different from person to person. Most of the symptoms of the disease are pain and lack of energy.

Parkinson's disease sometimes leads to other symptoms, such as depression or anxiety, problems with chewing and swallowing, and speech changes. Some people may have problems with urination or constipation. Others may have trouble sleeping or problems with skin that is too oily or too dry.

Parkinson's disease patients may notice by family members or friends are often the first to spot the early symptoms, such as a constant blank look on the face, shaky hands, decreased arm swinging, a stooped posture, or shorter steps when walking.

The symptom are tremors, movements or shaking, especially in the hands and particularly when they are at rest. Rigid limbs and trunk are stiffness, aching, or weakness and slow in movement such as problems with walking, shuffling, which may cause falls.

There is no cure; however, there are medications to treat the symptoms of the disease.

Intravenous glutathione injections improve Parkinson's disease

2006-10-01T20:21:00.000-07:00

A lot of people with the health issue of Parkinson's disease, the symptoms are often mild to moderate and they can still lead productive lives. They sometimes need to have treatment for the disease and modify their lifestyles, but it does not present a significant health issue.

Genetics researchers have found that the glutathione S-transferase gene controls the onset of Alzheimer's, Parkinson's disease and determines, not if we get these diseases, Free radicals and oxidative damage in neurons is known to be a primary cause of degenerative diseases like Alzheimer's disease.

However, intravenous glutathione therapy and glutathione precursors or dietary supplements are effective in boosting intracellular levels of glutathione. Intravenous glutathione injections have been shown to produce amazing and rapid results, in patients with Parkinson's disease. Following even a single dosage of intravenous glutathione, many of the symptoms of Parkinson's disease rapidly improve, often in as little as 15 minutes.

Eating a diet rich in Vitamin E can reduce the risk of developing Parkinson’s disease. Foods with high amounts of vitamin E include nuts, seeds, olives, olive oil, other vegetable oils, and avocados. Despite their high fat content, it’s important for people to understand that these foods are an important part of a healthy diet.

Treatment Parkinson's Disease

2006-09-19T22:02:00.000-07:00

To date, there is no known cure for Parkinson's disease, despite the ongoing research efforts of scientists across the world. Having said that, there are a number of treatments available which can substantially relieve the pain many patients feel as a result of the symptoms of the disease.

The most effective treatment for the symptoms of Parkinson's Disease by a long shot is the drug levodopa. This is derived from a naturally produced chemical in plant matter and animals, and works with the nerve cells to produce the dopamine which has been eroded by the patient's condition, and is thought to be an underlying cause of the disease. The drug allows the majority of patients to extend the period of time in which they can lead their normal lives, effectively stalling the development of their Parkinson's. Unfortunately, this treatment is only really effective in helping rigidity and bradykinesia, and may be of no help to the tremor or balance problems the patient may be experiencing. The drug is so effective, many patients forgot they are suffering from the disease as they continue to lead their lives as normal.
However, levodopa is only a short term solution, as it can never replace the nerve cells which have been irretrievably damaged within the brain.

When combined with the drug tolcapone, Parkinsons medicine significantly reduces the effects of the disease, and helps block the destruction of dopamine which worsens the condition.

symptoms of parkinsons disease : What are the four primary symptoms of Parkinson's?

2006-09-12T00:15:00.000-07:00

The following are the most common symptoms of Parkinson's disease. However, each individual may experience symptoms differently. Symptoms may include:

- rigidity - stiffness when the arm, leg, or neck is moved back and forth.
- resting tremor - tremor (involuntary movement from contracting muscles) that is most prominent at rest.
- bradykinesia - slowness in initiating movement.
- loss of postural reflexes - poor posture and balance that may cause falls; gait or balance problems.

As the disease progresses, walking may become affected, causing the patient to stop in mid-stride or "freeze" in place, and maybe even fall over. Patients also may begin walking with a series of quick, small steps as if hurrying forward to keep balance, a practice known as festination.

The symptoms of Parkinson's disease may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

http://www-neuro.med.ohio-state.edu/movementdisorders/pd/what-is-pd.htm

symptoms of parkinsons disease : Clincal trial

2006-09-12T00:08:00.000-07:00

Purpose

This study will examine the effects of transcranial electrical polarization (TEP) on gait (walking) problems and rigidity in patients with Parkinson's disease. TEP is a method of brain stimulation that may be able to change the electrical activity of the nerves of the brain, possibly causing Parkinson's disease symptoms to improve.

Patients between 40 and 80 years of age with moderately severe Parkinson's disease whose main symptoms are problems with walking, including freezing, or rigidity, may be eligible for this study. Candidates must be taking Sinemet or another L-DOPA drug and not have too much tremor.

Participants will be assigned to receive either real or sham (placebo) TEP. Both groups will have eight treatments over 3-1/2 weeks. For the TEP, electrodes are placed on wet pads on the scalp. An electrical current passes through the electrodes, travels through the scalp and skull, and causes small electrical currents in the cortex-the outer part of the brain. Participants will have a neurological examination, including an evaluation of walking, just before and just after each TEP session. Patients' motor function will be re-evaluated at 1, 3, and 6 months after the last TEP treatment.

Study Type: Interventional
Study Design: Treatment

Official Title: Transcranial Electrical Polarization for the Treatment of Bradykinesia and Rigidity in Patients With Parkinson's Disease.

Further study details as provided by National Institutes of Health Clinical Center (CC):
Primary Outcomes: Meaurement of the freezing and balance/gait, bradykinesia, and rigidity immediately before and after each TEP session, to estimate the therapeutic effect over the course of treatment.
Secondary Outcomes: Measure long-lasting therapeutuc TEP effects.
Expected Total Enrollment: 46
Study start: March 2003
Last follow-up: April 2006; Data entry closure: April 2006

The treatment of Parkinson's disease (PD) needs further improvement, particularly in the areas of gait and freezing. Transcranial electrical polarization (TEP) which passes weak direct current (DC) current through the skull and across the cortex has been done for many years with numerous effects described in healthy subjects and patients with mental illness. Recently, it has been shown by objective means, in controlled experiments, that this type of treatment has robust and lasting effects on the excitability of the motor cortex in healthy humans. We hypothesize that TEP will have a beneficial effect on gait and freezing in medicated patients, and we propose to test this in a controlled trial. Specifically, we propose to look at the effect of 1-2mA TEP with anode position over the frontal poles and/or premotor and primary motor cortex, and cathode over mastoid process. Over a one-year period, we will enroll 42 adults with PD and evaluate the acute TEP effects over a period of four weeks (eight TEP sessions, nine visits). Additional ratings will be done at one and three months after the end of TEP sessions. Symptoms will be evaluated with standard tests of motor function, including the Unified Parkinson's Disease Rating Scale (UPDRS) and specific tests of gait and freezing. We will also look for cumulative, long-lasting effects over the three-month period.

http://www.clinicaltrials.gov/ct/show/NCT00082342

symptoms of parkinsons disease : Other Parkinsonism Syndromes

2006-08-30T01:18:00.000-07:00

The characteristic symptom-complex of Parkinson disease (tremor, rigidity, bradykinesia, postural instability) is termed parkinsonism. This is a general term and not all patients with parkinsonism have typical Parkinson disease. Early in the disease process it may be difficult to know whether a patient has typical Parkinson disease or a syndrome that mimics it. The development of additional symptoms and the subsequent course of the disease generally points to the correct diagnosis.

Recognizing other causes of Parkinsonism

A number of patients with parkinsonism do not have PD. One study of patients with parkinsonism found that 65% had PD, 18% had drug-induced parkinsonism, 7% had vascular parkinsonism (i.e. from blocking-up of the small blood vessels feeding the brain) and 10% had atypical parkinsonism. Atypical parkinsonism should be considered particularly in patients with poor dopaminergic responsiveness, early loss of balance, prominent intellectual changes (dementia), rapid onset or progression, conspicuous postural hypotension, and little or no tremor. The present of neurological findings not associated with classic Parkinson disease, such as myoclonic jerking (shock-like sudden muscle contractions), should also suggest other diagnostic possibilities. The autonomic nervous system regulates the “involuntary” internal functions of the body, such as blood pressure, heart rate, and bladder, rectum, and sexual function. It may be affected in certain atypical parkinsonian syndromes.

Medication-induced Parkinsonism

Although tremor and postural instability may be less prominent, this condition may be indistinguishable from Parkinson disease. Medications frequently associated with the development of parkinsonism include antipsychotics, metaclopramide, reserpine, tetrabenazine and some calcium-channel blockers (especially cinnarizine and flunarizine). The parkinsonism usually resolves within weeks to months after discontinuing the offending medication.

Progressive Supranuclear Palsy (PSP)

Early onset of imbalance, frequent falls, rigidity of the trunk, and (eventually) eye-movement problems characterize PSP. Symptoms usually begin after age 50 and progress more rapidly than with Parkinson disease. The most characteristic eye movement abnormality is a vertical gaze paralysis. Upgaze and downgaze are therefore limited. Patients may present with frequent falls while walking downstairs, because they cannot look down. Dementia develops later in the disease. There is no specific treatment for PSP. Dopaminergic treatment should be tried but often provides little benefit. Supportive measures such as speech therapy, physical therapy, and antidepressants may help.

Corticobasal Degeneration (CBD)

CBD is the least common of the atypical causes of parkinsonism. It often affects patients quite asymmetrically and progresses more rapidly than Parkinson disease. The initial symptoms of CBD usually develop after age 60 and include asymmetric bradykinesia, rigidity, limb dystonia (abnormal postures), postural instability, and disturbances of language (speech expression or comprehension). There is often marked and disabling apraxia, i.e., it becomes difficult or impossible to use the affected limb even though there is no weakness or sensory loss.

There is no specific treatment for CBD. Supportive treatment such as botulinum toxin for dystonia, antidepressant medications and speech and physical therapy may help. Levodopa and dopamine agonists seldom offer benefit.

Multiple System Atrophy (MSA)

MSA is a neurodegenerative disease of unknown cause. Initially it may be difficult to distinguish from Parkinson disease, but it is far less common and progresses more rapidly. The mean age of onset is in the mid-50s. Clinically, it presents with bradykinesia, poor balance, abnormal autonomic function, rigidity, difficulty with coordination, or a combination of these features. Abnormalities of autonomic function include impotence, low blood pressure upon standing, excessive or reduced sweating, and constipation. There are three subtypes of the illness, each affecting different systems.

Striatonigral degeneration (SND) is characterized by parkinsonism, but without much tremor and with poor response to Sinemet. In the Shy-Drager syndrome, parkinsonism and autonomic abnormalities are conspicuous. In olivopontocerebellar atrophy (OPCA), patients have lack of coordination and clumsiness which affect balance and gait.

As MSA progresses, other symptoms and signs develop that reflect involvement of a different system. Patients with the parkinsonian presentation typically have an asymmetrical tremor, bradykinesa, rigidity and postural instability. Men often develop impotence; both men and women often experience urinary urgency and incontinence. Patients with Shy-Drager syndrome present with more prominent symptoms of autonomic dysfunction.

Although 30% of patients with MSA obtain a definite but short-lived benefit from levodopa and dopamine agonists, the parkinsonism is typically poorly responsive to medications. Dyskinesias and dystonia emerge in half of treated patients. There is not much experience of using deep brain stimulators (DBS) for MSA, but some researchers have found a modest benefit of DBS that persisted for over two years in a few patients.

Vascular Parkinsonism

Multiple small strokes can cause parkinsonism. Patients with this disorder are more likely to present with gait difficulty than tremor and are more likely to have symptoms that are worse in the lower than upper limbs. Some will also report the abrupt onset of symptoms or give a history of step-wise deterioration (symptoms get worse, then plateau for a period). Treatment is the same as for Parkinson disease, but the results are often disappointing.

Dementia with Lewy bodies (DLB)

This disorder is characterized by early dementia, prominent hallucinations, fluctuations over the day in cognitive status, and parkinsonism. The neuropsychological profile is characterized by deficits in attention, executive function (problem solving, planning) and visuospacial function (the ability to produce and recognize figures, drawing or matching figures).

Treatment with cholinesterase inhibitors may reduce delusions, apathy, agitation and hallucinations. A severe reaction to antipsychotic medication is another feature of this disease. If behavioral problems do not respond to cholinesterase inhibitors, low-dose treatment with atypical antipsychotic medications (quetiapine, resperidone, or clozapine) may be considered. Although motor symptoms may respond to levodopa, hallucinations may become worse with its use.

The above information was contributed by Mariann Di Minno, RN, MA, and Michael J. Aminoff, MD, DSc, of the Parkinson’s Disease Clinic and Research Center at the University of California, San Francisco.

symptoms of parkinsons disease : PARKINSON PRIMER 2

2006-08-30T01:13:00.000-07:00

Symptoms may originally be restricted to one limb, but will typically spread over time to the other limb on the same side. They eventually progress to the other side of the body. Generally this progression is gradual, but the rate of progression varies in different patients. As symptoms progress, it is important for patients to talk with their physicians so that optimal treatment can be established. The goal of treatment is not to abolish symptoms, but rather to help the patient manage their symptoms, function independently, and make the appropriate adjustments to a chronic illness. The illness will not go away, but management of its symptoms can be successful in reducing disability or other handicap.

Patients are aware of the progressive nature of the illness and this may become a source of much anxiety. It is not uncommon for patients to over-monitor themselves and their symptoms, compare themselves to other Parkinson disease patients whom they may meet (length of diagnosis, level of symptoms, etc.), and avoid situations such as support groups, where they may see patients who are worse off than they are. Concern about the progression of the disease and the ability to continue working is frequently voiced.

It is not possible to predict with any confidence the likely course of the disease in an individual patient. The rate of progression and resulting level of disability vary in different patients. Some guide to the likely outcome in individual patients is provided by the course of the illness since diagnosis, but this is no more than suggestive.

When the disorder is such that normal activities of daily living are impaired, at least to some extent, symptomatic treatment is begun.

Is PD Inherited?

There is a family history of Parkinson disease in 5-10% of patients. It may affect people of the same generation (e.g., a brother or sister) or in two generations, such as a father and son. Environmental toxins such as manganese, carbon monoxide, and, rarely, certain pesticides cause diseases that resemble PD. However, most people with Parkinson disease have not been exposed to these toxins. In less than 1% of cases, PD is clearly familial. Several gene mutations have been shown to cause Parkinson disease in a few families, but these have not been found in most individuals with PD. Studies of identical twins in which one twin was known to have PD showed no increase in the incidence of PD in the other twin compared to the general population of patients over the age of 60 years. However, among identical twins younger than 50, if one member of the twinship has Parkinson disease, there is an increased risk of PD in the other twin. This indicates heredity may play a role in young-onset cases. Currently, researchers suspect that the cause of Parkinson disease in most individuals reflects a combination of genetic factors and environmental exposures.

What Else Could It Be?

There are many causes of tremor other than Parkinson disease, and it generally requires examination by a neurologist to distinguish between them.

by Mariann Di Minno, RN, MA, and Michael J. Aminoff, MD, DSc

symptoms of parkinsons disease : PARKINSON PRIMER

2006-08-30T01:07:00.000-07:00

Overview of Parkinson Disease

Parkinson disease (PD) was first described in 1817 by Dr. James Parkinson, a British physician, for whom the disease was named. It is a disease that is characterized by four major features:

Rest tremor of a limb (shaking with the limb at rest)
Slowness of movement (bradykinesia)
Rigidity (stiffness, increased resistance to passive movement) of the limbs or trunk
Poor balance (postural instability)
When at least two of these symptoms are present, and especially if they are more evident on one side than the other, a diagnosis of PD is made, unless there are atypical features that suggest an alternative diagnosis. Patients may first realize something is wrong when they develop a tremor in a limb; movements are slowed and activities take longer to perform; or they experience stiffness and have balance problems. Initially, symptoms are a variable combination of tremor, bradykinesia, rigidity and postural instability. Symptoms typically begin on one side of the body and spread over time to the other side.

Changes occur in facial expression, so that there is a certain facial fixity (blank expression showing little emotion) or a staring appearance (due to reduced frequency of eye blinking). Complaints of a frozen shoulder or foot drag on the affected side are not uncommon. As symptoms come on gradually, older patients may attribute these changes to aging. The tremor is thought to be “shakiness,” bradykinesia is regarded as normal “slowing down,” and stiffness is attributed to arthritis. The stooped posture, common to PD, may be attributed to age or osteoporosis. Both younger and older patients may experience initial symptoms for a year or more before seeking medical evaluation.

Parkinson disease affects 1 in 100 people over the age of 60, with the average age of onset being 60 years. It can also affect younger people. Young-onset Parkinson disease (onset at age 40 or younger) is estimated to occur in 5 – 10% of patients with PD.

Disease Progression

After Alzheimer’s disease, Parkinson disease is the most common neurodegenerative disease.

It is a chronic, progressive disease that results when nerve cells in a part of the midbrain, called the substantia nigra, die or are impaired. These nerve cells produce dopamine, an important chemical messenger that transmits signals from the substantia nigra to another part of the brain called the corpus striatum. These signals allow for coordinated movement. When the dopamine-secreting cells in the substantia nigra die, the other movement control centers in the brain become unregulated. These disturbances in the control centers of the brain cause the symptoms of PD. When 80% of the dopamine-producing cells in the substantia nigra are depleted, symptoms of PD develop.

Initially the symptoms are mild, usually on one side of the body, and may not require medical treatment. Rest tremor is a major characteristic of PD, and the most common presenting symptom, but some patients never develop it. Tremor may be the least disabling symptom, but is often the most embarrassing to the patient. Patients may keep their affected hand in their pocket, behind their back, or hold something to control the tremor, which may be more psychologically distressing than any physical limitation that it imposes.

Over time, initial symptoms become worse. A mild tremor becomes more bothersome and more noticeable. Difficulties may develop with cutting food or handling utensils with the affected limb. Bradykinesia (slowness in movement) becomes a significant problem and the most disabling symptom. Slowness may interfere with daily routines; getting dressed, shaving or showering may take much of the day. Mobility is impaired and difficulty develops in getting into or out of a chair or a car, or turning over in bed. Walking is slower and there is a stooped posture, with the head and shoulders hanging forward. The voice becomes soft and monotonous. A disturbance of balance may lead to falls. Handwriting becomes small (“micrographia”) and illegible. Automatic movements, such as arm swing when walking, are reduced.

by Mariann Di Minno, RN, MA, and Michael J. Aminoff, MD, DSc, of the Parkinson’s Disease Clinic and Research Center at the University of California, San Francisco.

symptoms of parkinsons disease : Is There a Link?

2006-08-24T02:52:00.000-07:00

Both Alzheimer's and Parkinson's disease affect nearly half a million people each year with their debilitating and eventually life-robbing symptoms. While Alzheimer's steals memories and personality and eventually leads to decreased motor function, Parkinson's disease robs the person of basic motor function causing a shaking or palsy to run throughout the body. Scientists have wondered for years whether or not there was a connection for the two diseases, either in the genes or some environmental factor that triggered the onset of both Alzheimer's and Parkinson's Disease.

A Discussion of the Two Players:

Parkinson's disease is an incurable disease of the nervous system where the neuro-transmitters in the brain begin to malfunction, causing a trembling in the body and limbs that gets progressively worse over time. Symptoms of rigidity and trouble walking at a normal gait also appear over time. Eventually this disease will rob the person of the ability to control their balance leading to more falls and slips, which is a concern for their well being.

Alzheimer's and Parkinson's disease are different in that while Parkinson's disease appears to focus more on physical ailments, Alzheimer's appears to affect the mental capacities before the motor skills and physical ones deteriorate. Common everyday forgetfulness turns into confusion and forgetfulness that becomes a problem for every day activity. The location of homes or remembering the faces of children or friends becomes more and more difficult with time. Eventually, the personality can change as a result of the disease.

Is There a Connection?:

In April of 2003, a scientific study indicated that there may be a connection between Alzheimer's and Parkinson's disease. In that study, it was concluded that older adults who develop the tremors and other classical symptoms of Parkinson's disease may be up to eight times as likely to develop Alzheimer's disease as well. In addition, it has been shown that the symptoms of both Alzheimer's and Parkinson's disease can be very similar and perhaps follow the same lines, although the root cause may be somewhat different.

Research also suggests that Alzheimer's and Parkinson's disease may have a connection in how the two diseases progress over time. The same study published in the April 2003 issue of The Archives of Neurology tracked the progression of symptoms associated with Parkinson's disease among 824 Catholic clergy members with an average age of 75, and who had no signs of Alzheimer's disease at the beginning of the study. After approximately four and half years, 79% of the study's participants experienced a more rapid progression of the symptoms of Parkinson's disease. Of those who experienced the most rapid progression, it was found that they were eight times as likely to have symptoms of both Alzheimer's and Parkinson's disease.

