April 11 is celebrated across the world as World Parkinson’s Day to mark the birthday of the English physician, Dr. James Parkinson who was the first one to describe the symptoms of Parkinson’s in his seminal work titled, An Essay on the Shaking Palsy (1817). The celebrated French neurologist Dr. Jean-Martin Charcot besides listing rigidity as an important physical symptom also gave the label Parkinson’s to the condition some four decades after Dr.Parkinson’s essay.
What we know today as Parkinson’s disease is a complex and progressive brain disease which has no cure though there are medication and surgery to manage symptoms. The causes are unknown. The brain has vital nerve cells in the brain called neurons which produce dopamine which regulates movement and coordination. Parkinson’s is a condition when neurons start dying and reduce dopamine production leaves a patient with the inability to control movement like a normal person would. Researchers and scientists across the world are discovering and doing their best to include mood and cognitive symptoms like depression, attention struggles and roadblocks with verbal and non-verbal communication besides the better known and established motor symptoms.
Symptoms vary from person to person, and come and go, lasting as short as one minute. Primarily there are four types of motor symptoms:
- Tremor : Of the limbs, jaw and face
- Bradykinesia : Slowness of movement
- Rigidity: Stiffness of limbs and trunk where muscles freeze and stop functioning for a while.
- Postural instability : Impaired Balance and coordination
- Involuntary movements: Like head bobbing
Some of the common non-motor symptoms are:
- REM sleep behavioural disorder
- Reduced sense of smell
- Automatic dysfunction
- Impaired vision
- Attention deficit
- Difficulties planning and carrying out ordinary chores
This is a disease with grave social and economic impact for those suffering and also, on their family and caregivers. Some of the symptoms, both motor and non-motor have serious side-effects. Medication can trigger non-motor symptoms like impulse control disorders which are a set of psychiatric and behavioural issues like compulsive gambling and shopping and craving for sex, poor lifestyle habits like excessive partying and eating out and capacity issues in case of a withdrawal. Constant medication support also creates mental dependency and fear of possible consequences should the treatment be withdrawn/stopped for any reason.
Parkinson’s can happen to anyone. Many people are not even aware that it is a serious neurological condition which affects movement. A lot of people do not know that rigidity is a key motor symptom of this condition where a person is unable to move their body and certain limbs on their own. And given this kind of awareness, a lot others are not aware of the non-motor symptoms of this disease like the side effects of those on medication.
World Parkinson’s Days is a reminder for all of us to remember and work towards creating a support-group and work on education and awareness, research and advocacy to pause and unite, and help the medical community to find better modes of treatment on the path to find a cure.