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Treating Parkinson's: A Brief Overview of Options

Posted Aug 24 2008 1:49pm
ANNOUNCER: Giacomo Vigilanza is waiting to see his doctor. He's traveled all the way from Venezuela to Miami for a follow up on his Parkinson's Condition. He doesn't speak English. His daughter translates.

ADRIANA GARCIA: Ok, he says the shaking.

ANNOUNCER: Giacomo Vigilanza is 74. He's had Parkinson's disease for 8 years. Since his previous doctor's visit, his Parkinson's symptoms have advanced.

LUCIAN CÔTÉ, MD: Parkinson's disease is a progressive, degenerative process taking place in a certain part of the brain causing movement difficulties.

ANNOUNCER: That part of the brain is the Substantia Nigra. Loss of dopamine producing neurons in the substantia nigra cause the nerve cells to spin out of control resulting in an inability to control muscle and body movements normally.

LUCIAN CÔTÉ, MD: The most easily recognizable symptom of Parkinson's disease is of course is the tremor. The tremor is very specific. It's a rest tremor. Meaning that when the limb is at rest, the tremor shows up and when you move the limb, the tremor becomes less severe, sometimes even disappears completely.

The second symptom of Parkinson's disease is increased muscle tone rigidity.

A third symptom of Parkinson's disease is difficulty initiating movement. A patient with Parkinson's, for instance, will have difficulty getting up from a chair or any of the movements that they have to make that are automated tends to be slowed down.

BLAIR FORD, MD: About a million Americans are affected with Parkinson's disease. The average age of onset is mid-fifties -- 55, 56. Although 10 percent of patients have the onset before the age of 40, young onset Parkinson's disease.

The medications include drugs that treat the symptoms of Parkinson's disease. The first of these was levodopa or Sinemet. There are many subsequent medications, dopamine agonists. And all of these help Parkinson's disease for many years in patients. The problem with the medications is that after five years or more, although they still continue to work, they have side effects and the side effects include wearing off problems, the dyskinesia problem. These problems are manageable with a change in medication, but they're not necessarily easy to manage. For this reason, patients often consider a neurosurgical approach. These techniques go back to the 1950s, but only in recent years have they become refined. The most effective neurosurgical treatment for Parkinson's disease at the moment is deep brain stimulation.

ANNOUNCER: Today, Parkinson's patients can be active and mobile using combination therapies and treatment options available. And for Giacomo Vigilanza, now living 8 years with Parkinson's, it means symptoms can be eased to make living with Parkinson's manageable.

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