PARKINSON'S Disease is one of the most common disorders of the
nervous system. Each year in Scotland alone there are about 1000 new
cases diagnosed.
And, although the disease is most common in those over the age of
60, it is by no means always a disorder of old age. About one in 20
of all people diagnosed as suffering from Parkinson's are under the
age of 40, with men more likely to be affected than women.

It is not a respecter of persons either. Michael J Fox, star of the
Back to the Future films, experienced early symptoms of the disorder
in 2000 and has written very movingly about its effect upon him and
those around him in his book, Lucky Man. So what is going on here?

Normally our brain controls our muscles by sending them hundreds of
thousands of messages, day and night. A chemical called dopamine
helps pass these messages from one cell to another. In Parkinson's
Disease, not enough dopamine is produced. Without proper control the
muscles work together less smoothly.

At first this usually shows itself as a tremor of the hands. It is
common for only one hand to be affected at first and for the tremor
to disappear, or get less, when the hand is being used. Later there
may be clumsiness, slowness of movement and poor co-ordination. This
can lead to a shuffling way of walking, with the person at first
finding it difficult to get started and then moving too fast. Often
it becomes difficult, even impossible, to do simple tasks like doing
up buttons.

Some people with the disease lose the ability to move the muscles of
the face properly so that they don't smile at a funny story or when
meeting a loved one. People with Parkinson's may get an extremely
unfair reputation for not caring about others for this reason.

There is no special test or investigation to diagnose Parkinson's,
although tests are often carried out as symptoms that are very
similar can, rarely, have some other cause. It is most common for
someone suspected to be experiencing the early signs and symptoms of
Parkinson's to be referred for specialist opinion before any
treatment is commenced.

A specialist in the condition becomes expert, not only in confirming
the diagnosis, but in having the knowledge of when to recommend
medication and which preparation to use.

These days, treatment tends to be started earlier than in the past
as it is difficult to reverse changes that have already happened.
There is a whole range of drugs that can be used in Parkinson's
Disease and all have advantages and disadvantages.

You can see that someone with Parkinson's may need a lot of input
from many sources and it helps to have someone a bit like the
conductor of an orchestra to co-ordinate all this activity.

In Edinburgh, as in many other areas, there is a specialist
Parkinson's Disease nursing service to do just this, so that
patients and their relatives need never feel unsupported.

Parkinson's Disease is not curable, but it should not be treated as
a death sentence. Many of those affected can enjoy life and make a
useful contribution for many years to come. It is up to those of us
who come into contact with them to help achieve this aim by treating
them with care and respect.


DR IAN McKEE
21 Dec 2006(LivingScotsman.com) -