First described in 1817 as "the shaking palsy" Parkinson's has continued to baffle the medical community for the past two centuries. In the early 1960s, researchers identified a loss of brain cells that produce a chemical, dopamine, that helps direct muscle activity. The medical community accepts this as the physiological cause of Parkinson's. The discovery led to the first successful treatments for Parkinson's and suggested ways of devising new and more effective therapies.
Parkinson's disease is both chronic and progressive. This means that the disease persists over a long period of time and its symptoms grow worse over time. Parkinson's disease is among a group of conditions referred to as motor system disorders. The four primary symptoms of such disorders include tremor or trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; slowness of movement known clinically as bradykinesia; and impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks.
Parkinson's disease is the most common form of parkinsonism, a group of disorders involving dopamine-producing bran cell loss and the four primary Parkinson's symptoms. Doctors refer to Parkinson's disease as primary parkinsonism or idiopathic Parkinson's disease. Idiopathic describes disorders for which doctors have not yet determined a cause. In the other forms of parkinsonism doctors either know or suspect a cause or the disorder occurs as a secondary effect of another, primary neurological disorder.
The Demographics of Parkinson's
Doctors diagnose about 50,000 Americans with Parkinson's disease each year, while at any one time more than half a million Americans suffer from Parkinson's. Determining the actual number of cases represents a greater hurdle for doctors and researchers, since many people in the early stages of the disease assume their symptoms result from normal aging and consequently do not seek help or an evaluation from a physician. In addition, many Parkinson's sufferers may face misdiagnosis because the disease produces some of the same symptoms as a variety of other conditions.
Parkinson's disease afflicts men and women in near equal numbers. Researchers have found no discernible variation in the number of those afflicted according to social, economic, or geographic boundaries, though some studies suggest that African-Americans and Asians are less likely than Caucasian people to develop Parkinson's disease. Scientists have not been able to explain this apparent lower incidence in certain populations.
Age remains the one clear demographic that correlates with the onset of symptoms. Parkinson's disease most often surfaces in late middle age, usually affecting people over the age of 50. The average age of onset is 60 years. Some research does suggest an increase in the number of "early-onset" Parkinson's disease in the past several years, resulting in estimates that today, five to ten percent of patients are under the age of 40.
The United States pays a considerable price for Parkinson's disease. According to the National Parkinson Foundation (NPF), each patient spends an average of $2,500 a year for medications. After factoring in office visits, Social Security payments, nursing home expenditures, and lost income, NPF estimates the total cost to the nation as exceeding $5.6 billion annually.
Symptoms of Parkinson's Disease
Early symptoms of Parkinson's disease often go unnoticed, as they occur gradually. Patients may notice a general malaise or increased tiredness. Some may feel a little shaky, speak too softly, or lose track of a word or thought. They may begin to feel irritable or depressed for no apparent reason. Often, others notice the changes before the Parkinson's sufferer does. People may see that the person's face lacks expression and animation (known as "masked face"), that the person remains in a certain position for a long time, or does not move an arm or leg normally. Perhaps they notice that the person seems stiff, unsteady, and unusually slow. This very early period may last a long time before the more classic and obvious symptoms appear.
As the disease progresses, the shaking, known as tremor, that affects the majority of Parkinson's patients may begin to interfere with daily activities. Patients may have difficulty holding utensils steady or may find that the shaking makes reading a newspaper difficult. Parkinson's tremor is often more pronounced when the patient relaxes or is at rest. For most patients, tremor serves as the symptom that causes them to seek medical help.
Parkinson's disease affects sufferers differently. In some, the disease progresses quickly while in others the early symptoms last for years. 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 different symptoms are more troublesome.
Various other symptoms accompany Parkinson's disease some minor, others more bothersome. Doctors can treat many symptoms with medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person.
The tremor associated with Parkinson's disease typically takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. While tremor usually begins in a hand, sometimes a foot or the jaw is affected first. Tremor is rarely disabling and usually disappears during sleep or improves with intentional movement.
Another common symptom of Parkinson's
is rigidity, or a resistance to movement. 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.
Bradykinesia, or the slowing down and loss of spontaneous and
automatic movement, prevents sufferers from performing routine
movements as rapidly as they normally would. Consequently, activities
once performed quickly and easily, such as washing or dressing,
can take several hours. Patients can also suffer from postural
instability, or impaired balance and coordination, causing the
development of a forward or backward lean and a tendency to fall
easily.
As the disease progresses, a sufferer may notice changes in their ability to perform the most common tasks. They may halt in mid-stride and "freeze" in place, possibly even toppling over, or may walk with a series of quick, small steps as if hurrying forward to keep balance. About half of all Parkinson's sufferers have problems with speech, whether they speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. Muscles used in swallowing may also 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, resulting in choking or drooling.
Parkinson's disease sufferers can also suffer psychological symptoms, such as depression, insecurity, fear, paranoia, social anxiety, insomnia, and irritability. Memory loss and slow thinking may occur, although the ability to reason remains intact. The medical community still disagrees about whether people actually suffer intellectual loss, known as dementia, from Parkinson's disease.
If you believe that you have suffered an injury, such as the onset of Parkinson's disease, as the result of manganese exposure, it is imperative that you contact a qualified attorney in order to insure that you maintain and protect your rights.
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