Is there a connection between Alzheimer's and Parkinson's disease? So far the medical profession is still debating that idea, but more and more studies indicate that they're might be a link between these two debilitating diseases. Only more time, and more research will be able to explain the connection, if any, between Alzheimer's and Parkinson's disease.

By Jonty Smith

symptoms of parkinsons disease : Parkinsons Medicine

2006-08-24T02:48:00.000-07:00

To date, there is no known cure for Parkinson's, despite the ongoing research efforts of scientists across the world. Having said that, there are a number of treatments available which can substantially relieve the pain many patients feel as a result of the symptoms of the disease. It is not the case that every patient will require medication and drugs to treat their condition, and these will only be administered where the severity of the symptoms has a strong adverse affect on the patient's lifestyle. The course of Parkinsons Medicine offered to a patient will vary with the amount of disruption the symptoms cause, the state of the patient's condition and the severity of the condition within the patient. Even in these cases, it is not always a guarantee that the symptoms will be helped, although these treatments will go someway to making life more comfortable.

The most effective treatment for the symptoms of Parkinson's Disease by a long shot is the drug levodopa. This is derived from a naturally produced chemical in plant matter and animals, and works with the nerve cells to produce the dopamine which has been eroded by the patient's condition, and is thought to be an underlying cause of the disease. The drug allows the majority of patients to extend the period of time in which they can lead their normal lives, effectively stalling the development of their Parkinson's. Unfortunately, this treatment is only really effective in helping rigidity and bradykinesia, and may be of no help to the tremor or balance problems the patient may be experiencing. The drug is so effective, many patients forgot they are suffering from the disease as they continue to lead their lives as normal. However, levodopa is only a short term solution, as it can never replace the nerve cells which have been irretrievably damaged within the brain.

As with most medications, there are a number of side effects with levodopa, including restlessness, low blood pressure and vomiting. In some cases patients may also occasionally feel confused as to their surroundings , although this is a rare occurrence. It is important for physicians and patients to work together to come up with a happy medium between the benefits and side effects when using levodopa.

When combined with the drug tolcapone, Parkinsons medicine significantly reduces the effects of the disease, and helps block the destruction of dopamine which worsens the condition. Having said that, this tends to increase involuntary movement and twitching over a long course of treatment, and is sometimes withdrawn for several days at a time to ensure its continued effectiveness. However, patients should never completely cease treatment with levodopa without their physician's guidance, due to the extreme and serious side effects that can emerge as a result.

Although there is no cure for the disease, Parkinsons medicine can go a long way to suppressing the debilitating and disabling symptoms of the condition, and making life more bearable for the many thousands of sufferers around the world.

by Clive Jenkins

symptoms of parkinsons disease : Deep brain stimulation-Risks

2006-08-15T20:45:00.000-07:00

Risks

Deep brain stimulation is less risky than other surgical procedures used to treat Parkinson's disease. Risks may include:

Bleeding in the brain during the surgery, resulting in a stroke.
Numbness, tingling, twitching, or other abnormal sensations when the device is turned on. (These usually do not last long and can be eliminated by adjusting the programming of the deep brain stimulation device.)
Infection or skin irritation caused by the device in the chest (stimulator) or electrodes.
Break in the wire leading from the electrode to the stimulator. Repairing the problem requires another surgery but not usually in the brain itself.
Need for a new battery for the device. A battery typically will last about 5 years; surgery is needed to replace it. This is a relatively minor procedure and does not require surgery on the brain itself.
Failure or malfunction of the stimulator or the electrodes.
What To Think About

Deep brain stimulation may be considered as an addition to levodopa therapy, not a replacement for it. It does not cure Parkinson's disease and does not eliminate the need for medication. The surgery can help maintain and extend the benefits of levodopa therapy, but should not be considered for people with Parkinson's disease who also respond poorly to levodopa therapy.

One of the possible advantages of deep brain stimulation over "lesional" surgery for Parkinson's disease (such as pallidotomy) is that it can be reversed. While the effects of lesional surgery, which involves creating a lesion or intentionally destroying a small portion of the brain, are permanent, the electrodes used in deep brain stimulation can be turned off or removed if they cause problems.

© 1995-2006, Healthwise, Incorporated,

symptoms of parkinsons disease : Deep brain stimulation part 2

2006-08-15T20:39:00.000-07:00

Why It Is Done

Deep brain stimulation may be used to relieve symptoms of Parkinson's disease, especially tremor, when they cannot be controlled with medication. It is considered the surgical treatment of choice for Parkinson's disease because it is more effective, safer, and less destructive to brain tissue than other surgical methods.

Deep brain stimulation of the thalamus is done to treat disabling tremor caused by Parkinson's disease, as well as essential tremor.

Procedures that stimulate the subthalamic nucleus and the globus pallidus are done to help control a wider range of symptoms (in addition to tremor) and are used more often than stimulation of the thalamus.

How Well It Works

Deep brain stimulation of the thalamus is effective in reducing tremor. It does not affect slow movement (bradykinesia), stiffness (rigidity), or other symptoms.1

Deep brain stimulation of the subthalamic nucleus or the globus pallidus may:1

Reduce tremor and, to a lesser extent, other symptoms of Parkinson's disease. Deep brain stimulation tends to have the greatest effect on tremor, but slow movement and stiffness can also be reduced and gait can be improved.
Reduce the on-off motor fluctuations associated with long-term use of levodopa. During the course of a day, you may have “on” periods when the levodopa controls Parkinson's symptoms and “off” periods when the medication stops working. Deep brain stimulation can reduce the length and severity of “off” periods.
Reduce the abnormal movements (dyskinesias) that are side effects of levodopa therapy.
The practical effects of deep brain stimulation depend in part on which area of the brain receives the stimulation. Stimulation of the subthalamic nucleus reduces symptoms of Parkinson's disease, which allows people to reduce the amount of levodopa they are taking. Taking a lower dose helps reduce the abnormal movements (dyskinesias) that result from long-term levodopa therapy.

In contrast, stimulation of the globus pallidus reduces the dyskinesias associated with levodopa therapy, which allows people to increase the amount of levodopa they are taking without increasing side effects. In this case, the increased dosage of levodopa and the brain stimulation together help reduce tremor and other symptoms caused by Parkinson's disease.

By Healthwise

symptoms of parkinsons disease : Deep brain stimulation part 1

2006-08-15T20:33:00.000-07:00

Treatment Overview of parkinsons disease

Deep brain stimulation uses electrical impulses to stimulate a target area in the brain. The stimulation affects movement by altering the activity in that area of the brain. The procedure does not destroy any brain tissue, and stimulation can be stopped at any time by turning off the device that supplies the electrical impulses.

Surgery is required to implant the equipment that produces the electrical stimulation. You are awake during the procedure (your scalp is numbed and you won't feel any pain) because you must work with the surgeon in placing the electrodes where they will have the most benefit. A small hole is drilled in your skull, and tiny wire electrodes are placed in your brain. A small battery-powered device (generator) similar to a pacemaker is implanted in your chest and connected to the electrodes in your brain by a wire. The procedure usually takes 3 to 4 hours, although it may take as long as 8 hours in some cases.

When the device is turned on, it sends 100 to 180 electrical pulses per minute to stimulate the specific area of the brain. You can turn the device on and off by holding a magnet against the skin over the device. Newer models can be turned on and off with a small remote control unit. The device can be programmed so that it delivers the correct level of stimulation to provide the greatest relief of symptoms.

What To Expect After Treatment

You will remain in the hospital for several days after the procedure while your doctor checks the effect of deep brain stimulation.

By Healthwise

symptoms of parkinsons disease : Wise Symptoms Of Parkinson's Disease

2006-08-08T21:02:00.000-07:00

Parkinson's disease has been classified into five stages by Hoehn and Yahr. Their classification is based on the severity of symptoms and the degree of disability the patient experiences.

When prescribing treatment, the neurologist will take into account the stage at which the patient is perceived to be, among other things.

Stage 1 is called unilateral disease. The term means that only one side of the body shows symptoms of Parkinson's disease.

This is considered an early stage of the illness and may last for several years. Neuroprotective treatment is common at this stage. This treatment aims to prevent further damage to the nervous system.

Vitamin E was used at this stage, but many researchers are of the opinion that this is not very effective. A selective MAO-B inhibitor called Rasigiline has shown promise.

Stage 2 of Parkinson's disease is labeled bilateral disease. Meaning, symptoms of Parkinson's now show up on both sides of the body. The illness is considered to be at Stage 2 even if there is an insignificant symptom (an occasional tremor, for example) on the side of the body that was symptom-free earlier.

Recent therapies at this stage include use of dopamine agonists. Till some years ago, dopamine agonists were used only at later stages of the disease. Currently, researchers are of the view that if such treatment is started earlier, complications from using drugs like Levodopa may not arise at later stages.

The disease is said to be at stage 3 when symptoms show progression and especially when the patient has difficulty in maintaining their posture. Symptoms at this stage include postural instability and falling down.

Traditionally, this is the stage at which dopamine agonists or Levodopa was prescribed, but as mentioned above, some of these drugs are now used at earlier stages itself.

Stage 4 occurs when there is an increase in the severity of symptoms including postural instability and falling. Surgery is one option for treatment at this stage. Surgery can alleviate some of the symptoms. However, this is generally recommended only for relatively young patients who are in good health otherwise.

Stage 5 is the most advanced stage of Parkinson's disease. The patient is usually wheelchair bound. Walking is possible only with assistance.

Levodopa continues to be a prescribed drug at this stage, along with a COMT inhibitor, which ensures that the effects last longer. Surgery may also be an option, including pallidotomy, which destroys a small group of brain cells. This helps avoid the rigidity often experienced with Parkinson's disease and may stop tremors as well.

Another possible treatment is deep brain stimulation, where electrodes are implanted into the brain tissue and stimulated with low level electric currents.

The symptoms of Parkinson's disease progress as the patient moves from one stage to the next. Ongoing research is producing new treatments including stem cell implants and new drugs.

By Jane Peters

symptoms of parkinsons disease : Are Some People Predisposed To It?

2006-08-08T20:50:00.000-07:00

It is well known that Parkinson's disease mostly affects older people. But apart from that, what other factors indicate higher chances of developing this debilitating illness?

Let's take age itself as the starting point, because there are some nuances that are not generally known. In line with popular perceptions, about 90% of people with the illness are over 60 years old.

This is true even if you consider the age at which the symptoms first appear. Not even 10% of cases are diagnosed in adults under age 40. Most of the fresh diagnoses are in those above age 60.

However, that's not the whole story.

Among those over 60, the risk goes up from age 60 to age 75. After that, it drops sharply. In other words, someone who is 85 years old is less likely to get Parkinson's disease than someone who is 70, statistically speaking. This may seem surprising to most people.

Let's look at it from another angle. The above statistics apply to those who have been diagnosed with the illness. If we take what is called Parkinsonism (meaning, symptoms of Parkinson's that have other causes, or symptoms that may develop into the illness itself) into account, fully 15% of those between 60 and 75 have it. And between 75 and 84 years of age, an amazing 30% have the illness.

At the moment, around 3% of the population over age 65 is affected by the disease. But this percentage is estimated to double over the next four decades.

Age obviously has an impact on the disease. What other factors exist?

Gender is evidently another one. It is estimated that men have about twice as much risk of developing Parkinson's as women. This applies to every age group.

Researchers theorize that the female hormone estrogen is responsible for the lower incidence of the disease among women. There are two facts to support this view.

The first is that women who have undergone hysterectomies have a somewhat higher risk of developing Parkinson's disease. Secondly, women who are on hormone replacement therapies tend to have a lower incidence of the condition. These facts seem to imply that estrogen does play a role in preventing Parkinson's.

The illness also seems to progress faster in men than in women. In terms of symptoms, women tend to be prone to disturbances in their gait, while men are more at risk of tremors and rigidity.

Heredity appears to play a role in the disease. Someone whose siblings who have developed Parkinson's disease before the age 40 is at greater risk of falling victim to the illness. However, if the siblings develop the disease only in later years, heredity does not seem to play a prominent role.

There are differences among races in the incidence of Parkinson's, so ethnicity does appear to play a role. Caucasians are at greater risk than Asian Americans or African Americans. Some research indicates that although races other than Caucasians have lower overall risk, they may carry a higher risk of other types of Parkinsonism which involves problems with the thinking process.

Apart from the above, some evidence suggests that caffeine might offer protection against this disease, to an extent. Drinking coffee regularly, it seems, is a useful preventive measure.

As can be seen, some factors do seem to create a higher risk of a person developing Parkinson's disease. Researchers are digging deep for more clues that may one day lead to a full understanding of this condition.

by Jane Peters

symptoms of parkinsons disease : Things to Consider

2006-08-02T20:09:00.000-07:00

Being faced with the diagnosis of Parkinson's or any other disease is a frightening, but don't allow that initially felt fear, confusion, or even denial to cloud your judgment.

Doctor's are great at diagnosing diseases, but they 100's of patients and together with all of the paperwork and insurance headache, they tend to not personally get involved with each patient.

Meaning that you need to be the "captain of your own ship". You need to consider a number of things, such as:

Finding the "right" doctor, or doctors, for you. Develop a team of doctors, therapist, etc., that you trust and enjoy speaking with.

Join a support group near you and be on the look out for forums on the Internet where you can "chat" with others similarly affected so as to learn about solutions to problems and new treatments that you and your doctor may not be aware of.

All of the questions and thoughts to consider here are for you to ask yourself, your doctor(s), and other Parkinson's patients who you get to know via support groups and/or Internet forums.

Why did I get this disease?

Might have been a genetic predisposition for them to develop it or environmental factors that played a role, such as where they lived or elements of their workplace.

Or were lifestyle choices such as diet, personal habits and/or exercise to blame?

What treatments are available?

If the parkinsons symptoms are mild some doctors may prescribe nothing more than change in diet or suggest including more exercise into the patient's day-to-day routine.

For symptoms to are more severe the doctor may prescribe medication. Levadopa (Sinemet ® ) is the most common, but newer drugs, Requip ® and Mirapex ® are being prescribed now days too. However medications don't always have the same effect on patients, so while on drug may help one person considerably, it may not work for someone else.

In some cases, usually the severest, surgery is the best option.

Along with the benefits of the medications, don't forget the potential side effects. Parkinson's' sufferers are often going through enough discomfort so you must make sure that you are aware of and prepared for any potential side effects of a medicine.

Not all Parkinson patient are the same in the symptoms they suffer and some respond to medicines and other treatments differently.

What are the short and long term benefits of each treatment, is there anything that can be done to decrease the potential side effects of the treatment (particularly medicines)?

Don't just "sit back" and let your doctor decide everything, ask questions of your doctor but also be willing to allow yourself to accept what your doctor is recommending.

Look at the Yahoo, Healthboards.com, and BrainTalk Communities which are my favorite forums.

You can ask other members if there any alternative and/or non-drug related options that could help your condition?

You may find that some of the members have made modifications to their lifestyles (i.e. diet, exercise, reducing stress levels, etc.) that are helping them physically and emotionally to cope better with the progression of the disease.

Are there particular foods, drinks, over the counter medications and/or vitamin supplements that I should stay away from or look into?

Your health is not as it once was, even the "common" colds aren't so "common" any longer. You don't want any adverse drug reaction when your treatment and medications begin, be very careful about what you do and don't put into your body, especially supplements and other not so common over the counter vitamins and medications. Be sure to speak with your pharmacist.

Can your doctor, your support group, or the Internet forum members recommend any non-traditional (or naturopathic) techniques for relaxation and reducing stress levels?

Look at city services, the local junior college for classes in yoga, meditation, reflexology, massage, deep breathing, etc.

The local support group may be aware of classes that would be of help to you.

Are there any trials or clinical studies that you can be a part of?

If the idea interests you be sure to speak with your doctor, your support group and be on the look out, via the Internet, yourself.

Clinical studies need willing participants and these studies occasionally have very good results for the participants

By Mike Herman

symptoms of parkinsons disease : Why is Parkinson's Disease Difficult to Diagnose?

2006-08-02T20:02:00.000-07:00

While Parkinson's disease has very distinctive features, it is rather a difficult disease to identify, particularly while it is in its early stages. Unfortunately there are no precise tests, which doctors can do to establish an exact diagnosis of Parkinson's disease and regrettably especially in its early stages it might be mistaken for other diseases. If and when this happens, it delays or prevents the appropriate action being administered in the quickest feasible time.

The trouble with diagnosing Parkinson's disease accurately is just that the symptoms are not always as clear as doctors would like them to be, Actually there are suggestions that up to 25% of those people presently being treated for Parkinson's disease might have been wrongly diagnosed and are thus getting inappropriate treatment.

Generally patients that are suspected of suffering from Parkinson's disease are given tests to guarantee they are certainly not suffering from an illness that can be diagnosed using common methods such as CT scanning, urine sampling X-ray and blood tests etc. However just because these tests may have an inconclusive answer, it doesn't always mean the person is definitely suffering from Parkinson's disease. Regrettably some doctors think this is the case, and will automatically offer a diagnosis of Parkinson's disease.

Tests that can be carried out to test for Parkinson's disease involve systematic neurological assessments that comprise testing the person's reflexes, balance, muscle strength walk and common movement. Because there are a range of neurological disorders that have similar characteristics to Parkinson's disease, it's not very surprising that Parkinson's disease is so regularly misdiagnosed. If you or a loved one has been diagnosed with Parkinson's disease, it doesn't always hurt to ask your doctor for a second opinion or even better to request to be referred to a physician who specialises in this kind of disease.

An early accurate diagnosis of Parkinson's disease is normally the key to the sufferer being able to preserve their independence and a decent quality of life for fairly a long time.

Some neurological conditions that are regularly confused with Parkinson's disease include: -

Multiple system atrophy

Supranuclear palsy

Benign Essential Tremor

Multiple Sclerosis

Huntington's disease

Striato-Nigral Degeneration

Brain tumour

Remaining as independent as feasible is vital to the wellbeing of most sufferers of Parkinson's disease, and ensuring the symptoms are kept to a minimum by both an accurate diagnosis and treatment is the key to achieving this.

By Roger Overanout

symptoms of parkinsons disease : 7 Symptoms You Should Know

2006-07-31T00:48:00.000-07:00

Parkinson's disease affects millions of people through out the world everyday. This affliction affects not only the people who are actually diagnosed with it, but also their family and friends. While research is being conducted everyday into a possible cure, it is important to understand Parkinson's disease symptoms and how they affect the daily life of the individuals who live with this illness everyday.

1- To understand Parkinson's disease, you must first have to have at least a minimal understanding of what the disease is and what it does to the human body. This is a chronic illness that takes place when the neurons or the brain cells begin to deteriorate. This results in an insufficient amount of dopamine to be produced. Dopamine controls muscle activity. The result is Parkinson's disease symptoms such as walking difficulties, coordination issues and uncontrollable shaking.

2- Generally, Parkinson's affects one-half of the body initially. The condition can then travel to the opposite side of the body. When this occurs, the patient essentially has no voluntary muscle control. The result is stiff muscles, poor balance and coordination along with the possibility of tremors.

3- The muscle issues that are associatated with Parkinson's disease symptoms can affect the face as well as the larger muscles of the body. As this disease progresses you may notice that a Parkinson's patient is not able to show the same signs of emotion that they used to. This is because the muscles of the face are not as easily controlled. This lack of muscle coordination will lead to not being able smile, swallow or speak as they used to.

4- Other tasks that may seem mundane and ordinary all of a sudden become very difficult. Parkinson's disease symptoms also include the loss of fine motor skills, writing, brushing teeth and buttoning a shirt become almost impossible as the fingers begin to lose their flexibility and control.

5- Walking is, of course another factor of daily life that can, and usually is, interrupted with the onset of Parkinson's disease. Because of the lack of muscle control, a foot may drag along as opposed to being raised during stepping. The ability to navigate through a narrow doorway or hallway because impaired as the lose of balance becomes an issue.

6- It is important to note that while these Parkinson's disease symptoms are common, not every patient will experience all of them. While some patients may only have an occasional balance issue, others will experience symptoms that run the gamut from the barely noticeable, to the absolutely debilitating.

7- If you are caring for someone who has this issue and is experiencing Parkinson's disease symptoms, it is important to accompany them to their doctor's appointments. Ask questions, read up on this condition. The best thing that you can do for them is to arm yourself with the knowledge of what they may be experiencing.

