3-5. PARKINSONISM (PARKINSON'S DISEASE)

a. Definition of Parkinsonism. This is a chronic, progressive degenerative disease of the nervous system. The disease progresses for a number of years after which the person succumbs to an illness such as aspiration pneumonia or some other infection. Today, this disease is a common crippling disease in the United States and affects more men than women.

b. Cause of Parkinsonism. The disease affects the balance coordinating the extrapyramidal tract which is located at the idiopathic basal ganglia. Possible causes include atherosclerosis (a form of arteriosclerosis), head trauma, carbon dioxide or metal poisoning, a large dose of tranquilizers, or brain tumors which cause midbrain compression.

c. Signs/Symptoms of Parkinsonism. The signs and symptoms of this disease begin slowly. The basic symptoms are muscle rigidity, akinesia or dyskinesia (slowness of automatic movements), and a tremor that begins in the fingers. This tremor increases with stress or anxiety and decreases when the patient moves deliberately and after sleep. Other signs and symptoms include the following:

(1) Impaired locomotion with stiffness, dragging of one foot, and shuffling gait.

(2) Stiff, mask-like facial appearance.

(3) Impaired autonomic function such as constipation, incontinence, and excessive perspiration.

(4) Emotional strain resulting in mood swings. Examples include fear of being seen in public and quarrelsomeness with family.

d. Treatment for Parkinsonism. Treatment is aimed at relieving the patient's symptoms and keeping him functional for as long as possible. It is very important to prevent muscular rigidity. Treatment should include measures to improve the patient's general health and mild tranquilizers to reduce tremor. Synthetic medications which can be used include levodopa (L-dopa) and SymmetrelR.