Parkinson’s disease or Paralysis Agitans is a degenerative disorder of the central nervous system. Parkinson's disease is a progressive disorder of the nervous system that affects your movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.

Causes of Parkinson’s disease:

Parkinson’s disease is caused by the degeneration or destruction of dopamine-producing nerve cells (dopaminergic cells), in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. Which in turn makes it harder for the brain to control and coordinate muscle movement?

Several factors appear to play a role:

• ●Genes: Researchers have identified specific genetic mutations that can cause Parkinson's disease, but these are extremely uncommon, except in rare cases with many family members affected by Parkinson's disease. However, certain gene variations (polymorphisms) appear to increase the risk of Parkinson's disease, but with a relatively small risk of for each of these genetic markers.

• ●Environmental triggers: Exposure to certain toxins or environmental factors increase the risk of later Parkinson's disease, but the risk is relatively small.

• ●The presence of Lewy bodies: Clumps of specific substances within brain cells are microscopic markers of Parkinson's disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson's disease.

• ●A-synuclein is found within Lewy bodies: Although many substances are found within Lewy bodies, scientists believe the most important of these is the natural and widespread protein called a-synuclein. It's found in all Lewy bodies in a clumped form that cells can't break down. This is currently an important focus among Parkinson's disease researchers.

Risk factors of Parkinson’s Disease:

Risk factors for Parkinson's disease include:

Age: Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk continues to increase with age.

Heredity: Having a close relative with Parkinson's disease increases the chances that you'll also develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson's disease.

Sex: Men are more likely to develop Parkinson's disease than are women.

Exposure to toxins: Ongoing exposure to herbicides and pesticides may put you at a slightly increased risk of Parkinson's disease.

REM sleep disorder:people with REM (rapid eye movement) sleep behavior disorder may have twice the risk of developing Parkinson's disease or mild cognitive impairment, compared to others without the disorder.

Symptoms of Parkinson’s disease:

Parkinson's disease symptoms and signs may vary from person to person. Early signs may be mild and may go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides. Parkinson's signs and symptoms may include:

Tremor: Your tremor, or shaking, usually begins in your limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson's disease is tremor of your hand when it is relaxed (at rest).

Slowed movement (bradykinesia): Over time, Parkinson's disease may reduce your ability to move and slow your movement. This may make simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, your feet may stick to the floor as you try to walk, making it difficult to move.

Rigid muscles: Muscle stiffness may occur in any parts of your body. The stiff muscles can limit your range of motion and cause you pain.

Impaired posture and balance: Your posture may have become stooped, or you may have balance problems as a result of Parkinson's disease.

Loss of automatic movements: In Parkinson's disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk. You may no longer gesture when talking.

Speech changes: You often may have speech problems as a result of Parkinson's disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone, rather than with the usual inflections.

Writing changes: Writing may appear small and become difficult.Medications typically markedly reduce many of these symptoms. These medications increase or substitute for a specific signaling chemical (neurotransmitter) in your brain: dopamine. People with Parkinson's disease have low brain dopamine concentrations.

Secondary motor symptoms:

• ●A tendency to stoop, to lean forward

• ●Cramping

• ●Drooling

• ●Fatigue

• ●Handwriting may be very small and cramped (micrographia)

• ●Impaired fine motor dexterity (fine finger movements)

• ●Impaired motor coordination

• ●Involuntary movements and prolonged muscle contractions (dystonia)

• ●Loss of facial expression - some individuals may appear uninterested (not animated) when speaking, while others stare fixedly with unblinking eyes.

• ●Sexual dysfunction

• ●Swallowing difficulties (dysphagia)

• ●The arms may not swing when walking

Other signs and symptoms may include:

• ●Dementia: this may develop in the later stages of the disease. The patient may have memory and mental clarity problems. A person with Parkinson’s is six times more likely to develop dementia, compared to other people.

• ●Sleep problems : which may be worsened by medications for Parkinson’s disease. However, sleep problems are a core feature of the disease. The patient may be excessively sleepy during the day; there may be disturbances in REM (rapid eye movement) sleep, as well as insomnia.

• ●Constipation

• ●Depression

• ●Dysphagia (difficulty swallowing)

• ●Fatigue, tiredness, loss of energy

• ●Paresthesia : a sensation of tingling, pricking, or numbness of a person's skin (pins and needles)

• ●Reduced sensation of pain

• ●Reduced sense of smell

• ●Urinary incontinence (bladder weakness)

• ●Urinary retention (difficulty getting rid of urine)

 Treatment of Parkinson’s disease:

Homeopathic Treatment of Parkinson’s disease:

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. Homoeopathy with its deep acting constitutional medicines act on the altered immune system thus helps by controlling the disease process and preventing any further loss to the nerves. Homoeopathic treatment helps in relieving symptoms like, weakness of the body, tremors, rigidity, numbness, unsteady gait.