Visit http://about-parkinsons-disease.net or http://parkinsons-disease-online.info to learn more about chelation therapy for parkinsons disease and what is parkinsons disease.

Article Source: http://EzineArticles.com/?expert=Peter_Wallander

symptoms of parkinsons disease : The Progression of Parkinson's disease

2006-07-31T00:45:00.000-07:00

One health problem that over 50,000 Americans are diagnosed with each year is Parkinson's disease.

While most people are diagnosed with this health issue after age sixty, some people can have an early onset of Parkinson's disease before the age of forty, roughly 5 - 10% of all diagnoses of the disease.

The health problems associated with the disease can be mild or severe, and men tend to get it more than women.

Parkinson's disease is a chronic progressive neurological disease.

It affects certain nerve cells in the brain, and these nerve cells die.

When this happens, body movements of every kind are affected, and it can cause other health issues as a result of the disease's progression.

The progression of Parkinson's disease as a health problem often begins gradually

The symptoms are usually mild to begin with, but progress as time goes on.

The first health symptoms to appear are often fatigue, slight tremors, forgetfulness, or changes in handwriting and speech.

It most cases, it is often family or friends who notice the changes in the person's health with Parkinson's disease first. They often see the gradual stiffening of muscles, and the continual lack of facial expressions.

It is important for people who notice that their health is not as good as it was to consult their doctor.

As the disease progresses, the health symptoms can get worse.

The tremors can become more pronounced. The patient's movements become slower, and muscles become more rigid.

As the Parkinson's progresses further, balance can become a problem, and walking, posture and the possibility of falls becomes more worrisome. Handwriting and speech can change a great deal, as well.

The good news is that for a lot of people with the health issue of Parkinson's disease, the symptoms are often mild to moderate and they can still lead productive lives.

They sometimes need to have treatment for the disease and modify their lifestyles, but it does not present a significant health issue.

Drug therapy is the most common way to slow down the progression of Parkinson's disease and keep the patient in good health.

While there is no cure for this health problem, a lot of research is currently being done in this field.

Sources:
http://www.pdtrials.org
http://www.webmd.com

Learn More About Parkinson's By Going to Symptoms and Signs of Parkinsons

Article Source: http://EzineArticles.com/?expert=Mike_Herman

symptoms of parkinsons disease : Subarachnoid Hemorrhage: When a Brain Aneurysm Bleeds

2006-07-29T00:15:00.000-07:00

Spontaneous subarachnoid (pronounced sub-uh-RACK-noid) hemorrhage is rightfully the most feared cause of sudden headache. Usually due to rupture of aneurysms (abnormal, balloon-like outpouchings of arteries) located near the base of the brain, subarachnoid hemorrhages involve bleeding into the space between the brain and its surrounding membrane, known as the meninges. A traumatic blow to the head can also cause subarachnoid hemorrhage, but this is a completely unrelated process and is not the subject of this essay.

About 10% of people with spontaneous subarachnoid hemorrhages die before they even get to a hospital and over a third die within the first four weeks following the bleed. Survivors can have significant impairments due to brain damage.

And while the effects of the initial bleed are bad enough, in the following few weeks individuals with subarachnoid hemorrhage can suffer additional, serious complications. One complication is that the aneurysm responsible for the initial hemorrhage can bleed a second time and cause even more damage. This occurs in 4% of cases within the first 24 hours and there is another 1.2% chance of re-bleeding each day thereafter for the first two weeks. Thus, without treatment 20% of cases have a second hemorrhage within the first two weeks.

The other serious complication is that the blood deposited in the subarachnoid space can cause otherwise healthy arteries passing through this space to go into spasm. The spasm decreases blood-flow to the parts of the brain ordinarily nourished by these arteries and thereby inflicts additional damage. Or, said another way, a blocked artery causes a new stroke, this time of the non-bleeding type. For reasons that are not entirely understood, these spasms of the arteries do not occur within the first few days after the initial hemorrhage. Instead, they typically develop after a delay of 4-9 days.

What can be done to reduce these complications? In the case of blood-vessel spasm, the best treatment is a preventive one. Administering a drug called nimodipine (prononounced nye-MO-dih-peen) intravenously makes spasming less likely to occur. But in order to prevent the other major complication, re-bleeding, the best treatments are those which physically stabilize the aneurysm. In one such procedure, a surgeon places a metal clip across the aneurysm where it joins the otherwise normal artery. An alternative surgery is to wrap the outside of the aneurysm with surgical gauze or plastic sheeting. A newer procedure involves filling the aneurysm with tiny metal coils inserted via a flexible catheter snaked through the arteries.

How can one tell if a particular headache is caused by a bleeding aneurysm? It can be a tough call, but certain features make a ruptured aneurysm more likely. First, a headache due to a ruptured aneurysm is typically of very abrupt onset (often described as a “thunderclap”) and is classically the worst headache of one’s life. In people who already have recurrent severe headaches from other causes, the headache due to a ruptured aneurysm might feel different from the more usual attacks.

Medical evaluation of patients with ruptured aneurysms can turn up additional clues, like a stiffened neck or changes in the backs of the eyes made visible through an ophthalmoscope. Of course, if the patient is drowsy or confused, this might suggest that something serious is going on, as would any new impairment in the ability to move the eyes, an arm or a leg. A computed tomographic (CT) scan of the head performed within the first 24 hours is very sensitive in detecting a hemorrhage, but if the scan is delayed it is less able to detect the bleed. A lumbar puncture (also known as a spinal tap) always detects subarachnoid hemorrhage even when it is a few days old, but if the needle causes bleeding by piercing a blood-vessel on its way to the subarachnoid space, the test might give the false impression that a subarachnoid hemorrhage occurred when it hadn’t.

After discovery of subarachnoid hemorrhage, the next round of testing focuses on where exactly the bleeding occurred. While in over two-thirds of the cases it originates from ruptured aneurysms, other potential sources include tangles of abnormal blood-vessels known as arteriovenous malformations or from bleeds within the brain tissue that secondarily leak into the subarachnoid space. The managing physician can order any of three tests to image the blood vessels themselves and pinpoint the source of bleeding.

The oldest test--still considered the gold-standard--is known as an arteriogram or, alternatively, an angiogram. An arteriogram is considered an “invasive” test because the doctor must slide a long, flexible catheter through the arterial system (which is under much higher pressure than the veins) so that dye infused through the catheter will enter the arteries in question. Two newer tests are “non-invasive,” though, in truth, they often involve an infusion into a vein. One is magnetic resonance arteriography (MRA) which is performed with the help of an MRI-scanner. The other is computed tomographic arteriography (CT-A) which is performed with the help of a CT-scanner. While the non-invasive tests are getting better all the time, they still occasionally miss aneurysms otherwise visible on arteriograms.

Apart from identifying the bleeding aneurysms, these tests can detect additional aneurysms, when present. About 20% of people experiencing a ruptured aneurysm have one or more co-existing, unruptured aneurysms.

Subarachnoid hemorrhages occur annually in about 10 people out of 100,000. This computes to a 0.01% rate of annual occurrence. Contrast this figure with the 12% of the adult population who have migraine (most of whom have at least one severe headache per year) and it is apparent that the vast majority of severe headaches are not due to ruptured aneurysms. But the concern about missing a ruptured aneurysm means that many people without subarachnoid hemorrhage must receive tests in order to diagnose the few who have it.

What causes aneurysms in the first place? More than one factor is involved. First, there can be an inborn weakening of the artery’s wall. When the wall subsequently deteriorates in ways that can be accelerated by hypertension and smoking, an aneurysm can form.

Actually, aneurysms affecting the brain’s arteries are fairly common. Autopsy and arteriogram studies indicate that about 1-4% of the general population have them. This is many more people than have subarachnoid hemorrhages, so a logical conclusion is that most people with aneurysms go through their entire lifetimes without having symptoms. Studies show that aneurysms less than 5 millimeters (0.2 inches) in diameter have a very low rate of rupture, while aneurysms greater than 10 millimeters (0.4 inches) in diameter have a significant risk of bleeding.

Do ruptured aneurysms run in families? A 2005 report from the Scottish Aneurysm Study Group showed a slight tendency for this trait to be shared by close relatives. The 10-year risk for subarachnoid hemorrhage in first-degree relatives (parents, siblings and children) was 1.2%. The risk was even lower in more distant relatives. In families with two affected first-degree relatives there was a trend toward higher risk. The authors felt that most relatives of patients suffering subarachnoid hemorrhages have low risk of future hemorrhages, and that routine screening of family members is inappropriate unless there are multiple affected individuals in the same family.
symptoms of parkinsons disease
(C) 2005 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher who works in Athens, Ohio. For more health-related articles see his websites: http://www.cordingleyneurology.com and http://www.neurologyarticles.com

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symptoms of parkinsons disease : Blepharospasm: That Blinkety-Blink Movement Disorder

2006-07-29T00:12:00.000-07:00

The range of ailments falling under the umbrella-term of "abnormal involuntary movement disorders" is diverse and includes conditions as different from each other as Parkinson's disease, restless legs syndrome and blepharospasm. Cases of blepharospasm, like those of other movement disorders, often go unrecognized or are blamed on other causes.

The term "blepharospasm" is the sum of its parts. "Blepharon" is Greek for eyelid and "spasm" means excessive muscular contractions. In blepharospasm the eyes blink excessively. The blinking can be too frequent, too sustained, or both. The distinction between normal blinking and excessive blinking is not exact. A practical method for sorting out cases relies on the answers to two questions:

Does the blinking cause distress?
Does the blinking interfere with usual activities?

Blepharospasm can occur alone or in combination with other involuntary movements. When paired with involuntary movements of the lower face -- like puckering of the lips or grimacing expressions -- the problem is collectively known as Meige syndrome, named for Dr. Henri Meige who described the condition in 1904. Blepharospasm and Meige syndrome are forms of dystonia, a sub-grouping within the overall range of involuntary movement disorders. Another example of dystonia is torticollis, in which there is sustained involuntary twisting or cocking of the neck.

Blepharospasm, like any other condition, can be mild, moderate or severe. It is not necessarily disabling, but if the blinking is so frequent or sustained that it interferes with vision, then it can impact activities like driving. Blepharospasm does not appear to be an insurmountable barrier for people whose job is to appear in public, as a well-known television personality with blepharospasm seems to be doing just fine.

How common is this condition? Not very. Researchers at Mayo Clinic tracked cases of blepharospasm in Olmsted County, Minnesota, between 1976 and 1995. They calculated just 1.2 new cases per year per population of 100,000, although this might be an underestimate of the true incidence because it doesn't include undiagnosed cases. The diagnosed patients were equally divided between the sexes and half of the people had Meige syndrome, meaning that the blepharospasm was accompanied by dystonia of the lower face. One in four cases resolved on their own.

The diagnosis of blepharospasm is based mainly on its appearance. This condition is sometimes misidentified as a reaction to (or "secondary" to) an irritation of the eyes, and is treated with eyedrops. However, in true cases of blepharospasm (designated as "primary" or "essential" blepharospasm) the excessive blinking is not driven by irritation of the eyes. Instead, the eyelids are just following orders from overactive brain-circuits, though in fairness, those brain-circuits might be misinterpreting non-irritated eyes as being irritated. Eyedrops are not helpful for primary blepharospasm.

Another condition which is similar in appearance is hemifacial spasm in which there is excessive blinking of just one eye, often accompanied by excessive twitching of the lower face on the same side. But hemifacial spasm is not a form of primary blepharospasm. In hemifacial spasm the affected muscles are driven by an overactive nerve rather than an overactive brain-circuit. That's why just one side of the face is affected. There is another, unaffected nerve controlling the opposite side of the face.

Although the source of excessive blinking in blepharospasm is undoubtedly the brain, the disorder does not show up on usual, brain-oriented tests like computed tomographic (CT) scans, magnetic resonance imaging (MRI) scans or electroencephalograms (EEGs).

How about treatment? There is no curative treatment available. Existing treatments can relieve symptoms, but don't affect the course of the underlying disorder which usually continues long-term. Thus, the state of a person's blepharospasm in five or ten years will be the same whether or not symptom-relieving treatment is used in the meantime.

That said, many patients benefit from symptom-relieving treatment which nowadays usually takes the form of periodic injections of botulinum toxin (e.g. brand name Botox) beneath the skin, overlying the affected muscles. This weakens or relaxes the muscles involved in the excessive blinking to an extent that relieves the symptom without interfering with normal eye closure. Typical treatment cycles are no more often than every three months. Prior to the development of botulinum treatment for blepharospasm it was often treated with orally administered medications, though usually with a lower success rate.

As an example of clinical experience in treating blepharospasm, we can look at the results obtained by neurologists at the Sao Paulo School of Medicine in Brazil. Over the ten-year span from 1993 to 2003 they administered a total of 379 botulinum toxin treatments to 30 patients with blepharospasm. Sixty-six percent of the patients had previously tried oral medications for their condition and just 15% considered them satisfactory. (Of course, patients who were totally satisfied with oral medications were unlikely to seek treatment with botulinum toxin, so this figure probably underestimates the success rate with oral medication.)

So how did they do? Ninety-three percent of the patients showed significant improvement after their first injections with botulinum toxin and there was no loss of effectiveness when the first and last treatments were compared. Adverse effects -- "mostly minor" -- developed at least once in 53% of the patients. Six patients (20%) discontinued the treatment.

(C) 2006 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher who works in Athens, Ohio. For more health-related articles see his websites at: http://www.cordingleyneurology.com and http://www.neurologyarticles.com

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symptoms of parkinsons disease : A Brief Look At Parkinson's Disease

2006-07-26T23:47:00.000-07:00

The primary cause for developing the Parkinson's disease is the widespread damage of the dopamine-producing cells in a person's brain. Once the rate of damage rise up to 80% the risk against Parkinson's disease is inescapable.

This condition is a brain disease. Once the nerve cells in the substantia nigra, a part of the middle brain, die or become impaired, the production of the dopamine will diminish. Dopamine maintains the coordination and the smooth functioning of the body movements. If this condition occurs, other brain movement control centers become unchecked. This is the major reason why people affected with Parkinson's disease are experiencing shaking or tremor, slowness of movements, stiffness or rigidity and incapability of maintaining body balance. Other symptoms may include:

- Firm facial expression
- Small handwriting or micrographia
- Depression
- Muffled speech
- Irregular walks
- Reduced automatic movements

The initial symptoms of the disease are mild and may not even need to be attended medically. The most common sign of the disease is the rest tremor, but not all patients develop tremor. Unlike other symptoms, tremor does not seriously disable a person's usual activities but it is the most damaging if viewed on the psychological interpretation. a patient needs to hold onto something to gain control over the trembling hand or to put them in a secured place, like the pocket of the pants.

Symptoms are normally restricted on a single limb in the first phases of the disease. But they eventually affect the other half of the body. Most patients are aware of this nature of the disease, and this knowledge makes the condition even more unbearable (both physically and psychologically) which often leads to over-monitoring of their cases.

Women and men are at equal standing against the risks of developing the disease. In America, the present number of Parkinson's disease victims is near to 2 million. This makes it the second most prevalent neurodegenerative disease after the Alzheimer's disease.

Though the disease is more prevalent during the later years of a person's life, specifically age 65, individuals aged 50 comprises 15% of people diagnosed of the disease. And one in a group of 100 people is potential of developing the disease.

The diagnosis of the Parkinson's disease is complex. There are no ways that a person may be identified as a patient with blood tests and x-rays and other conventional methods of diagnosis. Often, a neurologist may only arrive at a result once a thorough MRI or Magnetic Resonance Imaging is complete. However, MRI is helpful only in separating the symptoms of Parkinson's disease with other neurological and brain disorders.

A number of medicines may be taken to diminish the occurrence of the symptoms of the disease. Most of these are aimed at replacing or copying the effects dopamine have over the abnormalities associated with the dopamine insufficiency in the brain such as rigidity, slowness and tremor. Newer researches are focused on finding the solution to control the progress of the disease and many are promising to bring new improvements to patients inflicted with Parkinson's disease.

Surgery is one solution that experts consider in Parkinson's disease treatment. However, it is not the answer to cure the disease. Because brain surgery is risky, it is usually placed at the bottom priority unless all necessary medications taken failed. It is important that both a brain surgeon and a neurologist are first consulted for the pre-treatment procedures.

Modern-day medicine has not yet found ways to cure the Parkinson's disease. Diagnosis would only identify if the person has it and how to minimize and control the symptoms. It is not aimed at banishing the disease itself.

Robert Thatcher is a freelance publisher based in Cupertino, California. He publishes articles and reports in various ezines and provides Parkinson's disease resources on http://www.about-parkinson-disease.info

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symptoms of parkinsons disease : Signs of Parkinson's Disease

2006-07-26T23:44:00.000-07:00

Parkinson's disease tends to be a very frightening disease to be diagnosed with. Knowing what it is and what the symptoms are will help you to catch it in the early stages and begin treatment right away.

What is Parkinson's Disease?

When brain cells (neurons) deteriorate, Parkinson's disease is the result. It is considered a chronic condition, as opposed to acute, because it has no cure and doesn't go away by itself. It is also a degenerative disease, meaning that it breaks down the body of the person it attacks. Muscle control is lost due to a lack of dopamine in the brain and, because of this, a difficulty in walking, coordination, and severe shaking develop.

Characteristics and Signs of Parkinson's

Some of the signs of Parkinson's to look out for include:

• Tremors or Trembling: for nearly three quarters of patients diagnosed with Parkinson’s disease, the appearance of tremors or trembling is the first noticeable symptom.

• Muscle stiffness -Parkinson’s patients experiencing stiffness or rigidity may not notice any other symptoms of this characteristic. In fact, the person may not even notice the signs of rigidity unless a physician notes it during a physical examination.

The presence of physical rigidity, such as decreased arm swing, is especially useful in helping medical personnel establish a diagnosis of Parkinson’s disease.

This may also include 'Freezing' which is the sudden inability to move when you want to , a foot on one side starts to drag, and difficulty walking through doorways and hallways.

• Lacking coordination

• Difficulty maintaining balance

• Difficulty controlling facial muscles - Akinesia and bradykinesia - these characteristics may manifest themselves in the face, for example, as reduced facial expression, infrequent blinking, and slow swallowing resulting in increased saliva secretion, and occasionally, drooling.

A person with Parkinson’s disease may also notice a change in his or her voice: it may become low and monotone, with little or no inflection. Akinesia and bradykinesia may also appear as trouble executing certain movements, and increased slowness when movements are attempted or executed.

• Talking more quietly

• Raspy voice

• Difficulty with motor skills - The result is lessened in fine motor skills dexterity and may mean the person with Parkinson’s may require help with everyday tasks such as shaving, tying laces, fastening buttons, and handwriting.

• Oily skin and dandruff - Seborrheic dermatitis: Parkinson’s patients may notice that they have developed greasier skin, especially around the nose and eyebrows, and a greasier scalp. This symptom is usually accompanied by increased sweating.

• Non-specific sensory symptoms - Unusual sensory feelings such as numbness, pain, burning sensation, restlessness and fatigue can also be indicators of Parkinson’s disease.

• Depression and senility, as well as dementia, are secondary symptoms of Parkinson's.

Feeling anxious, angry, discouraged or downright depressed is common as the brain is undergoing a number of chemical changes. Approximately 40-70 percent of Parkinson’s sufferers experience depression at times, while 20 percent of these are considered a major depressive disorder.

Anxiety or panic attacks are common psychological elements of the disease as well. An average of 70 percent of people who have pre-existing depression also develop anxiety whereas 90 percent who first experience anxiety fall victim to depression.

Dementia is evidenced in 20-30 percent of sufferers and this gradual decline first starts with slowness in thought and advances to a difficulty in properly organizing thoughts.

In Closing

In most cases, only one side of the body will be affected in the early stages of the disease, and the hands and feet are the most likely area where tremors will first be noticed.

One symptom does not mean that you have Parkinson's. It usually arrives in the form of a combination of symptoms over a prolonged period.

If you have concerns, consult your doctor.

Get The Information About Parkinson's By Going to Symptoms and Signs of Parkinsons.

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symptoms of parkinsons disease : The Facts About Glutathione and Parkinson's Disease

2006-07-24T23:26:00.000-07:00

Parkinson's Disease (PD), a devastating illness, occurs in one of every 100 people over 65.

It is a slowly progressing disease of the nervous system that results in progressive destruction of brain cells (neurons) in an area of the brain called the substantia nigra. Death occurs usually as a result of secondary complications such as infection.

