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Parkinson’s Disease

Parkinson’s Disease is a degenerative, slowly progressive deterioration of nerves in the brain stem’s motor system, characterized by a gradual onset of symptoms associated with ageing. A distinction is often made between Parkinson’s disease and parkinsonism, in which the same symptoms are produced by causes other than age.


A typical first sign is a slow tremor (shake) on resting, often initially on one side of the body. This is typically ‘pill rolling’ in form and diminishes on voluntary movement. It affects both sides involving the arms, legs, and jaw. Slowness of movement is often first noticed by the family or friends rather than by the patient.

Rigidity (‘cogwheel type’) of the muscles occurs, which adds the general slowness and leads to a stooping posture and ‘snuffling’ gait. There is a noticeable loss of arm swing on walking. The patient develops monotonous speech, a mask-like expressionless face and dribbles saliva because of difficulty in swallowing. Muscle aches and cramps occur, fatigue is often present and constipation is common. Writing becomes small, tremulous and untidy on account of the rigidity.

As the disease progresses, there may be major disability when the patient becomes immobile and chair-bound. The latter may lead to complications such as pneumonia, bedsores and urinary tract infections. Most patients have normal intellectual function but, with time, a proportion develop structural mental changes.


Extensive microbiological studies have failed to find an infective disease. Degeneration of the brain stem, presence of large bodies within the brain cells, and loss of neurons in important region of the brain causing severe loss of dopamine, are the main pathological changes.

Parkinson’s disease affects groups of nerve cells involved in movement, where the neurotransmitter dopamine facilitates signals across nerve junctions (synapses). Various drugs can partially restore this system.


Parkinson’s disease is slightly more common in men than women and does not seem to run in families. Interestingly, patients with Parkinson’s disease are less likely to die from lung cancer than the rest of the population.

As the cause of Parkinson’s disease is currently unknown, prevention is not possible.

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