Neurology
Parkinsonism
Parkinson's disease may be one of the most baffling and complex of the neurological disorders. Its cause remains a mystery but research in this area is active, with new and intriguing findings constantly being reported.
Parkinson's disease belongs to a group of conditions called motor system disorders.
The four primary symptoms are
- tremor or trembling in hands, arms, legs, jaw, and face;
- rigidity or stiffness of the limbs and trunk;
- bradykinesia or slowness of movement; and
- Postural instability or impaired balance and coordination.
As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks.
Treatment
At present, there is no cure for Parkinson's disease. But a variety of medications provide dramatic relief from the symptoms.
Medications
Medications can help manage problems with walking, movement and tremor by increasing the brain's supply of dopamine. Taking dopamine itself is not helpful, because it is unable to enter your brain.
- Levodopa. The most effective Parkinson's drug is levodopa, which is a natural substance that we all have in our body. When taken by mouth in pill form, it passes into the brain and is converted to dopamine. Levodopa is combined with carbidopa to create the combination drug Sinemet. The carbidopa protects levodopa from premature conversion to dopamine outside the brain; in doing that, it also prevents nausea.
- Dopamine agonists. Unlike levodopa, these drugs aren't changed into dopamine. Instead, they mimic the effects of dopamine in the brain and cause neurons to react as though dopamine is present
- MAO B inhibitors. These types of drugs, including selegiline (Eldepryl) and rasagiline (Azilect), help prevent the breakdown of both naturally occurring dopamine and dopamine formed from levodopa
- Catechol O-methyltransferase (COMT) inhibitors
- Anticholinergics.
In the last decade research has laid the groundwork for many of today's promising new clinical trials, technologies, and drug treatments. Scientists, physicians, and patients hope that today's progress means tomorrow's cure and prevention.
Parkinson's disease research focuses on many areas. Some investigators are studying the functions and anatomy of the motor system and how it regulates movement and relates to major command centers in the brain. Scientists looking for the cause of Parkinson's disease will continue to search for possible environmental factors, such as toxins that may trigger the disorder, and to study genetic factors to determine how defective genes play a role.
Alzheimer’s Diseaese
Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities.
AD begins slowly. It first involves the parts of the brain that control thought, memory and language.
People with AD may have trouble remembering things that happened recently or names of people they know.
Over time, symptoms get worse.
People may not recognize family members or have trouble speaking, reading or writing.
They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home.
Eventually, they need total care. This can cause great stress for family members who must care for them.
AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease.
No treatment can stop the disease. However, some drugs may help keep symptoms from getting worse for a limited time.
Multiple sclerosis
Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. They can include
- Visual disturbances
- Muscle weakness
- Trouble with coordination and balance
- Sensations such as numbness, prickling, or "pins and needles"
- Thinking and memory problems
No one knows what causes MS. It may be an autoimmune disease, which happens when your body attacks itself. Multiple sclerosis affects woman more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak or walk. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may
also help.
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