One of the mechanisms known to destroy neurons is damage by free radicals or reactive oxygen species - destructive molecules produced by oxidation of the neurotransmitter dopamine.

The Role of Dopamine

The cells of the substantia nigra use dopamine - a chemical messenger between brain or nerve cells - to communicate with cells in another region of the brain called the striatum.

When nigral cells are lost, nigral dopamine levels fall, resulting in a decrease in striatal dopamine.

The typical symptoms of PD - motor function deficiencies characterized by muscle rigidity, jerky movements, rhythmic resting tremors - are the result of low levels of striatal dopamine.

Most dopaminergic drugs used to treat PD, are aimed at temporarily replenishing or mimicking dopamine. They improve some symptoms, but do not restore normal brain function nor halt brain cell destruction.

Dopaminergic drugs are generally effective at first in reducing many PD symptoms, but over time they lose their effect.

They also cause severe side effects because they overstimulate nerve cells elsewhere in the body and cause confusion, hallucinations, nausea and fluctuations in the movement of limbs.

The Role of Antioxidants

When dopaminergic neurons are lost in the course of Parkinson's disease, the metabolism of dopamine is increased - which in turn increases the formation of highly neurotoxic hydroxyl radicals.

The most important free radical scavenger in the cells of the substantia nigra is the powerful brain antioxidant, glutathione. Glutathione levels in PD patients are low.

And as we age, levels of glutathione in the dopaminergic neurons of the substantia nigra decreases. This appears to hasten cell death and advance the progression of PD.

At least 80 percent of the substantia nigra cells are lost before symptoms of Parkinson's disease become apparent. This is why it becomes essential to protect or maintain these cells under oxidative stress.

How does Glutathione help in Parkinson's Disease?

Several factors explain why glutathione is so beneficial in Parkinson’s disease.

1. Glutathione increases the sensitivity of the brain to dopamine. So although glutathione doesn't raise dopamine levels, it allows the dopamine in the brain to be more effective.

2. Glutathione's powerful antioxidant activity protects the brain from free radical damage.

3. An even more intriguing benefit of glutathione lies in its powerful detoxification ability.

Its a well known fact that most Parkinson’s patients are deficient in their ability to detoxify chemicals to which they are exposed.

The unfortunate few who harbor an inherited flaw in their detoxification pathways are at far greater risk to the brain damaging effects of a wide variety of toxins.

Glutathione is one of the most important components of the liver’s detoxification system. Glutathione therapy is one of the most effective techniques for enhancing liver and brain detoxification.

Glutathione treatments considerably improve some of the symptoms of Parkinson's disease including difficulties with rigidity, walking, movement, coordination and speech. A marked reduction of tremor has been observed as well as a decrease in depression.

Glutathione and N-acetyl-L-cysteine (a glutathione precursor) have been shown to be very effective in protecting the nerves in the substantia nigra from being destroyed by oxidative stress.

Glutathione Therapy in Parkinson's Disease

The practical problem in increasing glutathione levels is that taking glutathione itself as a supplement does not boost cellular glutathione levels, since glutathione breaks down in the digestive tract before it reaches the cells.

However, intravenous glutathione therapy and taking glutathione precursors are both effective in boosting intracellular levels of glutathione.

Intravenous Glutathione Therapy:

Intravenous glutathione injections have been shown to have amazing and quick results.

Dr. David Perlmutter, a pioneer in this therapy, has developed a protocol utilized at the Perlmutter Health Center for administering intravenous glutathione to Parkinson's patients.

Following even a single dosage of intravenous glutathione - often in as little as 15 minutes - the ability to walk, turn around and move their arms is almost completely restored.

Glutathione Precursors:

Dietary antioxidants and supplements that increase cellular glutathione, such as alpha lipoic acid, NAC, pycnogenol, the herb silymarin (milk thistle), are effective in restoring normal function.

N-acetyl-cysteine (NAC) and un-denatured, whey protein both supply glutathione precursors intracellularly, enhance the body’s production of glutathione and aid the detoxification process.

Other nutritional supplements which aid the detoxification process include selenium, vitamins E and C.

Read the detailed report with references on Parkinson's Disease and Glutathione

Copyright © 2004 Priya Shah

About the author: Priya Shah is the Editor of The Glutathione Report, a newsletter featuring regular updates on the health benefits of glutathione. Get a Free report on Glutathione in Health and Disease

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symptoms of parkinsons disease : Who Gets Parkinson's Disease?

2006-07-24T23:22:00.000-07:00

Parkinson's Disease affects generally elder adults, among about 90% of the known cases are diagnosed in people over the age of 60. Within that population, there is a small amount of variance, with the danger increasing from age 60 through age 75, and then going down sharply. Currently, Parkinson's Disease is known to affect about 3% of the population over the age of 65. With present statistics and the probable aging of the population, authorities think that that percentage will double in the next 40 years.

When those with mild symptoms of Parkinsons (symptoms of Parkinson's Disease that may be caused by other things, or could develop into Parkinson's Disease), those numbers increase dramatically. 15% of those between the ages of 60 and 74 have been diagnosed with Parkinson's Disease. Between the ages of 75 and 84, that percentage rises to almost 30%.

However, when you look at it in terms of inception of symptoms, the picture changes. Fewer than 10% of new cases of Parkinson's disease are diagnosed in younger adults - under age 40. The majority of new diagnoses of Parkinson's disease are made between the ages of 60 and 75. After age 85, the danger of developing Parkinson's Disease then seems to fall off dramatically.

What are the factors that effect diagnoses?

Gender

Men appear to be at greater risk of developing Parkinson's Disease than women. Men have to deal with about double the risk of developing Parkinson's Disease as women in any age group. Scientists think that estrogens may play a function in protecting the body from the chemical changes that occur in Parkinson's Disease. This is further borne out by two facts - women who've had hysterectomies have a somewhat higher rate of Parkinson's Disease, and women who've had estrogen replacement therapy have a lower rate of Parkinson's Disease than other women their age.

Parkinson's Disease seems to growth more quickly in men than women according to one study, and another found a difference in the way that symptoms present. Men are more prone to rigidity and tremor, and women more at danger from gait disturbance and shuffling.

Ethnicity

Caucasians have a higher danger of developing Parkinson's Disease than either African Americans or Asian Americans. People of European descent appear most prone to usual Parkinson's Disease, but some studies hint at that non-Caucasians may be more at risk for a particular type of non-typical Parkinsonis that causes a disturbance in judgment.

Heredity

In a small percentage of cases, family history may play a part in the inception of Parkinson's Disease. People who have parents or brothers and sisters who had young-onset Parkinson's Disease, in which symptoms develop before the age of 40, are more probable to develop Parkinson's Disease than others their age. When Parkinson's Disease was diagnosed at older ages, family history looks like it's to play no part.

Cigarette Smokers

Oddly, cigarette smokers appear to have a diminished incidence of Parkinson's Disease, which has led researchers to explore the probability that nicotine may give some protection from the fluctuations caused by Parkinson's Disease. They are quick to point out that the other health problems associated with cigarette smoking are far too significant to think cigarette smoking as a way to avoid getting Parkinson's Disease.

Coffee Drinkers

Caffeine also seems to have a protective result against Parkinson's Disease. A study of Japanese-American men suggested that those who commonly drank coffee ran a lesser risk of developing Parkinson's Disease than other men their age. The more coffee they consumed, the lower the risk.

To find a host of tips and information on all aspects of Parkinsons Disease visit http://www.parkinsonsdiseaseadvisor.com

You may reproduce this article provided you maintain an active link back to http://www.parkinsonsdiseaseadvisor.com

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symptoms of parkinsons disease : Neurologists Can Improve 'Deep Brain' Therapy for Parkinson's

2006-07-18T22:04:00.000-07:00

WEDNESDAY, July 12 (HealthDay News) -- Neurologists with expertise in a therapy called deep brain stimulation can help improve outcomes for Parkinson's disease patients undergoing the treatment, a Canadian study finds.

Deep brain stimulation is a surgical procedure in which electrodes are implanted into the brain to electronically stimulate neurological areas controlling movement. The procedure is used to treat Parkinson's symptoms such as tremors, stiffness and difficulty walking, and is the most effective surgical treatment for advanced Parkinson's, according to background information in the study.

The treatment requires intensive patient management, such as adjustment of electrical currents and patient medication dosages. However, at many medical centers in North America, these duties are assigned to health workers -- such as surgical nurses, fellows or neurophysiologists -- who do not have extensive experience in caring for Parkinson's patients, the study authors explained.

In their study, the team from the University of Toronto followed outcomes in 44 Parkinson's patients treated with deep brain stimulation to see whether treatment could be improved through the direct involvement of a neurologist.

The patients in the study had already undergone deep brain stimulation treatment for an average of 3.5 years. For this study, the neurologist became directly involved in the treatment -- for example, making adjustments to electrical currents during the procedure and to the doses of medication received by patients after the procedure.

Patients' Parkinson's disease symptoms were assessed before and after (an average of five months, with a range of one hour to 14 months) they began this reprogrammed treatment.

The study found that 54.6 percent (24) of the patients showed additional improvement in their Parkinson's symptoms, while 36.4 percent (16) remained unchanged, and 9.1 percent (4) experienced worsened symptoms. Those who showed improvement had fewer tremors, less rigidity and slowness of movement (bradykinesia), and reductions in their medication dosages.

The four patients with worsened symptoms suffered more speech and gait problems. They were put back on their original treatment settings.

The findings were published in the July 11 online issue of the Archives of Neurology, and are expected to be in the September print issue of the journal.

HealthDay

Copyright (c) 2006 ScoutNews LLC. All rights reserved.

symptoms of parkinsons disease : Diagnosing Parkinson's Disease

2006-07-18T21:46:00.000-07:00

There are no laboratory tests currently available that can identify Parkinson's disease. Because it usually affects people over fifty, it is important to see a doctor if you begin experiencing mild tremors, shakiness, or any of the above-mentioned symptoms. Other diseases cause similar symptoms; your doctor can determine if what you are suffering from is, indeed, Parkinson's disease.

Young-onset Parkinson's disease, though rare, occurs in those younger than forty. The disease follows a smoother course. Those with young-onset Parkinson's typically have fewer problems with balance and memory loss. They can, however, have more problems with movement because of some of the medications.

Prognosis

Parkinson's disease is chronic and progressive, meaning it gets worse with time. Different people are affected by different symptoms; there is no way to predict the degree to which a person will be affected. Some people may become incapable of functioning normally, but others may experience only minor symptoms.

Treatment

Currently there is no cure for Parkinson's disease. There are, however, medications that can dramatically reduce the symptoms. The most common is levodopa combined with carbidopa. Nerve cells use this to replace the diminishing supply of dopamine in the brain. If used in young-onset Parkinson's, however, this can cause movement problems. Not all patients respond equally to the drug, but it helps at least 75 percent of cases. It does not affect all of the symptoms, either, helping most with bradykinesia and rigidity. It may only slightly affect tremors, and may not reduce other symptoms at all. Other drugs are available that mimic the role of dopamine in the brain; talk to your doctor about treatment options. Proper treatment and planning for the future are essential to living with Parkinson's disease.

Progress

Research is being done on all aspects of the disease, studying new drugs to reverse, delay, or prevent the disease, and trying to pinpoint the cause of the disease with the hope of prevention.

By Julia Countryman

symptoms of parkinsons disease : Parkinson Patients Can Be Apathetic without Depression

2006-07-13T06:24:00.000-07:00

ST. PAUL, Minn. – People with Parkinson disease can be apathetic without being depressed, and apathy may be a core feature of the disease, according to a study published in the July 11, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology.

Apathy is a mental state characterized by a loss of motivation, loss of interest, and loss of effortful behavior. In apathy, the mood is neutral and there is a sense of indifference. In depression, the mood is negative and there is emotional suffering. Because apathy and depression share some of the same symptoms, the disorders can be misdiagnosed.

“This study shows that it’s important to screen for both apathy and depression so patients can be treated appropriately,” said study author Lindsey Kirsch-Darrow, MS, of the University of Florida in Gainesville. “It will also be important to educate family members and caregivers about apathy to help them understand that it is a characteristic of Parkinson disease. Apathetic behavior is not something the patient can voluntarily control, and it is not laziness or the patient trying to be difficult – it is a symptom of Parkinson disease.”

The study compared 80 people with Parkinson disease to 20 people with dystonia, another movement disorder. The researchers hypothesized that apathy would occur more often in people with Parkinson disease, because the disease affects areas of the brain in the frontal cortex that are involved in non-motor activities, whereas dystonia affects areas mainly involved with movement.

Of those with Parkinson disease, 51 percent had apathy, compared to 20 percent of those with dystonia. Apathy with no depression occurred in 29 percent of those with Parkinson disease and none of those with dystonia. The rate of depression was the same in both groups.

Treatments for depression and apathy in people with Parkinson disease are still being evaluated.

The current criteria for diagnosing depression may not be appropriate for people with Parkinson disease, according to neurologist Irene Richard, MD, of the University of Rochester in New York, who wrote an editorial accompanying the study.

“A person with Parkinson disease might be diagnosed with minor depression based solely on the presence of apathy,” she said. “The recognition that apathy can be present without depression is important so that we do not inappropriately diagnose and treat a depressive disorder that is not present.”

The study is consistent with guidelines issued recently by the American Academy of Neurology recommending that all people with Parkinson disease be screened for and treated for depression, which can affect their quality of life and how well they function.

Media Contact: Robin Stinnett, (651) 695-2763, rstinnett@aan.com

symptoms of parkinsons disease : Apathy often a part of Parkinson's disease

2006-07-13T06:22:00.000-07:00

NEW YORK (Reuters Health) - Patients with Parkinson's disease may exhibit apathetic behavior without being depressed, a group of clinicians report. They suggest in the medical journal Neurology that apathy may therefore be a "core" feature of the disease.

"It's important to screen for both apathy and depression so patients can be treated appropriately," noted Dr. Lindsey Kirsch-Darrow in an American Academy of Neurology statement.

"It will also be important to educate family members and caregivers about apathy to help them understand that it is a characteristic of Parkinson's disease," she continued. "Apathetic behavior is not something the patient can voluntarily control, and it is not laziness or the patient trying to be difficult -- it is a symptom of Parkinson's disease."

Kirsch-Darrow, of the University of Florida in Gainesville and colleagues compared 80 patients with Parkinson's disease to 20 patients with dystonia, or impaired muscle control.

The team found observed a "significantly higher severity and frequency of apathy" in the Parkinson's disease patients compared to the dystonia patients. Fifty-one percent of Parkinson's disease patients exhibited apathy compared with 20 percent of those with dystonia.

Apathy in the absence of depression was common in Parkinson's disease patients (29 percent but was not seen in any of the dystonia patients. "This was the most dramatic and potentially important finding of the study," the researchers write.

In an editorial, Dr. Irene Hegeman Richard from the University of Rochester in New York notes that the "recognition that apathy can be present without depression is important so that we do not inappropriately diagnose and treat a depressive disorder that is not present."

For patients with apathy, stimulant-type drugs have been suggested as a possible treatment. "However, it is important to stop and ask ourselves who we are treating," Richard writes. "With apathy, it is generally the spouse, family or friends and not the patient who complain because the patient requires constant prompting to do anything and does not want to go anywhere."

SOURCE: Neurology, July 11, 2006.

Copyright © 2006 Reuters Limited. All rights reserved.

symptoms of parkinsons disease : Complementary Treatments

2006-07-11T10:43:00.000-07:00

A number of modalities and nutritional supplements can help relieve symptoms and improve quality of life. It is imperative that patients inform their physician of any over-the-counter medications, herbs, or other supplements that they use on a regular basis, because they may interact with medication and because drug dosages may need to be adjusted.

Physical therapy can help strengthen and tone underused muscles, and give rigid muscles a better range of motion. The goal is to help build body strength, improve balance, overcome gait problems, and improve speaking and swallowing.

Simple physical activity such as walking, gardening, and swimming can improves one's sense of well-being.

Gentle, soothing massage techniques may provide relief from muscle rigidity and may have some neuromuscular benefit as well.

The slow flowing movements of Tai Chi help maintain flexibility, balance, and relaxation. The Struthers Parkinson's Center in Minneapolis, which teaches a modified form of Tai Chi, consistently reports benefits achieved by patients in all stages of Parkinson's.

Support groups provide a caring supportive environment in which patients and their loved ones can ask questions about Parkinson's, expressing their frustrations, and obtain advice about coping with and treating symptoms from people who share the same problem.

Parkinson's appears to progress more slowly in those who remain involved in activities that they enjoyed before the onset of symptoms and in those who engage in new interests.

by Healthcommunities.com, Inc. All rights reserved.

symptoms of parkinsons disease : Surgery

2006-07-11T10:38:00.000-07:00

Surgery is another method of controlling symptoms and improving quality of life when medication ceases to be effective or when medication side effects, such as jerking and dyskinesias, become intolerable.
Not everyone is a good candidate for surgery. For example, if a patient never responded to, or responded poorly to levodopa/carbidopa, surgery may not be of any help. Only about 10% of Parkinson's patients are estimated to be suitable candidates.

Those who are suitable but forgo surgery may feel the risk outweighs the benefit. Every surgical procedure carries inherent risk. Additionally, there is the risk that symptoms will not improve or will worsen following the operation.

There are three surgical procedures for treating Parkinson's disease: ablative surgery, stimulation surgery or deep brain stimulation (DBS), and transplantation or restorative surgery.

Ablative Surgery
This procedure locates, targets, and then destroys (ablates) a clearly defined area of the brain affected by Parkinson's. The object is to destroy tissue that produces abnormal chemical or electrical impulses that produce tremors and dyskinesias.

A heated probe or electrode is inserted into the targeted area. It is often difficult to estimate how much tissue to destroy and the amount of heat to use. It is always safer to burn a small area and risk the tremor returning or not being eliminated, rather than burning a larger region and risking serious complications such as paralysis or stroke.

The patient remains awake during this procedure to determinine if the tremor or dyskinesia has been eliminated. A local anesthetic is used to dull the outer part of the brain and skull. The brain is insensitive to pain, so it can be manipulated and probed without the patient feeling it.

This type of surgery involves either pallidotomy or thalamotomy. Pallidotomy—ablation in the part of the brain called the globus pallidus—involves putting a hole (i.e., otomy) in the globus pallidus, the globe-shaped structure located deep inside the brain. This procedure is performed to eliminate uncontrolled dyskinesias.

Thalamotomy—ablation of brain tissue in the thalamus—involves creating an otomy in the thalamus. This structure is located below the globus pallidus. The procedure is performed to eliminate tremors.

A related procedure, cryothalamotomy, uses a supercooled probe that is inserted into the thalamus to freeze and destroy areas that produce tremors.

Deep Brain Stimulation (DBS)
DBS targets the subthalamic nucleus, which is located below the thalamus and is difficult to reach, the globus pallidus, or the thalamus. In DBS, the targeted region is inactivated, not destroyed, by an implanted electrode.

The electrode is connected via a wire running beneath the skin to a stimulator and battery pack in the patient's chest. It is reversible—just turn off the current—and allows for precise calibrated symptom control.

The risk for hemorrhage or stroke is reduced, but the electrode can become infected, the simulator may have to be periodically programmed, and the battery must be replaced every 5 years. Battery replacement involves minor surgery.

Transplantation or Restorative Surgery
In transplantation, or restorative, surgery dopamine-producing cells are implanted into the striatum. The cells used for transplantation may come from one of several sources: the patient's body, human embryos, pig embryos.

Using cells from the patient's body has been unsuccessful because of an insufficient supply of dopamine cells and the inability of the implanted cells to survive.

To use fetal cells, between three and eight embryos are needed per procedure, and even under the most favorable conditions, 90% of transplanted cells do not survive. This procedure is only moderately effective in some patients and usually in those younger than age 60.

Preliminary studies have shown that pig embryo cells do survive transplantation and have an effect on symptoms.

Stem cells, primitive cells that can grow into nerve cells, are able to survive and reproduce. Once they grow as nerve cells, they can be transformed into dopamine-producing cells.

Stem cells are obtained from discarded blood in a newborn's umbilical cord, the bone marrow of an adult, or an aborted embryo.

by Healthcommunities.com, Inc. All rights reserved.

symptoms of parkinsons disease : What Is It?

2006-07-06T21:51:00.000-07:00

Parkinson's disease is one of a larger group of neurological conditions called motor system disorders. Historians have found evidence of the disease as far back as 5000 B.C. It was first described as "the shaking palsy" in 1817 by British doctor James Parkinson. Because of Parkinson's early work in identifying symptoms, the disease came to bear his name.

