Parkinson's disease is a chronic neurodegenerative disorder that primarily affects the nervous system responsible for regulating body movement. The disease occurs due to damage to dopamine-producing nerve cells in the brain, a chemical that plays a role in sending signals for coordinating movement. Although it is more common in older people (usually over 60 years old), Parkinson's can also affect younger people, especially if there are genetic factors or certain environmental exposures.
What is Parkinson's Disease?
Parkinson's is known as a disease characterized by classic motor symptoms: tremors (trembling at rest), muscle rigidity, slow movement (bradykinesia), and balance disorders. The face of patients with Parkinson's also appears less expressive (hypomimia) with reduced voice volume and intonation. Due to muscle rigidity, especially in the trunk, the posture can change to hunchback. When walking, the swinging movement of the arms appears reduced along with short steps.
Not only symptoms that affect movement, patients with Parkinson's disease also experience non-motor problems that can occur early before the appearance of motor symptoms or occur in later stages.
Parkinson's Symptoms
Symptoms that may appear early in the disease include decreased sense of smell (hyposmia), sleep disturbances such as sleep talking or hitting/kicking as if acting out their dreams, digestive disorders such as constipation, and depression or anxiety. Other non-motor symptoms may appear in more advanced stages and are very disruptive and affect quality of life, such as pain, impaired thinking/cognition, weakness, hallucinations, urinary problems, sexual problems, and autonomic problems such as decreased blood pressure when changing positions.
The exact cause of Parkinson's is still not fully understood. A combination of genetic factors, exposure to toxins (such as pesticides), and aging of nerve cells are thought to be the main triggers. While it is not contagious or immediately life-threatening, the disease is progressive—symptoms will worsen over time if not properly managed.
How is Parkinson's Diagnosed?
Parkinson's cannot be diagnosed with a single blood test or imaging. Neurologists (nerve specialists) take several steps to establish a diagnosis, such as:
- Evaluation of medical history and symptoms
The doctor will ask about the patient's and family's medical history, and observe the symptoms that appear, whether they are related to movement or not. - Physical examination and nerve function tests
Patients are asked to perform a series of movement tests, such as opening and closing their hands, walking, or maintaining balance. The doctor also checks the muscle response to passive movements to assess stiffness. The doctor will check posture and gait. - Scans and Supporting Tests
Parkinson's disease can mostly be diagnosed with a medical interview and physical examination, but in some cases further tests such as an MRI or DaTscan brain scan (to see dopamine levels in the brain) are needed. This is necessary to confirm the diagnosis and rule out other diseases with symptoms similar to Parkinson's.
What to Do If Diagnosed with Parkinson's?
While a Parkinson's diagnosis can be frightening, the following proactive steps can help patients remain independent and maintain quality of life:
1. Plan Medical Treatment Immediately
Consult a neurologist to design a treatment plan that suits the stage of the disease. Drugs such as levodopa or dopamine agonists can be given to replace the lack of dopamine. The type of drug given and the frequency of administration depend greatly on the patient's age and the severity of the disease. In more severe disease stages, further therapy can be given such as drug injection through the skin like insulin administration in DM patients, dopamine agonists attached to the skin (patches), even administration of drugs through a pump, either drugs pumped into the skin or drugs pumped into the intestines. In some cases, DBS ( Deep Brain Stimulation ) with a surgical procedure to implant an implant in a specific area of the brain can be considered.
2. Supportive Therapy to Maintain Physical Ability
- Physiotherapy: Stretching exercises are very helpful in preventing muscle stiffness and maintaining good posture.
- Speech Therapy: Vocal exercises and stimulation of the mouth and throat area to improve voice and swallowing function.
- Occupational Therapy: learning to use assistive devices or modifying the home to make daily activities safer.
3. Adaptation of Lifestyle Patterns.
Balanced Nutrition: consume foods high in fiber (to prevent constipation) and antioxidants (such as berries or green vegetables). Avoid eating excessive protein at the same time as levodopa because it can interfere with the effectiveness of the drug.
Regular Physical Activity: Light exercise such as walking or swimming 30 minutes a day accompanied by neck, chest and thigh muscle exercises to maintain flexibility and maintain good posture.
Get Enough Rest: Sleep disturbances are common in Parkinson's patients—consult your doctor if you experience insomnia or recurring nightmares.
4. Mental and Social Support
Stress and depression often accompany a Parkinson's diagnosis. Join a support group to share experiences with fellow patients. Relaxation techniques such as meditation or music therapy can also help maintain mental health. Don't hesitate to ask family or professionals for help in dealing with emotional burdens.
5. Monitor Parkinson's Progression and Complications
Have regular check-ups with your doctor to adjust your medication dosage and detect other health problems early.
The Role of EMC Alam Sutera Hospital in Accompanying Parkinson's Patients
As a hospital with integrated neurology services, RS EMC Alam Sutera provides a multidisciplinary team (neurologists, radiologists, clinical rehabilitation, physiotherapists who are ready to help Parkinson's patients from diagnosis to management. We also organize educational programs for families related to Parkinson's patients, from how to take medication, the necessary nutrition, and home exercise programs.
With a personal approach, we are committed to providing holistic care so that patients can continue to live active and meaningful lives.
Article written by dr. Gloria Tanjung, Sp.N (Neurology Specialist Doctor, EMC Alam Sutera & Sentul Hospital).