subject: Parkinsonism Homeopathic Approach [print this page] Parkinson's disease is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills speech, and other functions.
Parkinson's disease belongs to a group of conditions called movement disorders.
It is characterized by muscle rigidity, tremor, a slowing of physical movement (BRADYKINESIA)and a loss of physical movement (AKINESIA) in extreme cases.
The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia normally caused by the insufficient formation and action of dopamine which is produced in the dopamanirgic neurons of the brain (specifically the substantia nigra).
Secondary symptoms may include high level cognitive dysfunction and subtle language problems.
Classification
There are other disorders that are called Parkinson plus syndromes.
These include:
1.multiple system atrophy (MSA)
2. progressive nuclear palsy (PSP)
3. cortico basal degeneration(CBD).
4.dementia with lewy bodies (DLB)
These Parkinson-plus diseases may progress more quickly than typical idiopathic Parkinson disease.
Causes
Most people with Parkinson's disease are described as having idiopathic Parkinson's disease (having no specific known cause). There are far less common causes of Parkinson's disease including genetic, toxins, head trauma, cerebral anoxia and drug-induced Parkinson's disease.
1.Genetic
Someone who has Parkinson's disease is more likely to have relatives that also have Parkinson's disease. However, the inheritance of Parkinson's disease is usually complex and not due to a single gene defect.
2.Toxins
One theory holds that many or even most cases of the disease may result from the combination of a genetically determined vulnerability to environmental toxins along with exposure to those toxins.
. The toxins most strongly suspected at present are certain pesticides and transition-series metals such as manganese or iron, especially those that generate reactive oxygen species or bind to neuromelanin.
3. Head trauma
Head trauma is considered a risk factor for PD since past episodes are reported more frequently by individuals with Parkinson's disease than by others in the population.
Pathophysiology
The symptoms of Parkinson's disease result from the greatly reduced activity of pigmented dopamine-secreting (dopaminergic) cells in the pars compacta region of the substantia nigra.
These neurons project to the straitum and their loss leads to alterations in the activity of the neural circuits within the basal ganglia that regulate movement, in essence an inhibition of the direct pathway and excitation of the indirect pathway
The direct pathway facilitates movement and the indirect pathway inhibits movement, thus the loss of these cells leads to a hypokinetic movement disorder. The lack of dopamine results in increased inhibition of the ventral anterior nucleus of the thalamus, which sends excitatory projections to the motor cortex thus leading to hypokinesia.
Excessive accumulations of iron, which are toxic to nerve cells, are also typically observed in conjunction with the protein inclusions.
Signs and symptoms
Parkinson's disease affects movement, producing motor symptoms
Non-motor symptoms, which include autonomic dysfunction, cognitive and neurobehavioral problems, and sensory and sleep difficulties, are also common but are under-appreciated.
Motor symptoms:
Four motor symptoms are considered cardinal in PD:
1.tremor
2. rigidity
3. bradykinesia
4.postural instability.
Tremor is the most apparent and well-known symptom. It is most commonly a rest tremor: maximal when the limb is at rest and disappearing with voluntary movement and sleep. It affects to a greater extent the most distal part of the extremity and is typically unilateral at onset.
Rigidity is due to joint stiffness and increased muscle tone , which combined with a resting tremor produce a ratchety, "cog wheel rigidity" when the limb is passively moved. Rigidity may be associated with joint pain, such pain being a frequent initial manifestation of the disease.
Bradykinesia (slowness of movement) is the most characteristic clinical feature of PD and it produces difficulties not only with the execution of a movement but also with its planning and initiation.
In the late stages of the disease postural instability is typical, which leads to impaired balance and falls.
PD motor symptomatology is not limited to these four symptoms. Gait and posture disturbances such as decreased arm swing, a forward flexed posture and the use of small steps when walking; speech and swallowing disturbances; and other symptoms such as a mask like expression (also known as poker-face) or a micrographia.
Neuropsychiatric
Parkinson's disease causes neuropsychiatric disturbances, which include mainly cognition, mood and behavior problems and can be as disabling as motor symptoms.
Most common cognitive deficits in non-demented patients are executive dysfunction which translates into impaired set shifting, poor problem solving, and fluctuations in attention among other difficulties; Slowed cognitive speed ,memory problems; specifically in recalling learned information, with an important improvement with cues; and visuospatial skills difficulties, which are seen when the person with PD is for example asked to perform tests of facial recognition and perception of line orientation.
Deficits tend to aggravate with time, developing in many cases into dementia.
In addition to cognitive and motor symptoms PD can impair other body functions. Sleep problems can be worsened by medications for PD, but they are a core feature of the disease. They can manifest as excessive daytime somnolence, disturbances in REM sleep or insomnia.
The autonomic system is altered which can lead for example to orthostatic hypotension oily skin and seborrheic dermatitis, excessive sweating, urinary incontinence and altered sexual function. Constipation and gastric motility can be severe enough to endanger comfort and health.
DIAGNOSIS:
Signs and sympotoms
Thorough examination
INVESTIGATIONS:
CT scan
MRI scan
Positron emission tomography
HOMOEOPATHIC APPROACH:
MERCURIUS SOLUBILIS:
Parkinsons disease due to the excessive exposure to the mercury
Slow in the movement
Excessive perspiration,weakness of the extremities
Cannot bear the extremes of the temperatures
Increased thirst and hunger are the physical symptoms