In the normal brain, some nerve cells produce the chemical dopamine, which transmits signals within the brain to produce smooth movement of muscles. In Parkinson's patients, 80 percent or more of these dopamine-producing cells are damaged, dead, or otherwise degenerated. This causes the nerve cells to fire wildly, leaving patients unable to control their movements. Symptoms usually show up in one or more of four ways:

tremor, or trembling in hands, arms, legs, jaw, and face
rigidity, or stiffness of limbs and trunk
bradykinesia, or slowness of movement
postural instability or impaired balance and coordination.
This diagram of the brain shows several structures related to Parkinson's disease. Basal ganglia affect normal movement and walking; substantia nigra are types of basal ganglia that produce the neurotransmitter dopamine, which sends messages that control muscles. The globus pallidus is part of a larger structure connected to the substantia nigra affecting movement, balance and walking. The thalamus serves as a relay station for brain impulses, and the cerebellum affects muscle coordination.
Though full-blown Parkinson's can be crippling or disabling, experts say early symptoms of the disease may be so subtle and gradual that patients sometimes ignore them or attribute them to the effects of aging. At first, patients may feel overly tired, "down in the dumps," or a little shaky. Their speech may become soft and they may become irritable for no reason. Movements may be stiff, unsteady, or unusually slow.

Joe Dulaney says he was in "perfect health" nine years ago when his wife noticed that he had stopped swinging his right arm when he walked. Soon, simple tasks such as brushing his teeth and combing his hair became major ordeals. His right hand was always ice cold and he produced small, jerky letters when he wrote.

Dulaney's doctor diagnosed the problem as arthritis and prescribed drugs to treat it. But symptoms worsened. Dulaney's voice dwindled to a slight whisper. Leg cramps, dry mouth, severe constipation, itchy eyes, and trouble turning over in bed tormented him. "My wrists were rigid and my fingers were not flexible, so I couldn't even button my shirt," he says. Still, another doctor seconded the arthritis diagnosis and prescribed different drugs.

Finally fed up because his deteriorating condition prevented him from doing simple tasks such as turning newspaper pages, putting money in his wallet, and replacing a light bulb, Dulaney checked himself into a local hospital, arriving in such a weakened state he couldn't walk.

Though a Parkinson's diagnosis rarely comes quickly, the three doctors who examined Dulaney at the hospital agreed within minutes that his classic symptoms indicated Parkinson's. The doctors gave him the Parkinson's drug levodopa, marketed as Larodopa and in generic forms, and the effect was nearly immediate.

"In one hour or so I was walking the halls. I took a shower by myself and did one push-up to show off," says Dulaney. It was, for the moment, as if the disease had somehow vanished. But Dulaney says he soon became "fully aware" that because Parkinson's is progressive, he could manage some symptoms with drugs, but the disease wasn't about to go away.

by John Henkel

symptoms of parkinsons disease : New Treatments Slow Onslaught of Symptoms

2006-07-06T21:47:00.000-07:00

Joe Dulaney calls himself the Backward Man.

Although the tag is lighthearted, the awkward and dangerous dilemma he often faces as his lower limbs simply lock in mid-stride is not. At these moments, his body halts abruptly like a movie freeze-frame, and the only way he can walk is to step backward.

"I've gotten to where I can move pretty fast in reverse," says Illinois resident Dulaney, 65, whose finessed footwork helps him cope with one of many symptoms of Parkinson's disease.

Nationwide, as many as 1.5 million people suffer from Parkinson's, according to the Parkinson's Disease Foundation. A chronic and progressive disorder, Parkinson's strikes slightly more men than women and more whites than blacks in the United States. Though the disease is found most often in patients over 50, as many as 10 percent of patients--afflicted with the so-called "young-onset" Parkinson's--are under 40. About 50,000 Americans are diagnosed with Parkinson's yearly, according to the National Institute of Neurological Disorders and Stroke, which estimates that the total cost of health care for Parkinson's patients will exceed $5.6 billion this year.

The Food and Drug Administration has approved nearly a dozen drugs for treating Parkinson's, three of which have been put on the market just in the past year. Also approved in 1997 was a device that is surgically implanted in the brain to lessen the violent shaking experienced by some Parkinson's patients. The 1996 discovery of a gene believed responsible for a form of Parkinson's may result in future innovative treatments. Despite the range of therapies available to ease the disease's debilitating symptoms, however, treatments now on the market can neither replace the faulty nerve cells that cause the disease nor stop Parkinson's from progressing.

Numerous public figures have acknowledged their battle with Parkinson's. Attorney General Janet Reno, evangelist Billy Graham, former boxer Muhammad Ali, and former Alabama governor George Wallace all are fighting the disease. Chinese leader Deng Xiaoping was in the late stages of Parkinson's when he died last year at age 92.

Parkinson's also gained attention last year with passage of the Morris K. Udall Parkinson's Research Act, which authorized $100 million for Parkinson's research. At press time, the funds had not yet been appropriated. Udall, who has Parkinson's, served in the House of Representatives for 30 years.

by John Henkel

symptoms of parkinsons disease : HOW IS PARKINSON'S DISEASE DIAGNOSED?

2006-07-04T02:29:00.000-07:00

Parkinson's disease is usually diagnosed by a neurologist who can evaluate symptoms and their severity. There is no test that can clearly identify the disease. Sometimes people with suspected Parkinson's disease are given anti-Parkinson's drugs to see if they respond. Other tests, such as brain scans, can help doctors decide if a patient has true Parkinson's disease or some other disorder that resembles it. Microscopic brain structures called Lewy bodies, which can be seen only during an autopsy, are regarded as a hallmark of classical Parkinson's. Autopsies have uncovered Lewy bodies in a surprising number of older persons without diagnosed Parkinson's -- 8% of people over 50, almost 13% of people over 70, and almost 16% of those over 80, according to one study. As a result, some experts believe Parkinson's disease is something of an "iceberg; phenomenon," lurking undetected in as many as 20 people for each known Parkinson's patient. A few researchers contend that almost everyone would develop Parkinson's eventually if they lived long enough.

WHAT TREATMENTS ARE AVAILABLE?

There is no cure for Parkinson's disease. Many patients are only mildly affected and need no treatment for several years after the initial diagnosis. When symptoms grow severe, doctors usually prescribe levodopa (L-dopa), which helps replace the brain's dopamine. Sometimes doctors prescribe other drugs that affect dopamine levels in the brain. In patients who are very severely affected, a kind of brain surgery known as pallidotomy has reportedly been effective in reducing symptoms. Another kind of brain surgery, in which healthy dopamine-producing tissue is transplanted into the brain, is also being tested. Finally, researchers are trying to identify substances that will prevent dopamine-producing brain cells from dying.

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

National Institute of Neurological Disorders and Stroke

symptoms of parkinsons disease : Study Shows Impact of Parkinson's Gene

2006-07-04T02:26:00.000-07:00

Researchers report that inheriting even one copy of a mutated gene known to cause Parkinson's disease might trigger early symptoms.

The parkin gene -- already known to hasten the age at which Parkinson's symptoms appear -- was previously linked to early-onset Parkinson's when two copies of the mutant gene were copied. This new study, conducted by a research team at Massachusetts General Hospital, shows that the risk increases with even one copy of the aberrant gene.

"This is the first time anyone has shown that a single parkin mutation can lower the age of onset," study author James Gusella, director of the MGH Center for Human Genetic Research, said in a prepared statement. "We don't know if that would be sufficient to cause the disease. It's more likely that these mutations increase susceptibility to other factors underlying the development of Parkinson's. The result also lets us know that future researchers shouldn't just study the effects of completely knocking out the parkin gene -- we'll need to examine knocking out a single copy as well."

The finding appears in the June issue of the Archives of Neurology.

The research team wanted to evaluate which genes are responsible for the hereditary forms of Parkinson's disease. To do so, they studied 329 families with at least two cases of Parkinson's per family from across North America, Europe and Australia.

Two types of families were studied from this group: those with siblings who have the same versions of the chromosome 6 region (where the parkin gene is found); and those with one family member whose symptoms appeared before age 54. Early onset for Parkinson's is defined as symptoms before age 50.

Patients in each family with the earliest symptoms underwent genetic screening to search for parkin mutations. If the screen was positive, the other family members with Parkinson's were also screened. Of the 183 families in this section of the study, 23 families had parkin mutations, 13 of which had at least one family member who had two mutated copies of the gene. Ten of the families had only one mutated copy of the parkin gene.

Of the population of families with parkin mutations, 43 was the average age at which symptoms began to appear. Onset began at an average age of 61 in families with identical chromosomal markers and no mutations, and about age 50 in families with one parkin gene mutation. Patients with two mutated copies of the parkin gene experienced onset at an average age of 36.

"This study reinforces the fact that there are multiple mechanisms behind Parkinson's disease, and will lead us to examine other pathways with which parkin interacts," Gusella said.

By Diana Kohnle

symptoms of parkinsons disease : Pesticides Could Raise Parkinson's Risk

2006-07-01T11:55:00.000-07:00

Exposure to pesticides, but not other environmental contaminants, may boost the long-term risk for developing Parkinson's disease by 70 percent, a new study suggests.

The researchers did not assess the length, frequency, or strength of pesticide exposure, and they stressed that the absolute risk of developing Parkinson's remains relatively small.

However, their finding does back up earlier animal studies linking pesticide exposure to motor function abnormalities and lower levels of the brain neurotransmitter dopamine. Declines in dopamine have long been associated with Parkinson's.

"This is the first large human study that shows that exposure to pesticide is associated with a higher incidence of Parkinson's," said study lead author Dr. Alberto Ascherio, associate professor of nutrition and epidemiology at the Harvard School of Public Health in Boston.

"It is, of course, a relative increase," emphasized Ascherio. "So, whereas normally the lifetime risk for developing Parkinson's is three percent, pesticide exposure will bring the risk to five percent."

Ascherio and his colleagues discussed their work in the July issue of the Annals of Neurology.

The authors reviewed lifestyle surveys completed in both 1982 and in 2001 by over 143,000 participants in the U.S. "Cancer Prevention Study II Nutrition Cohort," launched in 1982.

In addition to pesticide exposure, participants were asked about exposure to a host of chemicals and dusts, such as: asbestos, acids, solvents, coal and stone dust, coal tar, asphalt, diesel engine exhaust, dyes, formaldehyde, gasoline exhaust, herbicides, textile fibers, wood dust, and x-ray or radioactive materials. Nearly all the patients were white, with an average age just of over 60.

The researchers studied 413 participants who were diagnosed with Parkinson's disease.

The surveys revealed that just over eight percent of the men and just over three percent of the women reported exposure to pesticides.

Exposed patients were twice as likely to be blue-collar workers and 14 times more likely to work as either a farmer, rancher, or fisherman.

However, no differences were found in terms of risk increase between patients who experienced exposure because of their work, such as farmers, and those who came into contact with the chemicals because of home or garden use.

The Harvard team found that, regardless of occupation, pesticide exposure boosted long-term Parkinson's risk by 70 percent over the long-term.

Ascherio stressed that although the association found in his study was stronger than any previously documented, more work is needed to pinpoint what exactly it is about pesticides that may help spur Parkinson's.

"The key point would be to identify which chemicals cause Parkinson's," he said. "It's not very practical to tell people to avoid pesticides, because many people find it very useful. So this will require more detailed study," he added.

Robin Elliot, executive director for the Parkinson's Disease Foundation in New York City, described the findings as "important and solid."

"This is certainly the biggest and most serious populations study on people, and it appears to be the best proof today that there is a general association between pesticide and Parkinson's among people," said Elliot. "It merits further investigation," he said.

In a separate smaller study, published in the June issue of Movement Disorders, a team of researchers from the Mayo Clinic in Olmsted County, Minn., found that pesticide exposure seemed to increase Parkinson's risk for men, but not women.

Telephone interviews were conducted with 149 men and women, all local-area Parkinson's patients who developed the illness between 1976 and 1995. The Mayo team also interviewed 129 healthy individuals.

They found that male patients were 2.4 times more likely than healthy individuals to have been exposed to pesticides. No such increased risk was evident among the female patients.

Copyright (c) 2006 ScoutNews LLC. All rights reserved.

symptoms of parkinsons disease : FDA Approves the First Treatment for Dementia of Parkinson’s Disease

2006-07-01T11:50:00.000-07:00

The Food and Drug Administration (FDA) today approved Exelon (rivastigmine tartrate) for the treatment of mild to moderate dementia (chronic loss or impairment of intellectual capacity) associated with Parkinson's disease, a disorder of the central nervous system. Exelon was previously approved for the treatment of mild to moderate dementia of the Alzheimer's type.

"It's been recognized for almost a decade that the dementia of patients with Parkinson's disease differs from the dementia of patients with Alzheimer's," said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research, "but until now, there has been no treatment that has been shown to be effective specifically for the dementia associated with Parkinson's Disease. Today's approval of Exelon helps to fill this medical need."

It is estimated that about 0.2 percent to 0.5 percent of people over 65 years of age are affected by Parkinson's dementia and experience such symptoms as impairments in executive function, memory and attention. The approval of Exelon for the treatment of Parkinson's dementia is based on the results of a randomized, placebo-controlled clinical study with 541 patients who showed symptoms of mild to moderate dementia two years or later after their diagnosis for Parkinson's disease. At the end of the 24-week trial, the condition of the Exelon-treated patients, as shown on a scale that measures mental processes, was significantly better than the condition of the patients on placebo.

The use of Exelon has been associated with significant gastrointestinal adverse reactions. In clinical trials, 47 percent of the patients treated with the drug developed nausea, and 26 percent of women and 18 percent of men on high doses of Exelon experienced significant weight loss. Other common adverse events reported by patients on Exelon include vomiting, anorexia, dyspepsia and asthenia (loss of strength). In some patients with Parkinson's disease, treatment with Exelon was associated with a worsening of tremor.

by Novartis Pharmaceutical Corp. in East Hanover, NY.

symptoms of parkinsons disease : Alzheimer's Disease and Glutathione

2006-06-26T01:04:00.000-07:00

Free radicals and oxidative damage in neurons is known to be a primary cause of degenerative diseases like Alzheimer's disease.

Amyloid-ß peptide (Aß) accumulation in senile plaques, a pathological hallmark of Alzheimer's disease (AD), has been implicated in neuronal degeneration.

Amyloid plaques encroaching on the brain increase the production of free radicals, or oxidative stress. Antioxidants, such as vitamin C and E "mop up" the damaging free radicals.

Glutathione (GSH) precursors can prevent death of brain cells induced by amyloid plaques in Alzhiemer's disease, while substances that deplete GSH increase cell death. (5)

Evidence has been piling up over the link between the amount of an amino acid called homocysteine in the blood and the chance of developing Alzheimer's.

For people not genetically predisposed to developing Alzheimer's, cholesterol and homocysteine, largely caused by an unhealthy lifestyle, are the core causal factors.

Welsh GP, Andrew McCaddon, showed that the more homocysteine that patients with Alzheimer's had, the worse their mental performance, and the worse their "cognitive impairment," the less they had of the antioxidant glutathione. (6)

Glutathione and Mood Disorders

Studies have found that the mood stabilizing drug, valproate, used to treat epilepsy and bi-polar disorder, regulates expression of the genes that make glutathione-S-transferase (GST).

In addition, chronic treatment with lithium, another commonly prescribed mood stabilizer used in treating manic-depression, also increased levels of GST.

These findings led researchers to conclude that glutathione S-transferase may be a novel target for mood stabilizing drugs. (7)

Alcohol Consumption and Glutathione

Alcohol abuse is known to impair memory and other brain functions and increase brain cell death. A new study in rats has shown that alchol consumption causes fewer new brain cells to form and results in greater cell death. (8)

But rats that were fed alcohol along with Ebselen - a glutathione peroxidase mimic that acts as a free radical scavenger - showed no similar reduction in brain-cell formation and no increase in cell death.

Substances that Boost Glutathione Levels and Protect Brain Cells

Taking glutathione itself as a supplement does not boost cellular glutathione levels, since it breaks down in the digestive tract before it reaches the cells.

However, intravenous glutathione therapy and glutathione precursors or dietary supplements are effective in boosting intracellular levels of glutathione.

Intravenous Glutathione Injections: Intravenous glutathione injections have been shown to produce amazing and rapid results, in patients with Parkinson's disease. Following even a single dosage of intravenous glutathione, many of the symptoms of Parkinson's disease rapidly improve, often in as little as 15 minutes.

Glutathione Precursors: In the Alzheimer's study conducted by Welsh GP, Andrew McCaddon, adding the glutathione precursor, N-acetyl-cysteine (NAC) to a protocol that lowered homocysteine levels by simple supplementation with B12 and folate, resulted in prompt, striking, and sustained clinical improvement in nearly all the patients. (9)

Cucurmin (turmeric): Studies have shown that the Indian curry spice, cucurmin, has neuroprotective effects because of its ability to induce the enzyme, hemeoxygenase-1 (HO-1), which protects neurons exposed to oxidant stress. Treatment of brain cells called astrocytes, with curcumin, increases expression of HO-1 protein as well as glutathione S-transferase. (10)

Ebselen: Ebselen is a glutathione peroxidase mimic and potent synthetic antioxidant that acts as a neuroprotective agent and an inhibitor of free-radical induced apoptosis (cell death). It can protect brain cells from the neuro-toxic effects of alcohol consumption. (8)

Undenatured Whey Protein: Undenatured whey protein provides glutathione precursors, has been shown to raise intracellular glutathione levels in clinical trials, and has anecdotally been reported to improve the symptoms of Parkinson's disease.

by Priya F Shah

symptoms of parkinsons disease : Your Brain's Master Antioxidant Defense

2006-06-26T01:00:00.000-07:00

Free radicals and oxyradicals play an important role in the development and progression of many brain disorders such as brain injury, neurodegenerative disease, schizophrenia and Down syndrome.

Glutathione is the brain's master antioxidant and plays an important protective role in the brain.

According to Dr. Jimmy Gutman, "The brain is particularly susceptible to free radical attack because it generates more oxidative by-products per gram of tissue than any other organ."

Many neurological and psychiatric disease processes are characterized by... abnormalities in glutathione metabolism and antioxidant defenses."

Generation of reactive oxygen species (free radicals) and oxidative damage are an important cause of neuron (brain cell) death from brain injury.

Chemicals that cause toxicity to certain brain cells are known to decrease cerebral glutathione (GSH), making the cells more vulnerable to reactive oxygen species (ROS). (1)

On the other hand, over-expression of the glutathione peroxidase (GPX) enzyme potently decreases cell death from brain injury. (2)

Brain Injury and Glutathione - The Gender Difference

Researchers at Children's Hospital of Pittsburgh have found that males and females respond differently to brain injury. (3)

In animal models, levels of glutathione remain constant in females who have suffered a brain injury, but drop by as much as 80 percent in males with the same injury.

When glutathione levels drop, brain cells die much more quickly. This suggests that boys with brain injuries may require different life-saving treatments than girls.

N-acetyl-cysteine (NAC), a precursor of glutathione, already approved for use by the U.S. Food and Drug Administration to treat people who have overdosed on acetaminophen, may be an effective treatment for brain injury in boys whose brains are deprived of oxygen.

Brain Disorders and Glutathione - A Genetic Cause?

Genetics researchers have found that the glutathione S-transferase gene controls the onset of Alzheimer's, Parkinson's disease and determines, not if we get these diseases, but when. (4)

The glutathione S-transferase gene has previously been linked to the risk for Parkinson's disease among people who used pesticides.

A previous article covered the importance of glutathione in Parkinson's Disease.

by Priya F Shah

symptoms of parkinsons disease : Sleep Problems

2006-06-22T02:14:00.000-07:00

People who suffer from Parkinson’s disease are usually left to deal with a range of symptoms that can make day-to-day tasks difficult. Among these, sleep — one of our most basic needs — can be disrupted and hard to achieve. Often, Parkinson’s patients have sleep problems that are caused by the disease itself, or are brought on by medicines used to treat or help the patient.

Sleep problems associated with Parkinson’s usually include an inability to fall asleep, difficulty in staying asleep, uncomfortable sensations in the legs at night (a condition known as restless legs syndrome), nightmares, acting out of dreams that might lead to accidents or injuries, and daytime drowsiness. If you are encountering any of these symptoms, never take over-the-counter sleeping medicines to help the problem without first consulting your doctor. Some over-the-counter and prescription medicines cause or worsen sleep problems.

