Diagnosing, Treating, and Managing Parkinson’s
You’ve heard the horror stories associated with Parkinson’s disease, where patients have lost one physical thing they do after another until they’re left with the option of basically watching TV at home.
At Texas Neurosurgery, we think there is a better solution. Although there is no cure currently available for Parkinson’s disease, we offer a variety of drug and other treatments that can help our patients enjoy a full and happy life.
What is Parkinson’s disease?
Parkinson’s disease is a chronic motor system disorder that occurs when the cells that produce dopamine become destroyed or severely damaged. Dopamine is a chemical that sends signals to the brain to control movement. As Parkinson’s progresses, these cells diminish and patients gradually lose more and more control of their movements. What often happens is that the patient needs to stop participating in the activity, say something like playing tennis or running, due to their lack of muscle control.
What causes Parkinson’s?
The causes of Parkinson’s are still a mystery. Why do some people lose their dopamine cells while others do not? There is some thought that it may be linked with abnormal genes in some patients. Research is also looking at aging and environmental factors as potential causes. One thing is known — Parkinson’s is more common in men over the age of 50.
What are the symptoms of Parkinson’s?
Parkinson’s displays four main symptoms:
- Stiffness in the muscles
- Slow movement
- Difficulty walking and balancing
In most patients, the first sign is a slight tremor in one arm or leg. From there it slowly spread to other areas of the body.
How we treat Parkinson’s
The goal of treatment is to restore the proper balance of the neurotransmitters acetylcholine and dopamine by increasing the dopamine levels. Drug treatment is the first way we do this at Texas Neurosurgery. But as the disease worsens and drugs lose their effectiveness, we also may opt for deep brain stimulation.
Various available drug treatments can control Parkinson’s symptoms for years. Here are some of our options.
- Levodopa — Also known as L-dopa, the body metabolizes this drug to produce dopamine. The brain won’t allow the body to directly be given dopamine, as defense systems block it, but the metabolization of Levodapa bypasses those defenses.
- COMT inhibitors — These drugs prolong Levodopa by blocking the enzymes that break it down, lengthening symptom relief.
- MAO-B inhibitors — These drugs block the action of the enzyme that breaks down dopamine.
- Dopamine-like drugs — These drugs imitate dopamine’s activity in the brain.
There are also various drugs that control various symptoms.
When drugs don’t work
If drugs either don’t work or are losing their effectiveness, one surgical technique we use with Parkinson’s is called deep brain stimulation (DBS). In this procedure, our surgeons place a wire deep inside the brain. The location of the wire matches the symptoms we are targeting. We use MRI or CT scanning to locate these areas. In most patients, the electrodes are placed on the thalamus, subthalamic nucleus, and globus pallidus. This treatment inactivates the parts of the brain that trigger the disease without destroying nearby brain tissue.
DBS provides patients with significant symptom relief. Some patients still may need to take some medication in addition to DBS, but generally the dosages can be vastly reduced.
If you or someone you know has symptoms of Parkinson’s disease, make an appointment to see the team at Texas Neurosurgery by calling 214-823-2052. We can improve your quality of life throughout the progression of the disease.