Wednesday, January 16, 2019

Posted at: Apr 14, 2018, 12:55 AM; last updated: Apr 14, 2018, 12:55 AM (IST)

That tremor can be Parkinson’s

India has more than seven million patients of Parkinson's. According to the UN Population Division, India, the incidence of the disease is projected to rise by 19 per cent by 2050
That tremor can be Parkinson’s
shaky ground: There is no cure for Parkinson’s disease but its symptoms can be managed with medication

Dr Jyoti Bala Sharma

Parkinson’s disease (PD) is one of the most common neurologic disorders, affecting approximately 1 per cent of individuals older than 60 years. It is a chronic and progressive degenerative neurological disorder.

It happens due to deficiency of a chemical in the brain called dopamine which regulates smooth and coordinated muscle movements of our body. Dopamine is produced by the cells of a part of the brain called substantia nigra. In PD, there is loss of dopaminergic neurons of the substantia nigra resulting in decreased dopamine levels, affecting the muscle movements.

Parkinson’s disease progresses slowly over a period of many years. It causes progressive disability which can be slowed by treatments that can help the affected persons live an independent and productive life.


Most cases of Parkinson’s disease are thought to be due to a combination of genetic and environmental factors. Environmental risk factors commonly associated with the development of Parkinson disease include use of pesticides, living in a rural environment, consumption of well water, exposure to herbicides and proximity to industrial plants or quarries. However, no environmental cause of Parkinson disease has yet been proven. Genetic factors in Parkinson disease appear to be very important when the disease begins at or before age of 50 years and a genetic cause can be presumed in approximately in 5 to  10 per cent of cases.


People usually start to display PD’s symptoms between the ages of 50 and 60 but in some cases symptoms may start early.

Major symptoms of

Parkinson’s are:

n Trembling of hands, arms, legs, jaw and face 

n Stiffness of the arms, legs and trunk 

n Slowness of movement

n Poor balance and coordination 


There is no specific test for Parkinson’s. Diagnosis is based on clinical history and a physical and neurological exam. No laboratory or imaging study is required in patients with a typical presentation of Parkinson’s disease. Such patients are usually aged 55 years or older and have a slowly progressive and asymmetric Parkinsonism with resting tremor and bradykinesia or rigidity. Magnetic resonance imaging (MRI) of the brain can be considered to evaluate possible cerebrovascular disease (including multi-infarct state), space-occupying lesions, normal-pressure hydrocephalus, and other disorders. PET or SPECT scans can be considered in typical cases of Parkinsonism.


At present, there is no cure for Parkinson’s disease. However, there are several medicines that can control and manage its symptoms and make the disease easier to live with. Patients with Parkinson’s disease are encouraged to participate in decision-making process regarding their condition.

Other issues that commonly need to be addressed at appropriate times during the course of the disease include dementia, personality changes, depression, swallowing problems, sleepiness and fatigue. Prevention of falls is a must. Adequate exercise and a balanced diet are important. Speech therapy, occupational therapy and physical therapy can also help to improve communication.

The writer is senior consultant, Department  of Neurology, Fortis Hospital, Noida


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