What can I do to help my sleep problem?
Because the sleep disturbance might be caused by other medicines that are being prescribed to cope with Parkinson’s disease, you should consult your doctor about possible alternative medicines that could be used instead that will not interfere with sleep.

A sleep disturbance might also indicate depression in a person who has Parkinson’s disease. Depression might bring on fatigue, a changed level of physical and social activity, and a tendency to not sleep soundly or not at all. If these problems persist you should discuss them with your doctor.

Following are some tips for Parkinson’s patients to promote more restful sleep.

Avoid stimulants such as caffeine within six hours of bed time.
Do not take long naps during the day, and participate in activities that keep you physically busy.
Avoid using your bedroom for activities other than sleeping, such as reading, watching television, or working.
Remedies such as a warm glass of milk, a massage, and an expression of affection might also help a Parkinson’s patient to sleep better. Also, a hot shower or bath can be helpful in helping a patient to relax.
Depression, which is often common among Parkinson’s patients, can also contribute to insomnia. Doctors can usually prescribe an antidepressant or a sedative to aid in sleep. However, studies have shown that taking measures to promote relaxation and good sleep habits work better than sleeping pills.

© Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved

symptoms of parkinsons disease : The Facts About Glutathione

2006-06-22T02:01:00.000-07:00

Parkinson's Disease (PD), a devastating illness, occurs in one of every 100 people over 65.

It is a slowly progressing disease of the nervous system that results in progressive destruction of brain cells (neurons) in an area of the brain called the substantia nigra. Death occurs usually as a result of secondary complications such as infection.

One of the mechanisms known to destroy neurons is damage by free radicals or reactive oxygen species - destructive molecules produced by oxidation of the neurotransmitter dopamine.

The Role of Dopamine

The cells of the substantia nigra use dopamine - a chemical messenger between brain or nerve cells - to communicate with cells in another region of the brain called the striatum.

When nigral cells are lost, nigral dopamine levels fall, resulting in a decrease in striatal dopamine.

The typical symptoms of PD - motor function deficiencies characterized by muscle rigidity, jerky movements, rhythmic resting tremors - are the result of low levels of striatal dopamine.

Most dopaminergic drugs used to treat PD, are aimed at temporarily replenishing or mimicking dopamine. They improve some symptoms, but do not restore normal brain function nor halt brain cell destruction.

Dopaminergic drugs are generally effective at first in reducing many PD symptoms, but over time they lose their effect.

They also cause severe side effects because they overstimulate nerve cells elsewhere in the body and cause confusion, hallucinations, nausea and fluctuations in the movement of limbs.

The Role of Antioxidants

When dopaminergic neurons are lost in the course of Parkinson's disease, the metabolism of dopamine is increased - which in turn increases the formation of highly neurotoxic hydroxyl radicals.

The most important free radical scavenger in the cells of the substantia nigra is the powerful brain antioxidant, glutathione. Glutathione levels in PD patients are low.

And as we age, levels of glutathione in the dopaminergic neurons of the substantia nigra decreases. This appears to hasten cell death and advance the progression of PD.

At least 80 percent of the substantia nigra cells are lost before symptoms of Parkinson's disease become apparent. This is why it becomes essential to protect or maintain these cells under oxidative stress.

How does Glutathione help in Parkinson's Disease?

Several factors explain why glutathione is so beneficial in Parkinson's disease.

1. Glutathione increases the sensitivity of the brain to dopamine. So although glutathione doesn't raise dopamine levels, it allows the dopamine in the brain to be more effective.

2. Glutathione's powerful antioxidant activity protects the brain from free radical damage.

3. An even more intriguing benefit of glutathione lies in its powerful detoxification ability.

Its a well known fact that most Parkinson's patients are deficient in their ability to detoxify chemicals to which they are exposed.

The unfortunate few who harbor an inherited flaw in their detoxification pathways are at far greater risk to the brain damaging effects of a wide variety of toxins.
Glutathione is one of the most important components of the liver's detoxification system. Glutathione therapy is one of the most effective techniques for enhancing liver and brain detoxification.

Glutathione treatments considerably improve some of the symptoms of Parkinson's disease including difficulties with rigidity, walking, movement, coordination and speech. A marked reduction of tremor has been observed as well as a decrease in depression.

Glutathione and N-acetyl-L-cysteine (a glutathione precursor) have been shown to be very effective in protecting the nerves in the substantia nigra from being destroyed by oxidative stress.

Glutathione Therapy in Parkinson's Disease

The practical problem in increasing glutathione levels is that taking glutathione itself as a supplement does not boost cellular glutathione levels, since glutathione breaks down in the digestive tract before it reaches the cells.

However, intravenous glutathione therapy and taking glutathione precursors are both effective in boosting intracellular levels of glutathione.

Intravenous Glutathione Therapy:

Intravenous glutathione injections have been shown to have amazing and quick results.

Dr. David Perlmutter, a pioneer in this therapy, has developed a protocol utilized at the Perlmutter Health Center for administering intravenous glutathione to Parkinson's patients.

Following even a single dosage of intravenous glutathione - often in as little as 15 minutes - the ability to walk, turn around and move their arms is almost completely restored.

Glutathione Precursors:

Dietary antioxidants and supplements that increase cellular glutathione, such as alpha lipoic acid, NAC, pycnogenol, the herb silymarin (milk thistle), are effective in restoring normal function.

N-acetyl-cysteine (NAC) and un-denatured, whey protein both supply glutathione precursors intracellularly, enhance the body's production of glutathione and aid the detoxification process.

Other nutritional supplements which aid the detoxification process include selenium, vitamins E and C.

symptoms of parkinsons disease : Pain in Parkinson's Disease

2006-06-16T23:59:00.000-07:00

For most people with Parkinson's disease (PD), the most serious concern is with the motor system: stiffness, slowness of movement, impaired handwriting and coordination, poor mobility and balance. Descriptions of PD do not generally include the mention of pain. And yet, when carefully questioned, more than half of all people with Parkinson's disease say that they have experienced painful symptoms and various forms of physical discomfort. Most people experience aching, stiffness, numbness and tingling at some point in the course of the illness. For a few of them, pain and discomfort are so severe that they overshadow the other problems caused by the disease. This article will address these overlooked painful symptoms of PD, and describe an approach to diagnosing and treating the various pain syndromes that may occur.

Pain is described in textbooks as an unpleasant experience associated with physical injury or tissue damage. Pain can arise from anywhere in the body, of course. It goes without saying that people with Parkinson's are subject to all of the painful conditions - cardiac, gastroenterological, rheumatological, among others - that can affect people without PD. This discussion will focus on pain that is directly related to PD itself.

Pain syndromes and discomfort in Parkinson's usually arise from one of five causes: (1) a musculoskeletal problem related to poor posture, awkward mechanical function or physical wear and tear; (2) nerve or root pain, often related to neck or back arthritis; (3) pain from dystonia, the sustained twisting or posturing of a muscle group or body part; (4) discomfort due to extreme restlessness and (5) a rare pain syndrome known as "primary" or "central" pain, arising from the brain.

It takes diagnostic skill and clinical experience to determine the cause of pain in someone with PD. The most important diagnostic tool is the patient's history. Where is the pain? What does it feel like? Does it radiate? When does it occur during the day? Does it occur in relation to any particular activity or medication? Perhaps the most important task for people with Parkinson's who experience pain is to describe as accurately as they can whether their medications induce, aggravate or relieve their pain. To help your physician in diagnosing pain,

© 2005 The Parkinson’s Disease Foundation

symptoms of parkinsons disease : Giving to PDF

2006-06-16T23:56:00.000-07:00

For almost 50 years the Parkinson's Disease Foundation (PDF) has been a leading national presence in Parkinson's disease research, patient education and public advocacy. PDF is working for the nearly one million people in the US living with Parkinson's by funding promising scientific research and supporting people with Parkinson's, their families and caregivers through educational programs and support services.

Since our founding in 1957, PDF has funded more than $50 million worth of scientific research in Parkinson's disease, supporting the work of leading scientists throughout the world. Your contribution will help us continue to fund this essential research to find a cure for Parkinson's disease.

With your generous gift, we can continue to fund groundbreaking research and bring quality services and materials to people who live with Parkinson's disease. Learn more about Parkinson's disease and the Parkinson's Disease Foundation.

We understand how important it is that your money is used in the most effective way. In 2004, 60 percent of our budget was dedicated to research, and almost 20 percent went to providing educational materials, information and services to the Parkinson's community. That means that only 20 percent of our total budget is used for management, general expenses and fundraising.

To make a difference in the fight against Parkinson's, make a donation online today or download a donation form to fax or mail your contribution to the Parkinson's Disease Foundation. You can also make your donation over the phone by calling us at (800) 457-6676. We accept Visa, MasterCard and American Express.

Checks may be mailed to:
Parkinson's Disease Foundation
1359 Broadway, Suite 1509
New York, New York 10018

For other ways to contribute, including bequests and planned gifts, stock gifts, memorial gifts, automobile donations and more, visit our section on Other Ways to Give. Here you will also find information on organizing a fundraiser to benefit PDF.

Thank you for your generosity!

The Parkinson's Disease Foundation is a 501(c)3 nonprofit organization. PDF is a public charity exempt from federal income tax; our Federal Employer Tax ID number is 13-1866796. You can request a copy of our latest financial information by writing to our office or by reviewing our recent 990 online. Our most recent financial statement is also available for downloading.

© 2005 The Parkinson’s Disease Foundation

symptoms of parkinsons disease : What Other Diseases Resemble Parkinson's?

2006-06-13T01:19:00.000-07:00

A number of disorders can cause symptoms similar to those of PD. People with symptoms that resemble PD but that result from other causes are sometimes said to have parkinsonism. Some of these disorders are listed below.

Postencephalitic parkinsonism. Just after the first World War, a viral disease, encephalitis lethargica, attacked almost 5 million people throughout the world, and then suddenly disappeared in the 1920s. Known as sleeping sickness in the United States , this disease killed one third of its victims and led to post-encephalitic parkinsonism in many others. This resulted in a particularly severe form of movement disorder that appeared sometimes years after the initial illness. (In 1973, neurologist Oliver Sacks published Awakenings, an account of his work in the late 1960s with surviving post-encephalitic patients in a New York hospital. Using the then-experimental drug levodopa, Dr. Sacks was able to temporarily "awaken" these patients from their statue-like state). In rare cases, other viral infections, including western equine encephalomyelitis, eastern equine encephalomyelitis, and Japanese B encephalitis, have caused parkinsonian symptoms.

Drug-induced parkinsonism. A reversible form of parkinsonism sometimes results from use of certain drugs, such as chlorpromazine and haloperidol, which are prescribed for patients with psychiatric disorders. Some drugs used for stomach disorders (metoclopramide), high blood pressure (reserpine), and epilepsy (valproate) may also produce parkinsonian symptoms. Stopping the medication or lowering the dosage of these medications usually causes the symptoms to go away.

Toxin-induced parkinsonism. Some toxins — such as manganese dust, carbon disulfide, and carbon monoxide — can cause parkinsonism. The chemical MPTP also causes a permanent form of parkinsonism that closely resembles PD. Investigators discovered this reaction in the 1980s when heroin addicts in California who had taken an illicit street drug contaminated with MPTP began to develop severe parkinsonism. This discovery, which showed that a toxic substance could damage the brain and produce parkinsonian symptoms, caused a dramatic breakthrough in Parkinson's research: for the first time, scientists were able to simulate PD in animals and conduct studies to increase understanding of the disease.

Arteriosclerotic parkinsonism. Sometimes known as pseudoparkinsonism, vascular parkinsonism, or atherosclerotic parkinsonism, arteriosclerotic parkinsonism involves damage to the brain due to multiple small strokes. Tremor is rare in this type of parkinsonism, while dementia — the loss of mental skills and abilities — is common. Antiparkinsonian drugs are of little help to patients with this form of parkinsonism.

Parkinsonism-dementia complex of Guam. This disease occurs among the Chamorro populations of Guam and the Mariana Islands and may be accompanied by a motor neuron disease resembling amyotrophic lateral sclerosis (Lou Gehrig's disease). The course of the disease is rapid, with death typically occurring within 5 years.

Post-traumatic parkinsonism. Also known as post-traumatic encephalopathy or "punch-drunk syndrome," parkinsonian symptoms can sometimes develop after a severe head injury or frequent head trauma that results from boxing or other activities. This type of trauma also can cause a form of dementia called dementia pugilistica.

Essential tremor. Essential tremor, sometimes called benign essential tremor or familial tremor, is a common condition that tends to run in families and progresses slowly over time. The tremor is usually equal in both hands and increases when the hands are moving. The tremor may involve the head but usually spares the legs. Patients with essential tremor have no other parkinsonian features. Essential tremor is not the same as PD, and usually does not lead to it, although in some cases the two conditions may overlap in one person. Essential tremor does not respond to levodopa or most other PD drugs, but it can be treated with other medications.

Normal pressure hydrocephalus. Normal pressure hydrocephalus (NPH) is an abnormal increase of cerebrospinal fluid (CSF) in the brain's ventricles, or cavities. It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain. Symptoms include problems with walking, impaired bladder control leading to urinary frequency or incontinence, and progressive mental impairment and dementia. The person also may have a general slowing of movements or may complain that his or her feet feel "stuck." These symptoms may sometimes be mistaken for PD. Brain scans, intracranial pressure monitoring, and other tests can help to distinguish NPH from PD and other disorders. NPH can sometimes be treated by surgically implanting a CSF shunt that drains excess cerebrospinal fluid into the abdomen, where it is absorbed.

Progressive supranuclear palsy. Progressive supranuclear palsy (PSP), sometimes called Steele-Richardson-Olszewski syndrome, is a rare, progressive brain disorder that causes problems with control of gait and balance. People often tend to fall early in the course of PSP. One of the most obvious signs of the disease is an inability to move the eyes properly. Some patients describe this effect as a blurring. PSP patients often show alterations of mood and behavior, including depression and apathy as well as mild dementia. The symptoms of PSP are caused by a gradual deterioration of brain cells in the brainstem. It is often misdiagnosed because some of its symptoms are very much like those of PD, Alzheimer's disease, and other brain disorders. PSP symptoms usually do not respond to medication.

Corticobasal degeneration. Corticobasal degeneration results from atrophy of multiple areas of the brain, including the cerebral cortex and the basal ganglia. Initial symptoms may first appear on one side of the body, but eventually affect both sides. Symptoms are similar to those found in PD, including rigidity, impaired balance and coordination, and dystonia. Other symptoms may include cognitive and visual-spatial impairments, apraxia (loss of the ability to make familiar, purposeful movements), hesitant and halting speech, myoclonus (muscular jerks), and dysphagia (difficulty swallowing). Unlike PD, corticobasal degeneration usually does not respond to medication.

Multiple system atrophy. Multiple system atrophy (MSA) refers to a set of slowly progressive disorders that affect the central and autonomic nervous systems. MSA may have symptoms that resemble PD. It also may take a form that primarily produces poor coordination and slurred speech, or it may have a mixture of these symptoms. Other symptoms may include breathing and swallowing difficulties, male impotence, constipation, and urinary difficulties. The disorder previously called Shy-Drager syndrome refers to MSA with prominent orthostatic hypotension — a fall in blood pressure every time the person stands up. MSA with parkinsonian symptoms is sometimes referred to as striatonigral degeneration, while MSA with poor coordination and slurred speech is sometimes called olivopontocerebellar atrophy.

Dementia with Lewy bodies. Dementia with Lewy bodies is a neurodegenerative disorder associated with abnormal protein deposits (Lewy bodies) found in certain areas of the brain. Symptoms can range from traditional parkinsonian symptoms, such as bradykinesia, rigidity, tremor, and shuffling gait, to symptoms similar to those of Alzheimer's disease. These symptoms may fluctuate, or wax and wane dramatically. Visual hallucinations may be one of the first symptoms, and patients may suffer from other psychiatric disturbances such as delusions and depression. Cognitive problems also occur early in the course of the disease. Levodopa and other antiparkinsonian medications can help with the motor symptoms of dementia with Lewy bodies, but they may make hallucinations and delusions worse.

Parkinsonism accompanying other conditions. Parkinsonian symptoms may also appear in patients with other, clearly distinct neurological disorders such as Wilson's disease, Huntington's disease, Alzheimer's disease, spinocerebellar ataxias, and Creutzfeldt-Jakob disease. Each of these disorders has specific features that help to distinguish them from PD.
MSA, corticobasal degeneration, and progressive supranuclear palsy are sometimes referred to as "Parkinson's-plus" diseases because they have the symptoms of PD plus additional features.

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

symptoms of parkinsons disease ; Who Gets Parkinson's Disease?

2006-06-13T01:12:00.000-07:00

About 50,000 Americans are diagnosed with PD each year, but getting an accurate count of the number of cases may be impossible because many people in the early stages of the disease assume their symptoms are the result of normal aging and do not seek help from a physician. Also, diagnosis is sometimes difficult and uncertain because other conditions may produce symptoms of PD and there is no definitive test for the disease. People with PD may sometimes be told by their doctors that they have other disorders, and people with PD-like diseases may be incorrectly diagnosed as having PD.

PD strikes about 50 percent more men than women, but the reasons for this discrepancy are unclear. While it occurs in people throughout the world, a number of studies have found a higher incidence in developed countries, possibly because of increased exposure to pesticides or other toxins in those countries. Other studies have found an increased risk in people who live in rural areas and in those who work in certain professions, although the studies to date are not conclusive and the reasons for the apparent risks are not clear.

One clear risk factor for PD is age. The average age of onset is 60 years, and the incidence rises significantly with increasing age. However, about 5 to 10 percent of people with PD have "early-onset" disease that begins before the age of 50. Early-onset forms of the disease are often inherited, though not always, and some have been linked to specific gene mutations. People with one or more close relatives who have PD have an increased risk of developing the disease themselves, but the total risk is still just 2 to 5 percent unless the family has a known gene mutation for the disease. An estimated 15 to 25 percent of people with PD have a known relative with the disease.

In very rare cases, parkinsonian symptoms may appear in people before the age of 20. This condition is called juvenile parkinsonism. It is most commonly seen in Japan but has been found in other countries as well. It usually begins with dystonia and bradykinesia, and the symptoms often improve with levodopa medication. Juvenile parkinsonism often runs in families and is sometimes linked to a mutated parkin gene.

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

symptoms of parkinsons disease : What are the Symptoms of the Disease?

2006-06-09T10:40:00.000-07:00

Early symptoms of PD are subtle and occur gradually. Affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly or that their handwriting is slow and looks cramped or small. They may lose track of a word or thought, or they may feel tired, irritable, or depressed for no apparent reason. This very early period may last a long time before the more classic and obvious symptoms appear.

Friends or family members may be the first to notice changes in someone with early PD. They may see that the person's face lacks expression and animation (known as "masked face") or that the person does not move an arm or leg normally. They also may notice that the person seems stiff, unsteady, or unusually slow.

As the disease progresses, the shaking or tremor that affects the majority of Parkinson's patients may begin to interfere with daily activities. Patients may not be able to hold utensils steady or they may find that the shaking makes reading a newspaper difficult. Tremor is usually the symptom that causes people to seek medical help.

People with PD often develop a so-called parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward (called festination), and reduced swinging of the arms. They also may have trouble initiating movement (start hesitation), and they may stop suddenly as they walk (freezing).

PD does not affect everyone the same way, and the rate of progression differs among patients. Tremor is the major symptom for some patients, while for others, tremor is nonexistent or very minor.

PD symptoms often begin on one side of the body. However, as it progresses, the disease eventually affects both sides. Even after the disease involves both sides of the body, the symptoms are often less severe on one side than on the other. The four primary symptoms of PD are:

Tremor. The tremor associated with PD has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion at a rate of 4-6 beats per second. It may involve the thumb and forefinger and appear as a "pill rolling" tremor. Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. For example, the shaking may become more pronounced a few seconds after the hands are rested on a table. Tremor usually disappears during sleep or improves with intentional movement.

Rigidity. Rigidity, or a resistance to movement, affects most people with PD. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In PD, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient's arm, which will move only in ratchet-like or short, jerky movements known as "cogwheel" rigidity.

Bradykinesia. Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it may make simple tasks somewhat difficult. The person cannot rapidly perform routine movements. Activities once performed quickly and easily — such as washing or dressing — may take several hours.

Postural instability. Postural instability, or impaired balance, causes patients to fall easily. Affected people also may develop a stooped posture in which the head is bowed and the shoulders are drooped.
A number of other symptoms may accompany PD. Some are minor; others are not. Many can be treated with medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms varies from person to person.

