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Parkinson disease is a brain
disorder. It occurs when certain nerve cells (neurons) in a part of the
brain called the substantia nigra die or become impaired. Normally, these
cells produce a vital chemical known as dopamine. Dopamine allows smooth,
coordinated function of the body's muscles and movement. When approximately
80% of the dopamine-producing cells are damaged, the symptoms of Parkinson
disease appear.
As PD progresses, patients may have difficulty in adjusting psychologically
to the challenges that PD may present. This can result in problems not only
for the patient, but impact on others close to the patient. These
difficulties can include:
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Persistent high levels of anxiety
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Intrusive thoughts
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Body self-absorption
- Dementia
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Social withdrawal
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Inability to tolerate frustration
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Anger
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Depression
Role change is a major transition for the
patient and for any others involved. It is accompanied by many feelings,
some positive and some negative, which can feel overwhelming and in the
process raise feelings of disappointment, resentment, and anxiety.
Symptoms usually begin in middle to later life with
trembling of the lips and hands, loss of facial expression, and muscular
rigidity. As it progresses it may bring on body tremors, particularly in
muscles at rest. Movements become slow and difficult; walking degrades to a
shuffle. After many years physical incapacity may occur.
Dementia occurs in at least 50% of the patients;
depression is also common.
Rapid-Onset Parkinsonism (RDP), is characterized by the abrupt onset
of slowness of movement (parkinsonism) and dystonic symptoms.
To
describe the severity of the symptoms, a scale of one to four has been
developed based on the presence of parkinsonism and the ability to walk
unassisted. The scale assigns 0 to those unaffected; 1 to those having limb
dystonia only, including writer's cramp; 2 to those affected in the face,
arm, and neck, and walking normally; 3 to those who are the same as 2 but
affected in the legs and walk unassisted; and 4 to those who are the same as
3 but need a walker or use a wheelchair
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