Parkinson's disease is a chronic degenerative disease of the central nervous system. It causes movement disorders along with changes in cognition and mood. It is clustered in families, but the actual specific etiology is currently unknown.
The hallmarks of the disease are hand tremors, muscular rigidity, loss of facial expression, bradykinesia and gait disturbances, the most common being shuffling. Symptoms begin as a gradual onset of aches, fatigue and malaise followed by tremors in the extremities, usually the hands. Later, symptoms including the softening of the voice, stooped posture and difficultly turning in bed. As the disease progresses, falls are common and the shuffling gait, known as festination, tends toward falling backwards. Facial expressiveness may diminish and the handwriting become smaller.
There is no cure for Parkinson's. Medications used for control include dopamine agonists such as bromocriptine and monoamine oxidase-B inhibitors like deprenyl. Surgical therapy is available but performed in very few hospitals — the surgical process involves the transplantation of dopamine-secreting cells into the affected areas of the brain.
Deep brain stimulation surgery is available for patients who qualify. It improves movement and delays the progression and the symptoms of Parkinson's for a time, but it is not a cure for the disease.
Caring for a Parkinson's patient is a team undertaking and usually involves a neurologist, a physiotherapist, nurses and a speech therapist, amongst others. Patients must be watched carefully because of the possibility of drug-drug interactions that may be caused by the mixing of medications for the condition. The patient and his or her family must be educated about safety measures, drug-related dietary restrictions and the need for frequent small feedings rather than large meals because of issues with swallowing (dysphagia).