Depression. This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Fortunately, depression usually can be successfully treated with antidepressant medications.

Emotional changes. Some people with PD become fearful and insecure. Perhaps they fear they cannot cope with new situations. They may not want to travel, go to parties, or socialize with friends. Some lose their motivation and become dependent on family members. Others may become irritable or uncharacteristically pessimistic.

Difficulty with swallowing and chewing. Muscles used in swallowing may work less efficiently in later stages of the disease. In these cases, food and saliva may collect in the mouth and back of the throat, which can result in choking or drooling. These problems also may make it difficult to get adequate nutrition. Speech-language therapists, occupational therapists, and dieticians can often help with these problems.

Speech changes. About half of all PD patients have problems with speech. They may speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. A speech therapist may be able to help patients reduce some of these problems.

Urinary problems or constipation. In some patients, bladder and bowel problems can occur due to the improper functioning of the autonomic nervous system, which is responsible for regulating smooth muscle activity. Some people may become incontinent, while others have trouble urinating. In others, constipation may occur because the intestinal tract operates more slowly. Constipation can also be caused by inactivity, eating a poor diet, or drinking too little fluid. The medications used to treat PD also can contribute to constipation. It can be a persistent problem and, in rare cases, can be serious enough to require hospitalization.

Skin problems. In PD, it is common for the skin on the face to become very oily, particularly on the forehead and at the sides of the nose. The scalp may become oily too, resulting in dandruff. In other cases, the skin can become very dry. These problems are also the result of an improperly functioning autonomic nervous system. Standard treatments for skin problems can help. Excessive sweating, another common symptom, is usually controllable with medications used for PD.

Sleep problems. Sleep problems common in PD include difficulty staying asleep at night, restless sleep, nightmares and emotional dreams, and drowsiness or sudden sleep onset during the day. Patients with PD should never take over-the-counter sleep aids without consulting their physicians.

Dementia or other cognitive problems. Some, but not all, people with PD may develop memory problems and slow thinking. In some of these cases, cognitive problems become more severe, leading to a condition called Parkinson's dementia late in the course of the disease. This dementia may affect memory, social judgment, language, reasoning, or other mental skills. There is currently no way to halt PD dementia, but studies have shown that a drug called rivastigmine may slightly reduce the symptoms. The drug donepezil also can reduce behavioral symptoms in some people with PD-related dementia.

Orthostatic hypotension. Orthostatic hypotension is a sudden drop in blood pressure when a person stands up from a lying-down position. This may cause dizziness, lightheadedness, and, in extreme cases, loss of balance or fainting. Studies have suggested that, in PD, this problem results from a loss of nerve endings in the sympathetic nervous system that controls heart rate, blood pressure, and other automatic functions in the body. The medications used to treat PD also may contribute to this symptom.

Muscle cramps and dystonia. The rigidity and lack of normal movement associated with PD often causes muscle cramps, especially in the legs and toes. Massage, stretching, and applying heat may help with these cramps. PD also can be associated with dystonia — sustained muscle contractions that cause forced or twisted positions. Dystonia in PD is often caused by fluctuations in the body's level of dopamine. It can usually be relieved or reduced by adjusting the person's medications.

Pain. Many people with PD develop aching muscles and joints because of the rigidity and abnormal postures often associated with the disease. Treatment with levodopa and other dopaminergic drugs often alleviates these pains to some extent. Certain exercises also may help. People with PD also may develop pain due to compression of nerve roots or dystonia-related muscle spasms. In rare cases, people with PD may develop unexplained burning, stabbing sensations. This type of pain, called "central pain," originates in the brain. Dopaminergic drugs, opiates, antidepressants, and other types of drugs may all be used to treat this type of pain.

Fatigue and loss of energy. The unusual demands of living with PD often lead to problems with fatigue, especially late in the day. Fatigue may be associated with depression or sleep disorders, but it also may result from muscle stress or from overdoing activity when the person feels well. Fatigue also may result from akinesia – trouble initiating or carrying out movement. Exercise, good sleep habits, staying mentally active, and not forcing too many activities in a short time may help to alleviate fatigue.

Sexual dysfunction. PD often causes erectile dysfunction because of its effects on nerve signals from the brain or because of poor blood circulation. PD-related depression or use of antidepressant medication also may cause decreased sex drive and other problems. These problems are often treatable.

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

symptoms of parkinsons disease : What Genes are Linked to Parkinson's Disease

2006-06-09T10:32:00.000-07:00

Several genes have now been definitively linked to PD. The first to be identified was alpha-synuclein. In the 1990s, researchers at NIH and other institutions studied the genetic profiles of a large Italian family and three Greek families with familial PD and found that their disease was related to a mutation in this gene. They found a second alpha-synuclein mutation in a German family with PD. These findings prompted studies of the role of alpha-synuclein in PD, which led to the discovery that Lewy bodies from people with the sporadic form of PD contained clumps of alpha-synuclein protein. This discovery revealed a potential link between hereditary and sporadic forms of the disease.

In 2003, researchers studying inherited PD discovered that the disease in one large family was caused by a triplication of the normal alpha-synuclein gene on one copy of chromosome 4. This triplication caused people in the affected family to produce too much of the normal alpha-synuclein. This study showed that an excess of the normal form of the protein could result in PD, just as the abnormal form does.

Other genes linked to PD include parkin, DJ-1, PINK1, and LRRK2. Parkin, DJ-1, and PINK-1 cause rare, early-onset forms of PD. The parkin gene is translated into a protein that normally helps cells break down and recycle proteins. DJ-1 normally helps regulate gene activity and protect cells from oxidative stress. PINK1 codes for a protein active in mitochondria. Mutations in this gene appear to increase susceptibility to cellular stress.

LRRK2, which is translated into a protein called dardarin, was originally identified in several English and Basque families and causes a late-onset form of PD. Subsequent studies have identified this gene in other families with PD as well as in a small percentage of people with apparently sporadic PD.

Researchers are continuing to investigate the normal functions and interactions of these genes in order to find clues about how PD develops. They also have identified a number of other genes and chromosome regions that may play a role in PD, but the nature of these links is not yet clear.
Parkinson's Disease

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

symptoms of parkinsons disease : What is Parkinson's Disease?

2006-06-04T23:04:00.000-07:00

Parkinson's disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50. Early symptoms of PD are subtle and occur gradually. In some people the disease progresses more quickly than in others. As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.
Is there any treatment?

At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms. Usually, patients are given levodopa combined with carbidopa. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can use levodopa to make dopamine and replenish the brain's dwindling supply. Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all. Anticholinergics may help control tremor and rigidity. Other drugs, such as bromocriptine, pergolide, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine. An antiviral drug, amantadine, also appears to reduce symptoms. In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD.

In some cases, surgery may be appropriate if the disease doesn't respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.
What is the prognosis?

PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and other symptoms are more troublesome. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts PD research in laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country. Current research programs funded by the NINDS are using animal models to study how the disease progresses and to develop new drug therapies. Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role. Other scientists are working to develop new protective drugs that can delay, prevent, or reverse the disease.

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

symptoms of parkinsons disease ; What causes Parkinson抯 disease?

2006-06-04T22:56:00.000-07:00

Parkinson抯 disease is a condition affecting the nervous system. It causes muscle tremor, stiffness and slowness of movement that becomes progressively worse over time. The condition was first described by Dr James Parkinson in 1817.

It affects approximately one in 100 people over 65 years old, and one in 10 people over 80. The symptoms of Parkinson抯 disease often begin around the age of 55.

What causes Parkinson抯 disease?
In Parkinson抯 disease, production of a substance called dopamine in the brain is reduced. Dopamine is a neurotransmitter involved in passing messages within the brain and from the brain to the muscles. The part of the brain affected is called the substantia nigra, which co-ordinates muscle movement.

No one knows exactly what causes Parkinson's disease, but studies with identical twins suggest that genetic factors play a part. Also, some patients with generalised brain disease get Parkinson-like symptoms, which suggests that earlier damage to the brain might have a role in causing the disease. Parkinson抯 disease is not contagious.

The symptoms
The main symptoms of Parkinson抯 disease are:

Shaking (muscle tremor) ?though not always present, this is often the first sign of Parkinson抯 disease. It often starts in the arms and may spread to the face, jaw and legs.
Stiffness (rigidity) ?this makes the limbs feel weak and difficult to move. This may be intermittent or continuous. People with advanced Parkinson抯 disease may lose use of the limb altogether.
Slowness ?bradykinesia (slow movement) and akinesia (inability to move) are common in people with Parkinson抯 disease. Walking may start with a hesitant step, followed by a shuffle without swinging the arms.
As the disease progresses, other symptoms that develop include:

Problems with posture and balance ?people with Parkinson抯 disease often stoop, fall forwards and lean to one side when sitting.
Bowel and bladder problems ?constipation is very common and there may be a frequent urge to urinate.
Speech changes ?the voice becomes weak, and weakness of the swallowing muscles may cause drooling.
Loss of facial expression ?a mask-like appearance with loss of emotional expression gradually develops. Blinking and smiling are reduced.
Small writing ?this commonly develops over time.
Anxiety and depression ?this occurs in about a third of people with Parkinson抯 disease.
Intellect ?slowness of thought and memory problems can develop in the later stages.
Diagnosis
There is no single test for Parkinson's disease. Diagnosis is usually based on symptoms, and by ruling out other conditions that cause similar symptoms. This can often be done with an X-ray examination called computerised tomography (a CT scan), which is useful in detecting diseases that affect large areas of the brain. Then, if the symptoms are reduced by treatments given for Parkinson抯 disease, this confirms the diagnosis.

Symptoms similar to Parkinson抯 disease ?known as Parkinsonism ?can be a side-effect of some medications, such as anti-sickness drugs and drugs used in the treatment of mental illness. If this is the case, changing the medication should reduce symptoms.

Treatment
Treatment with medication is aimed at restoring the levels of dopamine in the brain and controlling symptoms.

There are six main groups of drugs:

Drugs which replace dopamine ?these are the most commonly used treatments. They are combinations of levodopa ?a drug which breaks down in the body to form dopamine, plus a chemical which ensures the optimum dopamine concentration in the brain. They are effective at treating symptoms, although there are some side-effects. These include nausea, dizziness and constipation. Also, they can cause long term problems such as unwanted movements of the face and limbs (dyskinesia) and they may become less effective over time.
Drugs which mimic the action of dopamine ?eg. bromocriptine. Using these early on in the course of Parkinson抯 disease may delay the long-term problems of the dopamine replacement drugs. Side-effects can include nausea and hallucinations.
Drugs which block the action of the brain chemical acetylcholine ?eg benzhexol. These help to correct the balance between dopamine and acetylcholine. Side-effects can include dry mouth and blurred vision. They are not usually used in people aged over 70 as they can cause memory loss, and urine retention in men.
Drugs which prevent the breakdown of dopamine ?eg selegiline. This gives a little relief from symptoms and is also a mild antidepressant. Low blood pressure and irregular heartbeat are the most significant side effects.
Amantadine ?acts like a dopamine replacement drug but works on different sites in the brain. It can cause side-effects such as sedation at high doses.
COMT (catechol O-methyl transferase) inhibitors ?eg tolcapone. This is a new class of drugs that stops the breakdown of dopamine. They are usually given when dopamine replacement drugs start to lose their effectiveness. They can affect liver function, so blood tests are needed for the first few months.
Surgery
This is currently used as a last resort when drugs no longer give benefits. Electrodes guided by X-rays (stereotactic surgery) are used to destroy the tiny areas of the brain responsible for tremor and abnormal movements.

A device called a deep brain stimulator can also be used to give the same effect as stereotactic surgery, without destroying brain tissue.

Radiosurgery is a new technique currently available at only a few specialist centres. It uses high energy radiation to focus on very precise areas of the brain.

A new treatment, where brain cells from human fetuses are transplanted into diseased areas of the brain, is at the experimental stage.

Other therapies
Other therapies that have a crucial role in managing and coping with Parkinson抯 disease include physiotherapy, speech therapy, and occupational therapy. Staying active will help to maintain muscle tone and function. A doctor or physiotherapist can recommend an appropriate range of exercises and activities.

Living with Parkinson抯 disease
A diagnosis of Parkinson抯 disease can be very upsetting. However, most people remain reasonably active, and symptoms may progress no further than slight tremor. However, some people do become debilitated, needing help with washing, eating and dressing. With proper treatment, life expectancy for people with Parkinson抯 disease can be normal.

by The Parkinson抯 Disease Society

symptoms of parkinsons disease : Parkinson's disease

2006-06-02T02:51:00.000-07:00

Parkinson's disease is a chronic, progressive neurodegenerative movement disorder. Tremors, rigidity, slow movement (bradykinesia), poor balance, and difficulty walking (called parkinsonian gait) are characteristic primary symptoms of Parkinson's disease.

Idiopathic Parkinson's disease is the most common form of parkinsonism, a group of movement disorders that have similar features and symptoms. Parkinson's disease is called idiopathic Parkinson's because the cause is unknown. In the other forms of parkinsonism, a cause is known or suspected.

Parkinson's results from the degeneration of dopamine-producing nerve cells in the brain, specifically in the substantia nigra and the locus coeruleus. Dopamine is a neurotransmitter that stimulates motor neurons, those nerve cells that control the muscles. When dopamine production is depleted, the motor system nerves are unable to control movement and coordination. Parkinson's disease patients have lost 80% or more of their dopamine-producing cells by the time symptoms appear.

Incidence and Prevalence
Parkinson's disease afflicts 1 to 1 1/2 million people in the United States. The disorder occurs in all races but is somewhat more prevalent among Caucasians. Men are affected slightly more often than women.

Symptoms of Parkinson's disease may appear at any age, but the average age of onset is 60. It is rare in people younger than 30 and risk increases with age. It is estimated that 5% to 10% of patients experience symptoms before the age of 40.

Risk Factors

In a small number of cases worldwide there is a strong inheritance pattern. A genetic predisposition for Parkinson's disease is possible, with the onset of disease and its gradual development dependant on a trigger, such as trauma, other illness, or exposure to an environmental toxin.

The risk increases with age, as Parkinson's disease generally manifests in the middle or late years of life.

Causes

The cause of Parkinson's disease is unknown. Many researchers believe that several factors combined are involved: free radicals, accelerated aging, environmental toxins, and genetic predisposition.

It may be that free radicals—unstable and potentially damaging molecules that lack on electron—are involved in the degeneration of dopamine-producing cells. Free radicals add an electron by reacting with nearby molecules in a process called oxidation, which can damage nerve cells. Chemicals called antioxidants normally protect cells from oxidative stress and damage. If antioxidative action fails to protect dopamine-producing nerve cells, they could be damaged and, subsequently, Parkinson's disease could develop.

Dysfunctional antioxidative mechanisms are associated with older age as well, suggesting that the acceleration of age-related changes in dopamine production may be a factor.

Exposure to an environmental toxin, such as a pesticide, that inhibits dopamine production and produces free radicals and oxidation damage may be involved.

Roughly one-fifth of Parkinson's disease patients have at least one relative with parkinsonian symptoms, suggesting that a genetic factor may be involved. Several genes that cause symptoms in younger patients have been identified. Most researchers believe, however, that most cases are not caused by genetic factors alone

© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.

symptoms of parkinsons disease : Common Symptoms

2006-06-02T02:43:00.000-07:00

It is important to realize that not every person with Parkinson's develops all signs or symptoms of the disease. For example, some people experience tremor as the primary symptom, while others may not have tremor but do have balance problems. Also, for some people the disease progresses quickly, and in others it does not. The following are descriptions of the most common primary symptoms of Parkinson's disease.
Tremor: In the early stages of the disease, about 70 percent of people experience a slight tremor in the hand or foot on one side of the body, or less commonly in the jaw or face. It appears as a "beating" or oscillating movement. Because the Parkinson's tremor usually appears when a person's muscles are relaxed, it is called "resting tremor." This means that the affected body part trembles when it is not doing work, and it usually subsides when a person begins an action. The tremor often spreads to the other side of the body as the disease progresses, but remains most apparent on the original side of occurrence.

Rigidity: Rigidity, also called increased muscle tone, means stiffness or inflexibility of the muscles. Muscles normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of motion. For example, a person who has rigidity may not be able to swing his or her arms when walking because the muscles are too tight. Rigidity can cause pain and cramping.

Bradykinesia: Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. People who have bradykinesia may walk with short, shuffling steps (this is called festination). Bradykinesia and rigidity can occur in the facial muscles, reducing a person's range of facial expressions and resulting in a "mask-like" appearance.

Postural instability or impaired balance and coordination: People with Parkinson's disease often experience instability when standing or impaired balance and coordination. These symptoms, combined with other symptoms such as bradykinesia, increase the probability of falling. People with balance problems may have difficulty making turns or abrupt movements. They may go through periods of "freezing," which is when a person feels stuck to the ground and finds it difficult to start walking. The slowness and incompleteness of movement can also affect speaking and swallowing.

Secondary symptoms of Parkinson's can be, for many, as troublesome as the primary movement symptoms of the disease. PDF receives many inquiries about secondary symptoms, and you can often find information about these problems in our educational materials and in our newsletter, the PDF News & Review. Secondary symptoms of Parkinson's include stooped posture, a tendency to lean forward or backward and speech problems, such as softness of voice or slurred speech caused by lack of muscle control. Non-motor symptoms, such as depression, also affect the life of a person with Parkinson's

© 2005 The Parkinson’s Disease Foundation

symptoms of parkinsons disease : Parkinson's disease

2006-05-29T10:17:00.000-07:00

Treatment

There is no cure for Parkinson's disease. Currently, the best treatments for PD involve the use of conventional drugs such as dopamine antagonists and levodopa. However, therapies such as acupuncture, massage, and yoga can help relieve some symptoms of the disease and loosen tight muscles. Some healthcare professionals have used herbal and dietary therapies, including amino acid supplementation, essential fatty acids (omega-3, omega-6, fish oil , and flax oil), antioxidant (carotenoids, bioflavenoids, vitamins A, C, E, selenium, and zinc) therapy, B vitamin supplementation, and calcium and magnesium supplementation, to treat PD. Anyone using these therapies in conjunction with conventional drugs should check with their doctor to avoid possible adverse interactions. For example, vitamin B6 (either as a supplement or from foods such as whole grains, bananas, beef, fish, liver, potatoes) can interfere with the action of L-dopa when the drug is taken without carbidopa.

Meditation and movement therapies such as Feldenkrais, t'ai chi , qigong, and yoga regain focus.

No evidence indicates that vitamin or mineral supplements can have an effect on the disease other than in their improvement of general health. No antioxidants used to date have shown promise as a treatment except for selegiline, an MAO-B inhibitor.

Regular, moderate exercise has been shown to improve motor function without an increase in medication for a person with PD. Exercise helps maintain range of motion in stiff muscles, improve circulation, and stimulate appetite. An exercise program designed by a physical therapist has the best chance of meeting the specific needs of the person with PD. A physical therapist may also suggest strategies for balance compensation and techniques to stimulate movement during slowdowns or freezes.

Practitioners of Ayurveda, or traditional Indian medicine, have prescribed mucuna seeds (Mucuna pruriens) to treat Parkinson's disease (or Kampavata) for over 4,000 years. Mucuna contains a natural form of L-dopa, a powerful anti-parkinsons drug.
Allopathic treatment

Most drugs treat the symptoms of Parkinson's disease only, although one drug, selegiline (Eldepryl), may somewhat slow the degeneration of the substantia nigra.
Drugs

The pharmacological treatment of Parkinson's disease is complex. While there are a large number of drugs that can be effective, their effectiveness varies with the patient, disease progression, and the length of time the drug has been used. Dose-related side effects may preclude the use of the most effective dose, or require the introduction of a new drug to counteract them. There are five classes of drugs currently used to treat PD.
Drugs that replace dopamine

One drug that helps replace dopamine is levodopa (L-dopa). L-dopa is a derivative of dopamine, and is converted into dopamine by the brain. It may be started when symptoms begin, or when they become serious enough to interfere with work or daily living. L-dopa therapy usually remains effective for five years or longer. Following this, many patients develop motor fluctuations, including peak-dose dyskinesias (abnormal movements such as tics, twisting, or restlessness), rapid loss of response after dosing (known as the on-off phenomenon), and unpredictable drug response. Higher doses are usually tried, but may lead to an increase in dyskinesias. In addition, side effects of L-dopa include nausea and vomiting, and low blood pressure upon standing (orthostatic hypotension), which can cause dizziness. These effects usually lessen after several weeks of therapy.

