Parkinson's Disease

 Parkinson’s disease is characterized by muscular difficulties and postural abnormalities. It usually affects persons over 60.

Characteristics of Parkinson’s disease include: tremors while resting, rigidity, and akinesia (absence of movement).

It can be manifested as: poor posture control, shuffling gait, and loss of overall muscle control (flexed stance, difficulty in turning, and hurried gait). As the elderly population continues to increase, this debilitating disease may become more prevalent.

There is no cure for Parkinson’s disease; goals of treatment are to minimize disability and help patients maintain the highest possible quality of life. Drug therapy has greatly improved functional ability and temporary remission from the disease, allowing patients to live productive lives.

On-off phenomenon – wide functional state fluctuation, including hyperkinetic (abnormally increased motor function) to hypokinetic (abnormally diminished motor function).

Dyskinesia – impairment of the power of involuntary movement.

Akinesia – “freezing” episodes.

Patients taking levodopa-carbidopa can experience these on-off phenomenon where the drug appears to stop working and then suddenly start working. There can also be neuropsychiatric disorders, dementia, loss of memory, hallucinations, and postural hypotension (reduced blood pressure in certain positions, due to inhibition of neurons responsible for vasoconstriction). This drug requires careful titration for optimal control at minimal doses, delaying the on-off phenomenon as long as possible.