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Humanity has encountered many diseases, disorders, and conditions of the human body for which an etiology has yet to be discovered. Examples of this are some bacteria, viruses and other many other pathological agents like toxins and prions, but there are some diseases and disorders which originate from within the human body. Many of these pathological conditions are treatable in modern medicine; however, some others not only are untreatable, but their onset is of unknown origin. This invisible enemies could be living inside us unknowingly, and with no ways to predict there existence. The purpose of this research paper would be to discuss one of those unpredictable and disease causing enemies. We have no way to predict if we are going to be one of its many victims. This famous and well known disease in medicine is Parkinson disease (PD).
Parkinson's disease is been around us for thousands of years. The symptoms were recognized in Chinese and Indian medicine books. The first evidence of the disease was not available until 1817 when the first modern description was made available. In 1817 in a paper by a London physician named James Parkinson. He called the paper "An Essay on the Shaking Palsy". In this essay he briefly summarizes some of the symptoms and signs perceived by a patient with the disease. The first symptoms he mentioned are slight sense of weakness, with resting tremors usually first noticed in one hand or arm and sometimes involving the head. Mr. Parkinson also mentioned that in more advanced stages of the disease the tremulous agitation become more intense. According to Mr. Parkinson by this point the patient's will to control the muscle, the initiation of movement and amplitude of movement became more difficult.
In 1877, sixty years passed until a French neurologist, Martin Charcot, recognized the importance of Parkinson works in the study of the disease named after him. But it was not until a hundred years later that a chemical difference in the brain was noticed between patients affected with the disease and healthier individuals. In the nineteen sixties, George Cotzias lead the discovery of the first ethic and medical treatment of the disease. The drug gold standard Levodopa was administrated to treat the symptoms, and since then this drug became the primary medication to treat patients with the disease.
Neurons the circuits of the brain communicate with each other by producing neurotransmitters. The neurotransmitters are chemical molecule such as dopamine and serotonin. There are responsible for coordination of body movements and other body functions. Parkinson's disease is a disorder in which neurons deteriorate in specific area of the brain referred to as the basal ganglia known to be responsible for the control and coordination of body movement. When these neurons die or lose efficient communicating, the brain is no longer able to control body movements effectively. As a result, patients with Parkinson's disease exhibit tremors or suddenly spasm of body part. Neurons are like circuits that make up the brain and the entire nervous system. In Parkinson's disease they change their behavior because of different factors such as toxins, tumors, viruses, genetically mutations, smoking, and alcoholism which can induce the symptom of Parkinson. Deterioration of neurons and limited production of dopamine continues evolving in the affected area of the brain until the body cannot longer perform their daily and essential functions. Nevertheless, Parkinson's disease patient usually do not die of PD effects. They majority of patients usually die of pneumonic, from declining mobility skills, and impaired ability swallow and clear airway effectively.
Parkinson disease can be divided into four categories. These categories are all known as Parkinsonian Syndromes, similar symptoms but different origins. The symptoms are trembling of the hand, arms, legs, jug and face; furthermore, stiffness of the arms, legs and trunk, also slowness in movement, and last but no least, poor balance and coordination. As this disease progresses, patients develop difficulty walking, talking, swallowing and doing simple tasks until death. Parkinsonian's syndromes can be divided into idiopathic, acquired, hereditary Parkinsonism, and Parkinson plus syndrome.
The pathology of Parkinson's disease is characterized by death of neurons on the Basal Ganglia a region of the brain that contains Dopamine producing cells. Resent research suggests that neuronal death is not necessary for symptoms of Parkinson's to appear , rather a loss of Dendritic Spine by degradation of the Neuronal Cytoskeleton the structure of the neurons may be the most direct cause of dopamine deficiencies. Dendrites are part of neurons that form connection call synapsis with other cell. Without synapsis cell cannot sent message or communicate to each other and perform their function properly.
The diagnosis of the disease is based on the characteristics and manifestation of the sign and symptoms; however, there are also several neurological examinations that are performed to diagnose the disease. Since the symptoms and signs of Parkinson's develop gradually many of the Parkinson's disease symptoms are mistaken or associated with age, or even other diseases. For instance, the rigidity of the muscles can sometimes be associated with arthritis. Likewise numerous patients blame their advance age for some their pain and suddenly shaking of a body part such as one of their finger. Furthermore, while the disease silently progress, patients start to notice changes their writing. With time their writing become smaller and difficulties in performing this activities. In the majority of the cases even the patient's signature change. Their facial expression changes to the point that they may look sad or like their wearing a mask. They begging to blink less frequently so there is more of stare appearance in their facial expression. Their voice volume and the swallow frequency decrease therefore many patients begging to notice some drooling when they are at sleep. In general, all or the majority of body movement become less frequently. It is not until some of this patient daily activity start to become impossible to perform that they begging to share with their family members or even consult their doctor to talk about their symptoms.
An important aspect in the diagnosis of the disease that help doctors to differentiated Parkinson from other disease is that Parkinson is unilateral. It begins in one side of the body. It does not matter could be right or left and the patient can be right or left handed. However this pattern is only observable in an earlier stage, later when the disease become more advances it becomes bilateral therefore it affects both sides of the body. After the disease becomes bilateral, the patient starts to have trouble balancing, and then become ambulatory. Since the disease affect the autonomic nervous system, patients also experience, constipation, insomnia, and in later stages difficulties breading.