L-dopa is an amino acid, and is absorbed by the digestive system by the same transporters that pick up other amino acids broken down from proteins in the diet. Limiting protein, under the direction of the physician or a nutritionist, can improve the absorption of L-dopa.

As of early 2000, L-dopa had been the front line medication of choice for treating Parkinson's disease for over 30 years. However, a study published in the May 2000 issue of the New England Journal of Medicine followed 300 Parkinson's patients in locations throughout the world and found that for young patients in the early stages of the disease, treatment was more effective with a class of drugs known as dopamine agonists .

symptoms of parkinsons disease : symptoms of parkinsons disease

2006-05-29T10:13:00.000-07:00

Definition

Parkinson's disease (PD) is a progressive movement disorder marked by tremors, rigidity, slow movements (bradykinesia), and postural instability. It occurs when, for unknown reasons, cells in one of the movement-control centers of the brain begin to die.
Description

PD affects approximately 500,000 people in the United States, both men and women, with as many as 50,000 new cases each year. Usually beginning in a person's late 50s or early 60s, it causes a progressive decline in movement control, affecting the ability to control initiation, speed, and smoothness of motion. Symptoms of PD are seen in up to 15% of those between the ages 65-74, and almost 30% of those between the ages of 75 and 84.
Causes & symptoms

The immediate cause of PD is the degeneration of brain cells in the area known as the substantia nigra, one of the movement control centers of the brain. Damage to this area leads to the cluster of symptoms known as parkinsonism. In PD, degenerating brain cells contain Lewy bodies, which help identify the disease. The cell death leading to parkinsonism may be caused by a number of conditions, including infection, trauma, and poisoning. Some drugs given for psychosis, such as haloperidol (Haldol) or chlorpromazine (thorazine), may cause parkinsonism. When no cause for nigral cell degeneration can be found, the disorder is called idiopathic parkinsonism, or Parkinson's disease. Parkinsonism may be seen in other degenerative conditions, known as the parkinsonism plus syndromes, such as progressive supranuclear palsy.

The substantia nigra, or black substance, is one of the principal movement control centers in the brain. By releasing the neurotransmitter known as dopamine, it helps to refine movement patterns throughout the body. The dopamine released by nerve cells of the substantia nigra stimulates another brain region, the corpus striatum. Without enough dopamine, the corpus striatum cannot control its targets, and so on down the line. Ultimately, the movement patterns of walking, writing, reaching for objects, and other basic programs cannot operate properly, and the symptoms of parkinsonism are the result.

Much research has gone into identifying the cause of PD, but as of July 2000, no clear culprit has been found. Both genetic and environmental factors are suspected. In addition to these causes, there are some known toxins that can cause parkinsonism, most notoriously a chemical called MPTP, found as an impurity in some illegal drugs. Parkinsonian symptoms appear within hours of ingestion, and are permanent. MPTP may exert its effects through generation of toxic molecular fragments called free radicals, and reducing free radicals has been a target of several experimental treatments for PD using antioxidants.

It is possible that early exposure to some as-yet-unidentified environmental toxin or virus leads to undetected nigral cell death, and that PD then becomes manifest as normal age-related decline brings the number of functioning nigral cells below the threshold needed for normal movement. It is also possible that, for genetic reasons, some people are simply born with fewer cells in their substantia nigra than others, and they develop PD as a consequence of normal decline. As of early 2000, however, no gene or toxin had been identified to explain the large number of cases of Parkinson's disease seen each year.

The identifying symptoms of PD include:

* Tremors, usually beginning in the hands, often occurring on one side before the other. The classic tremor of PD is called a pill-rolling tremor, because the movement resembles rolling a pill between the thumb and forefinger. This tremor occurs at a frequency of about three per second.
* Slow movements (bradykinesia) occur, which may involve slowing down or stopping in the middle of familiar tasks such as walking, eating, or shaving. This may include freezing in place during movements (akinesia).
* Muscle rigidity or stiffness, occurring with jerky movements replacing smooth motion.
* Postural instability or balance difficulty occurs. This may lead to a rapid, shuffling gait (festination) to prevent falling.
* In most cases, there is a masked face, with little facial expression and decreased eye-blinking.

In addition, a wide range of other symptoms may often be seen, some beginning earlier than others:

* depression
* speech changes, including rapid speech without inflection changes
* problems with sleep, including restlessness and nightmares
* emotional changes, including fear, irritability, and insecurity
* incontinence
* constipation
* handwriting changes, with letters becoming smaller across the page (micrographia)
* progressive problems with intellectual function (dementia).

Diagnosis

The diagnosis of Parkinson's disease involves a careful medical history and a neurological exam to look for characteristic symptoms. There are no definitive tests for PD, although a variety of lab tests may be done to rule out other causes of symptoms, especially if only some of the identifying symptoms are present. Tests for other causes of parkinsonism may include brain scans, blood tests, lumbar puncture, and x rays.
Encyclopedia of Alternative Medicine
by Paula Ford-Martin

symptoms of parkinsons disease

2006-05-29T10:11:00.000-07:00

Although genetic susceptability plays a role in early-onset Parkinson's Disease (PD) that arises before age 50, genetics is not as significant in the majority of cases, according to a National Institute of Environmental Health Sciences factsheet. Occupational exposure to heavy metals and pesticide exposure appear to be primary triggers in PD that arises after age 50. The fact sheet says, "Case-control studies have found increased incidence of PD associated with pesticide use, rural environments, consumption of well water, exposure to herbicides, and living near industrial plants, printing plants, or quarries." Many of these chemicals cause free radical damage.

In Jill Selby's interview with Dr. David Perlmutter, Dr. Perlmutter discusses glutathione treatment to alleviate PD's symptoms. He explains that glutathione, a free radical scavenger, slows the disease's progression by limiting free radical damage to neurons. In addition, glutathione apparently increases the brain's sensitivity to dopamine although it does not actually raise dopamine levels. PD patients are known to have low levels of dopamine and glutathione. Glutathione also increases sensitivity to serotonin. Dr. Perlmutter says that 80-90% of the PD patients that he has treated have improved dramatically. At the time of the interview, Dr. Perlmutter and his colleagues had determined a standard dosage of 1400 mg of glutathione mixed with saline and given intravenously for ten minutes three times a week. He says that IV administration is needed because glutathione is digested very rapidly when given orally. Dr. Perlmutter also recommends the amino acid Nacetylcysteine and milk thistle. He urges doctors to avoid mixing glutathione with vitamin C because "vitamin C renders glutathione useless by causing it to oxidize." Dr. Perlmutter also notes that glutathione therapy may interfere with chemotherapy because glutathione increases the liver's ability to process chemicals.

National Institute of Environmental Health Sciences, National Institutes of Health. Parkinson's Disease Research at the NIEHS. April 1999. www.niehs.nih.gov/oc/factsheets/parkinson.htm

SOUND; PRIZE WINNERS IN CAR STEREO

2006-05-16T02:16:00.000-07:00

Just as they do for home stereo equipment, the editors of Audio-Video International - a leading trade publication - bestow annual ''Grand Prix'' citations on outstanding new entries among car stereo components. Reflecting the results of a nationwide poll of 531 car-stereo dealers and installers, these honors represent a statistically derived critical assessment in a field otherwise lacking comprehensive review. The list of winners also provides a handy shopping guide for quality-conscious listeners who consider music an essential travel accessory.

Among so-called front-end units -i.e., radio/cassette combinations that are mounted in the car's dashboard - the top award went to Alpine's Model 7165, which offers exceptional performance and value for $380. Its digital tuner permits 12 stations to be preset for single-touch tuning, and it also provides the convenience of ''automatic seek.'' This feature allows the set to pick out radio stations in a given area one by one without the driver having to hunt for them on the dial. That way, his attention is not distracted, and he need not take his eyes off the road. This feature is particularly valuable when driving in unfamiliar territory where the driver does not know the frequencies of local stations.

Another thoughtful touch contributing to safer night driving is the soft illumination of the cassette loading slot, enabling the driver to insert a cassette without searching or fumbling. Separate treble and bass controls permit a fair degree of flexibility in adjusting the tonal balance to the acoustical needs of a particular car interior, and the music-search feature on the cassette player helps find particular selections on the tape.

By HNS FANTEL

How Home Theater Works

2006-05-13T21:07:00.000-07:00

Until recently, the best way to watch a movie was to go to a movie theater. The introduction of VCRs made it easy to rent or buy movies and watch them at home, but TVs just didn't compare to movie theaters' huge screens and surround-sound systems. Not only did TVs have comparatively tiny screens and lower quality speakers, formatting a movie to fit the screen got rid of a substantial part of the picture.

Now, more and more people are turning their ordinary TV rooms into home theaters. This used to involve a projector and a screen, and it was too expensive for most people to afford. But advances in technology have given people more choices for home theater setups, and some people find that a home theater is quieter and more convenient than a movie theater -- and the picture and sound are great.

If you're looking for a home theater system, you have a lot of decisions ahead of you. In this article, we'll go over all the components that make up a home theater system. You'll learn what each component does and what to keep in mind when you make your selection. If you're thinking of turning your den into a fully functioning home theater, this article will help you get started.

by Tom Harris and Tracy V. Wilson

If we get our Scottish version of Las Vegas

2006-05-10T22:29:00.000-07:00

The British government is making something of a meal of awarding a licence for a super casino. Only one such gambling emporium is to be allowed in the sceptred isle, and 27 councils are competing for the right to soak the punters.
This enthusiasm is hardly surprising. Las Vegas, the paradigmatic gaming city, reported a 15% increase last year in revenues from visiting gamblers. Glasgow, West Dunbartonshire and Midlothian are the three Scottish local authorities hustling for the casino licence. They face competition from the likes of Blackpool (a town with much experience in separating mugs from their money), Cardiff, and Havering in London. Havering sounds like an ideal place to fritter away your money, although the neighbouring borough of Barking would also be a candidate.

For some reason, the allocation of Britain’s only mega-casino is in the hands of Tessa Jowell, the English culture secretary. We do not want to be excessively Scottish here, but surely the inalienable right to lose your shirt should be a devolved matter.

I have no real preference as to the Scottish candidates. Bowling in Dunbartonshire and Straiton in Midlothian are in the frame but there would be a delicious irony if the Scottish mecca (so to speak) for games of chance were to be Glasgow’s St Enoch Centre, a mammonistic enterprise funded, if memory serves, by the Church of England property division.

If Scotland is to get into the casino business, we should do it in a big way. Why go for one big casino when we can create a whole new Las Vegas? Like the American version, the Scottish casino industry should be built in a desert. The closest Scotland has got to a desert is that strip of North Lanarkshire and West Lothian on either side of the M8 motorway. It is a region which could certainly benefit from an infusion of betting beneficence.

Play the slots in Shotts, poker in Pumpherston, blackjack in Blackridge, or craps almost anywhere. Circus Circus in West Calder has a certain ring to it, as does Caesar’s Palace in Salsburgh. Who needs New York, New York when you can have Harthill, Harthill?

But Las Vegas is not just about gambling. Some people go there to get married by Elvis Presley in the Wee Kirk O’ The Heather chapel. I can see a thriving wedding business in the Scottish Las Vegas with Sydney Devine in his rhinestone outfit conducting ceremonies at the Wee Kirk O’ Shotts.

On the tourist front, a helicopter trip over the slagheaps of West Lothian may not quite compete with the Grand Canyon experience. One service Nevada offers that Scotland is unlikely to match is the legalised brothel. Our Calvinistic society is not ready for the Chicken Ranch with a roadside neon sign advertising the Best Little Whorehouse In Whitburn.

I find myself unmoved by gambling and cannot understand the attraction it holds for some people. One-armed bandits or puggies or whatever they are now called are far too complicated. With all those flashing lights and decisions to be taken on the holds, the nudges, the winks, it is a science I have been unable to master. I tried bingo once but could not stand the pace, even with just the one card to mark while adjacent old ladies were nonchalantly coping with half-a-dozen.

I find card games too stressful and intimidating. I have never really recovered from losing four and ninepence in a poker school at Strathclyde University union in 1966. I couldn’t get to grips with all that holding and folding and working out the numbers, which was a sad state of affairs for a mathematics student. The saddest bit was parting company with my four and ninepence. That is 24p in new money and doesn’t sound much, but in those days it was equal to two pints of lager.

I used to frequent Glasgow’s casinos but only because they were the only places a late-shift worker could relax after the midnight hour. I was more interested in the steak and chips (very reasonably priced at about 30 bob) than the gaming chips.

In order not to be seen abusing Mr Reo Stakis’s hospitality, we would have a shot at the roulette table. Roulette has to be the most boring game on Earth. Especially if you’re gambling on the red and your pal is on black and as a team you break even.

I spent three days in Las Vegas once and it seemed like a month. It was certainly two days too long. Once you become immune to the excessive architecture of the hotels, it is an ineffably boring city. I did apply myself to a slot machine where you could win a Cadillac for 10 cents. I didn’t win the car but after 10 minutes I had a large bucket full of dimes. Faced with the boredom of playing on to get rid of this mountain of coins, I gave the bucketful to the Mexican bloke who was cleaning the toilets. Shortly after this magnanimous gesture, I spotted the counter where you can change your bucket of coins for folding stuff.

The only good thing about Las Vegas, apart from Gil Grissom in CSI, is that Barry Manilow is permanently in concert at the Hilton. He never appears anywhere else. This means that if you avoid the Las Vegas Hilton, you will never have to hear Barry Manilow sing.

I am sure a similar deal can be done somewhere on the West Lothian strip for the afore-mentioned Sydney Devine. There is a precedent for this. I did see Sydney perform live at La Fabrique nightspot in Bo’ness in 1974. It was unforgettable, no matter how hard I have tried.

ONE of the joys of Barcelona is being able to indulge in a large seafood dinner without having to take out a second mortgage. And just when I thought things could not get better or cheaper, I was directed last week to a restaurant called La Paradeta. This is a place, which makes the finest fish and shellfish affordable by the simple tactic of making the customer do most of the work.

You start by choosing what you want from a counter the size of a stall at the fish market. The woman weighs or counts your choice of items and places them in a box which is passed through to the kitchen with instructions on how you want them cooked. You are given a tray of plates and cutlery for you to set your own table.

At another counter you collect your bread, wine, fizzy water, beer, and various pots of tartare and romesco sauces. Then you pay your bill before setting to the business in hand.

You get your salad and make up your own dressing. When your tea is ready you are summoned to collect it from the kitchen hatch. In our case, it was two lobsters, a dozen large prawns, two calamari, six razor clams, and a hillock of tallarinas, which are small sweet clams.

We would have had the oysters, the monkfish, and some of the other stuff, but there were only three of us and we feared more indulgence might lead to a wafer-thin moment.

Sated and happy, we took the dirty crockery back to the kitchen, the glasses to the bar, and wiped the table ready for the next customers. Our efforts were rewarded with a free digestivo from the bar staff. At £20 a head for the entire shooting match, the DIY dinner is a concept some Scottish restaurants might consider. We might even get to eat some of our own seafood instead of sending it to Barcelona.

©2006 newsquest (sunday herald) limited. all rights reserved

ASIAN COOKING WITH SUNKIST

2006-05-07T22:04:00.000-07:00

Citrus flavors are important to Asian and Chinese cooking. And no wonder! Historians believe that all citrus except grapefruit had its origins in the Orient. The juicy oranges we eat today were once a sour fruit growing wild in China. Satsuma tangerines were first cultivated in Japan, limes are native to Malaysia, lemons come from India and pummelos have been popular throughout Asia for centuries.

While there are many Asian cultures, Martin's virtual tour explores these two basic categories.

Southeast style includes the foods of Thailand, Laos, Cambodia, Vietnam, Indonesia, Malaysia and Singapore. The focus is on aromatic foods prepared with a light touch using citrus juices, basil, cilantro and mint. Lemongrass and the pungent fish sauce, naam plaa, are also prominent flavors.

Northeast style includes China, Korea and Japan. Food here goes beyond the table; it also figures prominently in medicine and rituals. Fats, oils and sauces are often used. Because it covers such an enormous area, there are several variations in the way foods are flavored and prepared between the northern and southern regions.

So pack your chopsticks and come along as Martin Yan takes you on a wok through Asia!

Sunkist is a registered trademark of ® 2006 Sunkist Growers, Inc. All rights reserved.

Caravan Kingdoms

2006-05-03T20:22:00.000-07:00

NUMEROUS PIECES OF extraordinary art take center stage in the exhibition "Caravan Kingdoms: Yemen and the Ancient Incense Trade." Located on the Gulf of Aden at the south of the Arabian Peninsula and bordering the Arabian and Red Seas, this region once played a central role in an ancient "global economy" that extended from the Mediterranean Sea to the Indian Ocean.

During a 1,400-year period between the eighth century B.C. and the sixth century A.D., the southern Arabian kingdoms of Saba (biblical Sheba), Qataban, and Himyar were home to sophisticated civilizations that flourished through their control of the trade in frankincense and myrrh. Now best-known as the Gifts of the Magi, these valuable resins were harvested from bushes native to the region and were essential ingredients for court and temple ceremonies and in the spice markets and perfume industries of the Near East and Mediterranean worlds.

"Caravan Kingdoms" brings together for the first time in North America 129 archaeological objects to tell the story of these little-known, wealthy caravan kingdoms, examining the monumental structures, distinctive stone funerary sculptures, elaborately carved inscriptions, and sophisticated metalwork that have been unearthed there since the mid 20th century.

Dominated by the great interior desert known as the Ramlat as-Sabatyn, Yemen's four major valleys were occupied during this period by sophisticated states, which constructed complex irrigation systems and built imposing palaces and temples. These kingdoms competed for control over the lucrative overland caravan and later maritime trade routes to the Mediterranean coast and the western shores of the Persian Gulf.

During this time, multiple burials and cave tombs often contained miniature offerings; examples included in the exhibition are tiny vessels, incense burners, and altars. Bulls and ibex frequently appeared in temple decoration as capitals, on friezes, and gutter spouts, examples of which are on display.

A hallmark of Yemen's ancient cultural traditions is the creative use of a translucent, alabaster-like stone to carve funerary monuments and decorate temples and palaces. Statues of three generations of Awsan kings on view--each individualized by variations in dress, hairstyle, jewelry, and footwear--depict the typical funerary convention of a standing figure with arms extended in a gesture of offering.

COPYRIGHT 2005 Society for the Advancement of Education
COPYRIGHT 2005 Gale Group

Excuse Again?

2006-04-28T23:16:00.000-07:00

When we fail to do something we are expected to do,
we almost always have an excuse for it. That's just
how our habit acts. But we have a choice to change that
for good.

If we analyze it closely -- an excuse is a self-destructive
alibi for having failed to do something, especially
when it involves attaining a goal. Instead of trying to
persevere in finding ways to continue achieving a goal,
some of us resort to excuses.

Why?

To avoid pain. Excuses. The best medicine.

But you should not use excuses for not becoming
successful! That's self-destructive.

Whenever we look at a "handicap", we almost always
look on the negative side only. It's about time we
take a look at the positive side of it. The positive
side may be the difficult side, but it's the one worth
looking into. It's the side that is going to lead us
to excel in life.

Hadicap can appeared in many forms -- Physical
handicap, mentally handicap, emotional handicap,
financial handicap, etc.

It your handicap is financial, then the more reason
you have to rise above your present status. And if
your financial status limits your educational
attainment to improve your life, do you really think
that you cannot get the education you want? Make use
of libraries. Come up with creative ideas to improve
your life and you will find it.

If you are emotionally disturbed with negative
thoughts, it is like you are sitting on a chair with
wobbling legs. Try sitting on a chair with sturdy
legs; meaning, look at the bright, positive side of
life. Put aside negativity and start thinking
positively. The only one who can stop you is yourself.

If you always have a lot of excuses, you should strive
more to overcome them because you'll be able to
double the achievement. Where the odds are greater,
the prize gets much bigger. After all the efforts you
have exerted, the prize of success shall be a
well-deserved one.

Make sure you have full control of your life. You
should have no problem managing the
things you can control. Don’t let 'excuses' to
control your decisions.

Accept things you cannot control the way they are,
if you cannot do without them. If you can do without them,
leave them and divert your attention to something else
that will make your life more meaningful. Never pick
on something you cannot control and turn it into
'excuses' that will block your success.

So what's your excuse for not being successful?

Answer from today onwards: NONE.

Warmest regards,

Patric Chan
http://www.motivatedforsuccess.com

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