Allopathic Treatment of Parkinson’s disease:

Although Parkinson's disease can't be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms. PD is more common in the elderly, with most cases occurring after the age of 50.

Medications can help you manage problems with walking, movement and tremor by increasing your brain's supply of dopamine. However, dopamine can't be given directly, as it can't enter your brain.

You may have significant improvement of your symptoms after beginning Parkinson's disease treatment. Over time, however, the benefits of drugs frequently diminish or become less consistent, although symptoms usually can continue to be fairly well controlled.

Doctor may prescribe medications, which may include:

Carbidopa-levodopa (Parcopa): Levodopa, the most effective Parkinson's disease medication, is a natural chemical that passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa, which protects levodopa from premature conversion to dopamine outside your brain, which prevents nausea.

After years, as your disease progresses, the benefit from levodopa may become less stable, with a tendency to wax and wane ("wearing off"). Also, you may experience involuntary movements (dyskinesia) after taking higher doses of levodopa. Your doctor may lessen your dose or adjust the times of your doses to control these effects.

Dopamine agonists: Unlike levodopa, dopamine agonists don't change into dopamine. Instead, they mimic dopamine effects in your brain. They aren't as effective in treating your symptoms as levodopa. However, they last longer and may be used with levodopa to smooth the sometimes off and on effect of levodopa.

MAO B inhibitors: These medications include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). They help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO B). This enzyme metabolizes brain dopamine

Catechol O-methyltransferase (COMT) inhibitors: Entacapone (Comtan) is the primary medication from this class. This medication mildly prolongs the effect of levodopa therapy by blocking an enzyme that breaks down levodopa.

Anticholinergics: These medications were used for many years to help control the tremor associated with Parkinson's disease. Several anticholinergic medications are available, including benztropine (Cogentin) and trihexyphenidyl. However, their modest benefits are often offset by side effects such as impaired memory, confusion, hallucinations, constipation, dry mouth and impaired urination.

Amantadine: Doctors may prescribe amantadine alone to provide short-term relief of symptoms of mild, early-stage Parkinson's disease. It also may be added to carbidopa-levodopa therapy for people in the later stages of Parkinson's disease, to help control involuntary movements (dyskinesia) induced by carbidopa-levodopa. Side effects may include a purple mottling of the skin, ankle swelling or hallucinations.

Surgical procedures:

Deep brain stimulation: In deep brain stimulation (DBS), surgeons implant electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest that sends electrical pulses to your brain and may help improve many of your Parkinson's disease symptoms.

Deep brain stimulation is most often a procedure to treat people with advanced Parkinson's disease who have unstable medication (levodopa) responses. DBS can help stabilize medication fluctuations, reduce or eliminate involuntary movements (dyskinesia), reduce tremor, reduce rigidity, and improve slowing of movement. DBS is very effective in controlling erratic and fluctuating responses to levodopa or for controlling dyskinesias that can't be controlled with medication adjustments. However, it's not helpful for treating problems that don't respond to levodopa therapy, apart from tremor.

Speech therapy: A speech and language therapist can help with the use of language and speech. Patients with swallowing difficulties may also be helped by a speech therapist.

Occupational therapy: an occupational therapist can pinpoint everyday life problems and help work out practical solutions. Examples include getting dressed, or getting the shopping done.

Self Care Measures for Parkinson’s Patient:

Healthy eating:

Eat a nutritionally balanced diet that contains plenty of fruits, vegetables and whole grains. Eating foods high in fiber and drinking an adequate amount of fluids can help prevent constipation that is common in Parkinson's disease. A balanced diet also provides nutrients, such as omega-3 fatty acids, that may be beneficial for people with Parkinson's disease.

Walking with care:

Parkinson's disease can disturb your sense of balance, making it difficult to walk with a normal gait. These suggestions may help:

• ●Try not to move too quickly.

• ●Aim for your heel to strike the floor first when you're walking.

• ●If you notice yourself shuffling, stop and check your posture. It's best to stand up straight.

• ●Look in front of you, not directly down, while walking.

Avoiding falls:

• ●In the later stages of the disease, you may fall more easily. In fact, you may be thrown off balance by just a small push or bump. The following suggestions may help:

• ●Don't pivot your body over your feet while turning. Instead, make a U-turn.

• ●Don't lean or reach. Keep your center of gravity over your feet.

• ●Don't carry things while you're walking.

• ●Avoid walking backward.

• ●Daily living activities

• ●Daily living activities, such as dressing, eating, bathing and writing, can be difficult for people with Parkinson's disease. An occupational therapist can show you techniques that make daily life easier.

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