Parkinson Disease Essay

Parkinson Disease

The first scientist who discovered Parkinson Disease (PD) was an English doctor, James Parkinson. In 1847 Dr Parkinson published a paper entitled "Essay on Shaky Palsy" describing six cases he studied having PD.(1)

PD is one of the most common neurodegenerative diseases that afflict about 1% of individuals over the age of 65 and its occurrence increases by age. Its symptoms are characterized typically by slow but progressive neurological and non-neurological disabilities such as tremor, memory problems, declining sense of smell, rigidity, drooling, and constipation. PD is also commonly associated with other psychiatric diseases e.g. depression, anxiety and psychosis.

The neurological manifestations of PD usually begin unilaterally; most common is the resting tremor which usually happens in the hands before the feet. The hand would not move during walking, followed by the foot (of the same side) would start rubbing the floor. Then the posture becomes more flexed and the steps shorter.
The most common type of non-neurological manifestations is declining sense of smell, an early symptom not usually recognized by patients. Among other common signs is the disturbance of the Rapid Eye Movements (REM) during sleep. Patients while sleeping could also have abnormal involuntary movements such kicking, hitting and even shouting. There are other symptoms but are less specific for PD like constipation and lethargy.

Basically there are 4 main symptoms, at least 2 of which must be detected in order to diagnose a patient is likely suffering from PD: (1)

1 – Resting tremor: It generally starts unilaterally in the upper extremities as shakiness in the thumb or fingers. It may then extend to the lower limbs or...

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...tting.
2 – Weakening sense of smelling. l
3 – Declining memory and recall ability.
4 – Excessive salivation and drooling particularly during sleep.
5 – Fatigability and Insomnia.
6 – Depressed mood

Medical History
1 - 10 years history of Diabetics Mellitus type 2
2 - Benign Prostatic Hyperplasia for 7 years
3 – One episode of acute gout 3 years ago.
4 - Chronic constipation for more than 3 years.
5 – 2 years history of depression.

Social History
1 – Non smoker
2 – 1 unit of alcohol every night

Drug History
1 – Citalopram 10 mg/day (selective Serotonin Reuptake Inhibitor agent) for his depression
2 – Metformin 500 mg/3 a day (Biguanide agent) for his diabetic mellitus disease
3 – Tamsulosin 0.4 mg/day (Alpha blocker agent) for his benign prostatic hyperplasia