Parkinson’s is a chronic progressive degenerative disorder affecting mainly people above the age of 60. Males are more prone than females. Worldwide prevalence is 0.3 – 1 %. If we talk about India alone, Parkinson’s disease is the second leading chronic degenerative disorder after Alzheimer, with a prevalence that is directly proportional to age. Between the age of 70-79 years, it could be as high as 280 for a Hundred thousand people.
Cause - It is triggered by the deficiency of chemical neurotransmitters, like dopamine and norepinephrine, in the substantia nigra, which is the part of the brain responsible for controlling mobility.
Symptoms- The main symptoms are tremor, rigidity, stiffness, slowing and imbalance however there are othernon-motor symptoms like apathy, anxiety, depression, dementia, sexual disturbances and sleep disturbances. It also affects the gastric system leading to lack of appetite, indigestion, constipation and Genito-urinary system producing a frequency of micturition and incontinence of urine.
Pre-detection tests - In Parkinson’s there is no test to detect Parkinson; it is mainly clinical examination to confirm the onset and the stage of the diseases. An isotope scan can be carried out to confirm the disease however, it is available in very few centres. The diseases relentlessly progress inspire of medicines as there is no curative treatment but these medications improve quality of life and patients can live a normal life with proper adjustment of treatment for a very long time.
Treatment - The treatment in the early Parkinson’s symptoms are very amenable to medical therapy mainly dopamine replacement therapy with L-dopa and carbidopa however as the disease advances and age advances there is less response to the standard medication and one needs to increase the frequency of medication and there are side effects of medications.
The non-motor symptoms also advance in the late Parkinson’s after 8-10 years of the disease and will require very complex treatment to continue dopaminergic stimulation.
Continuous Dopaminergic Therapy in Parkinson’s disease - For the first time in India, Nanavati Super Speciality Hospital in collaboration with Kings College of London launches Non-Oral Infusion Therapies - APO-Pen and APO-Pump. This radical treatment is a dopamine agonist and has a noble method of supplying dopamine stimulation at a low dose to get the desired benefits and prevent any side effects.