Introduction
Parkinson’s disease is a progressive nervous system disorder that affects movement and often causes tremors, stiffness and slowness of movement. As one of the most common neurological conditions in the UK, it’s estimated that about 145,000 people have Parkinson’s disease in the country. Getting an early and accurate diagnosis is key to effectively managing symptoms through treatment options available via the NHS. This article will provide an overview of Parkinson’s disease, causes, symptoms, diagnosis and the medication, therapies and surgery options typically covered by NHS England treatment guidelines.
What Causes Parkinson’s Disease?
Parkinson’s disease is caused by low dopamine levels in the brain. Dopamine is a chemical that helps nerve cells communicate and control movement. When dopamine producing nerve cells become impaired or die, communication between the brain and muscles weakens, resulting in Parkinson’s symptoms.
The exact reason these cells deteriorate is still unknown, but research suggests a combination of genetic and environmental factors contribute to most cases. Only about 10% of cases can be directly linked to specific genetic mutations.
Early Symptoms of Parkinson’s
Symptoms often begin gradually, occasionally starting on one side of the body. Early signs can be subtle and are different for each person. The main symptoms associated with Parkinson’s disease include:
- Tremor – Usually begins in the hand. May affect the hands, arms, feet or legs. Often starts on one side of the body.
- Slowed movement (bradykinesia) – Over time everyday tasks become slower and more difficult. Steps may become shuffled or arms not swing when walking.
- Muscle stiffness or rigidity – Muscles can stiffen or spasm, especially in the limbs, neck or trunk. Can cause pain and restrict range of motion.
- Impaired posture and balance – Stooped posture, instability or loss of balance can increase risk of falls.
As the condition progresses, additional symptoms may emerge like soft speech, masked facial expressions, dysphagia (trouble swallowing), bladder issues, sleep disturbances, fatigue, memory problems or depression.
Getting an Accurate Parkinson’s Diagnosis with the NHS
There are no standard diagnostic tests for Parkinson’s disease yet. NHS doctors typically diagnose it based on a thorough medical history, neurological exam, tests to rule out other conditions with similar symptoms, and observing response to Parkinson’s medication.
To evaluate symptoms, NHS neurologists may perform exercises to assess motor skill function. They’ll often look for at least two of the three main movement symptoms – resting tremor, rigidity or bradykinesia.
Doctors may order imaging tests like CT scans or MRI scans to check for other potential causes of symptoms. Blood tests can also help rule out conditions like vitamin deficiencies or thyroid disorders.
In uncertain cases, especially early on, it can take time to officially diagnose. Follow up medical reviews help confirm it’s Parkinson’s as symptoms progress and response to medication is assessed over months.
NHS Covered Treatment Options for Parkinson’s
While there is no current cure for Parkinson’s disease, various therapies and medication can provide relief for motor and non-motor symptoms. Treatment is tailored to each patient’s evolving array of symptoms through the NHS.
Medications
Several types of drugs and combinations may be prescribed based on symptoms:
- Levodopa – Helps replace lost dopamine. Usually part of long-term treatment plans.
- Dopamine agonists – Mimic dopamine effects in the brain. Examples are ropinirole or pramipexole.
- MAO-B inhibitors – Prevent dopamine breakdown. Selegiline or rasagiline often given early on.
- Catechol-O-methyltransferase (COMT) inhibitors – Prevent levodopa breakdown. Entacapone commonly paired with levodopa.
Therapies
Beyond medication, additional therapies can improve mobility, speech or tremors:
- Physiotherapy – Stretches and exercises that increase strength, flexibility and balance.
- Occupational therapy – Adapting environments or learning ways to manage daily activities.
- Speech and language therapy – Exercises and strategies if speaking becomes difficult.
- Deep brain stimulation – Electrical impulses regulate brain activity. For advanced Parkinson’s.
Lifestyle Factors
Healthy lifestyle habits can also minimize symptoms. Tips include staying active, eating more fiber, establishing good sleep routines, working on cognition, avoiding triggers like infections, and joining a support group.
Surgical Options Available on the NHS
For patients who do not adequately respond to medication or therapy, two types of surgery may be considered:
- Deep brain stimulation (DBS) – Delivers electrical signals to targeted areas of the brain that help control movement. Can significantly improve motor function when done properly.
- Duodopa treatment – Involves continuously administering levodopa combined with carbidopa gel directly into the small intestine via a portable pump and tube. Helps during end of dose “off” periods when oral meds aren’t working.
These surgical options are only recommended for a small percentage of Parkinson’s patients. Strict eligibility criteria for DBS and duodopa treatment applies under NHS guidelines.
Conclusion
Parkinson’s disease diagnosis and tailored treatment can vastly improve quality of life through the NHS. By understanding the common symptoms and exploring medication, therapies and advanced surgical options, patients can work with their healthcare providers to find an effective care plan for managing this chronic neurodegenerative disorder.
The key is getting properly diagnosed early then consistently monitoring progression of symptoms over time. This allows doctors to make proactive treatment adjustments as Parkinson’s disease runs its course. Managing Parkinson’s requires dedication from both patients and NHS medical teams to control symptoms long-term.
