Between stigma and fact: Parkinson's not necessarily scary

Ingy Deif, Wednesday 18 Apr 2012

A specialist reveals the secrets of one of the most surreptitious diseases, and sheds light on how to deal with it

understanding parkinson

Fear, uncertainty and denial: these are your worst enemies when dealing with any medical condition whose causes are vague; and this is how, for many years, people have felt about Parkinson’s disease. The time has come however to shed more light on such an issue that unfortunately affects more and more people in Egypt and whose symptoms are even sometimes overlooked by doctors.

Who could have imagined that a figure as tough as boxer Muhammad Ali or as lively as actor Michael J Fox could fall victim to such a debilitating ailment? Fox was diagnosed at the age of 30, but he stayed in denial, covering up the symptoms for seven years before being able to talk publically about it .The more we know about Parkinson’s the better we understand that there is no special category for people at risk, it could strike as early as the twenties and could be tricky to diagnose.

"Parkinson’s disease (PD) is a movement disorder known locally in Egypt as “shaking paralysis”, says Dr Ahmed Abdel-Alim, assistant professor of neurology at Cairo university. "It’s a progressive disease that involves certain areas of the brain responsible for motor functions, especially involuntary ones. It stems from a loss of some cells in these areas, and an imbalance between chemical materials occurs in the brain, specifically Dopamine and Acetyl choline, causing the symptoms.”

Dr Abdel-Alim points out that the cause of PD is unknown, but scientists have pointed to genetic factors, noting that commonly it affects the elderly but may start as early as at the age of twenty.

Tricky symptoms

"Its tricky when it comes to encountering a disease whose first symptom in many patients may be back pain, and patients may seek orthopaedic rather than neurological consultation at the beginning," says Dr Abdel-Alim. “The clinical picture includes tremors that start usually on one side, stiffness, slowness and walking difficulties. The full picture of PD include a flexed posture, shuffling of feet during walking, tremors in the hands, a rigid facial expression and monotonous voice. The lifestyle of the patient may be affected as they suffer impairment in daily activities and may require constant assistance. They also may complaint of difficulty swallowing and constipation. And it is of utmost importance when diagnosing PD to first exclude other diseases that may resemble its picture such as cerebral atherosclerosis, hypothyroidism and drug induced symptoms. These conditions are called Parkinsonism as they resemble Parkinson’s disease, but their treatment is different."

Handling Parkinson's

Although there is no current curative treatment for PD, there is ongoing research in many fields such as stem cell transplant, aiming at a complete cure of the disease. Dr Abdel-Alim summarises how to manage the disease: "Handling the condition has two main perspectives: treatment and rehabilitation. Drug treatment includes agents that directly increase Dopamine in the brain such as L-Dopa or drugs that augment its effect. Drugs that decrease Acetylcholine may be helpful in treatment of tremors. Rehabilitation may be helpful for patients to overcome functional disabilities and be less dependent. There is also the option of surgical treatment that may include cutting certain circuits in the brain to restore balance or the implantation of a pacemaker-like device that can be adjustable according to symptoms, and this is a technique called 'deep brain stimulation'."  


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