Parkinson Disease

In the United States there are about one million people who suffer from Parkinson disease (one person in 100 over the age 60), and each year 50,000 new cases are reported. The elderly are most vulnerable to the condition, with men showing a greater tendency toward the disease than women. In about 10% of cases, symptoms of the disease begin to show when patients are in their 40s, but in the majority of cases most symptoms appear occur after age 50. Parkinson disease symptoms are most pronounced in patients between the ages of 70 and 80. While there is no cure for the disease and the factors responsible for the brain damage are not fully understood, the mechanism of brain-cell deterioration and the brain chemicals involved has been carefully studied.

At the beginning of the illness, one side of the body may begin to exhibit symptoms. Eventually, however, the disorder spreads to both sides of the body. At first there are signs of difficulty in walking and other basic movements of the body, such as turning, rising from a seated position, standing, and sitting down. These movements seem labored and become difficult to perform. Body movements slow down, and they are executed very carefully with much deliberation. The muscles at rest are so tense that they become rigid. Simple facial movements become difficult to execute because of this rigidity of muscle tone. The face begins to look like a mask. Walking movements become altered. Instead of the natural arm swing, the arms hang limply at the side. The patient shuffles while walking, and sideways turns of the head are replaced by whole body movements.

Tremor is one of the characteristic signs of Parkinsonism, but not all patients actually display that symptom. While it is immediately obvious and recognizable, tremor is not necessarily more of a disability than the other symptoms of the disorder. Tremor occurs while the patient is at rest and is reflected mostly in the hands, in spasms entailing a rolling motion of various fingers. Other parts of the body may also be involved in the tremor, notably the lips and the head. While the Parkinson's patient is involved in some task, the tremor may relent for a short period of time.

Some patients undergo a general decline of mental ability (dementia). They begin to forget recent events, get lost in a known neighborhood, or fail to comprehend what is going on about them. The skin becomes excessively oily, a condition known as seborrhea, particularly in the areas of the face and scalp. Blood pressure may also begin to fluctuate over a wide range, and these fluctuations create further difficulties in treatment. Toward the later stages of the disease, when all of these symptoms are present, some patients become totally helpless.