Hinduja hospital conducts regular webinars and tweetinars for online users where they can seek advice from expert doctors of hinduja hospital for free. Above is the webinar conducted by hinduja hospital on Parkinsons Disease where issues like parkinson disease, parkinson disease cure,parkinson disease symptoms,parkinson treatment were discussed successfully by Consultant Neurophysician, Dr. Charulata Sankhla. To know more about such upcoming webinars and tweetinars from hinduja hospital, visit http://www.hindujahospital.com/communityportal/

1. Things you want to know about
Parkinson's Disease
Dr. Charulata Sankhla
Consultant Neurophysician
Hinduja Hospital, Mumbai

2. What Is Parkinson's Disease (PD)?
• A brain disorder that causes a
gradual loss of muscle control
• Symptoms of PD tend to be
mild initially and can
sometimes be unnoticed.
• Typical signs include
tremors, stiffness, slowed
body movements, and poor
balance. Parkinson's was
originally called a "shaking
palsy," but not everyone with
Parkinson's has a tremor

3. James Parkinson 1817
“Involuntary tremulous
motion, with lessened
muscular power, in part
not in action and even
when supported; with a
propensity to bend the
trunk forward, and to
pass from a walking to a
running pace: the
senses and intellect
being uninjured”

4. Progression of the disease
• While Parkinson's can be a
frightening diagnosis, life expectancy
does not change particularly with
better care. and prompt treatment
• symptoms progress slowly over 10 to
20years
• Early treatment can allow patients to
live a normal life , maintain their job
• We see young patients with PD in
India as compared to west
• Two advocates for research
development in PD: Boxer
Muhammad Ali at age 42 and actor
Michael J. Fox at age 30

5. Early Signs of this disease
It may be subtle and can be confused with other
conditions. They include:
• Mild shaking of a finger, hand, leg, or lip
• Frozen shoulder
• Stiffness or difficulty walking
• Difficulty getting out of a chair
• Small, crowded handwriting
• Stooped posture
• A 'masked' face, lack of expression

6. Tremor
• It is an early symptom and is
seen in about 70% of patients
• Usually occurs in a finger or
hand when the hand is at rest
when patient is walking or
watching TV- but not when the
hand is in use
• Hands and fingers shake as if
rolling a pill between the
thumb and index finger

7. Bradykinesia
• As we grow older, we slow down. bradykinesia in
PD patients mean slow movement which impairs
daily activities
• They tend to take small steps. They may suddenly
stop particularly near doors or in crowded places.
Their body does not respond to commands right
away
• The PD patients blink less and have mask like face
and have a soft voice or slurred speech

8. Impaired Balance
• These patients have difficulty in turning swiftly
• They tend to develop a stooped posture, with
drooping shoulders and their head jutted forward
• They may have a problem with balance. This
increases the risk of falling
• They tend to run in small steps forward

9. Rigidity
• Rigidity means stiff muscles which don't relax
• It is difficult to move patients arms and legs
passively , there is some resistance
• Due to rigidity the arms may not swing when a
person is walking
• There may be cramping or pain in the muscles

10. Non motor symptoms
• Night terrors, Restless sleep
• Daytime fatigue
• Constipation
• Increase tendency to pass urine particularly in
night
• Difficulty swallowing
• Memory problems, confusion, or dementia
• Oily skin and dandruff

11. Can I get PD?
• The average age of onset is 55 as one gets older
the chances increase
• Having a family member with PD slightly
increases the risk
• Men are more likely to have Parkinson's than
women

12. What happens in Brain?
• A small area in the brain stem called the
substantia nigra produces dopamine, a chemical
that controls movements, their speed, planning
• In PD these dopamine-producing cells die;
• Resulting in the misplanning and altered speed of
the movement. Also there is difficulty in
initiating movements

13. DAT SCAN

14. Various strategies in treatment of PD
• Multidisciplinary approach
• Medical
• Surgery
• Physiotherapy
• Occupational therapy to modify home
• Support group to increase awareness
• Speech therapy

15. Drugs in PD
• Levodopa preparations.
• Dopamine receptor agonists.
• Monoamine oxidase-B inhibitors.
• Catechol-o-methyltransferase inhibitors.
• Anticholinergics.
• Amantadine

16. Deep Brain Stimulation
• Electrodes are implanted into one of three areas
of the brain -- the globus pallidus, the
thalamus, or the subthalamic nucleus -- on one or
both sides. A pulse generator goes in the chest.
• Electric pulses stimulate the brain to reduce a
patient's rigidity, tremors, and bradykinesia.
• It doesn’t stop the progression of PD or affect
other symptoms. Not everyone is a good
candidate for this surgery. Selection of a proper
patient is essential for good outcome
postoperatively

17. Deep brain stimulation

18. Can we prevent PD?
• Various researchers have been
trying to prevent PD or halt
progression of disease, but it is too
soon to tell whether this works
• Well water drinking in early age
have been found to increase the
chances of developing the disease
• Coffee drinkers and smokers may
have a lower risk of developing
Parkinson's (although smoking
obviously has other serious health
consequences)

19. The Role of Environmental Toxins
• Exposure to pesticides
and herbicides may
increase the risk of PD
• There may be genetic
susceptibility to
environmental exposures
• Workers exposed to
manganese in mines in
India developed
parkinsonian features

20. Parkinson's and Exercise
• Exercise may actually have a
protective effect by
enabling the brain to use
dopamine more effectively.
It also helps improve motor
coordination, balance, gait,
and tremor. It releases
nerve growth factor which
may play key role in PD
brains. Working out on a
treadmill or biking have
been shown to have a
benefit. Tai chi and yoga
may help with balance and
flexibility.

21. Living With PD
Parkinson's affects many aspects of daily life, but
with medications and supportive therapies
patient can remain active. Medication can help
patients cope with mood disorders, such as
depression and anxiety. An occupational
therapist can provide a home safety evaluation
such as to remove fall hazards, throw rugs or
cords, and add grab bars in the bathroom. A
speech therapist can help with swallowing and
speech problems.

22. Caregivers most important person
• In addition to loosing motor skills PD patients are
emotionally low. Depression often precedes motor
slowness.
• To do daily tasks are marathon efforts for PD patients and
they should be constantly encouraged to do simple tasks
independently
• Caregivers need to understand this and provide necessary
support to keep patient active and independent
• Support groups and online forums are available

23. OPD Appointment Helpline: 022-39818181/67668181/24451515
VOPS Schedule: Every Wednesday - 1300 to 1400 hours
Online Appointment: http://www.hindujahospital.com/vops/
Visit us on: http://www.hindujahospital.com/dr-charulata-sankhla/
For any Queries, please write us on: info@hindujahospital.com
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