Parkinson’s disease Diagnosis and Treatment
Parkinson’s disease (PD) is a brain or neurological condition that causes uncontrolled and unintended movements such as difficulty with coordination and balance, stiffness, and shaking (Trist et al., 2019). The symptoms of the disease worsen over time. As the disease progresses, a patient might find it difficult to walk or move other body parts. The disease is also characterized by bradykinesia, rigidity, and tremor with postural instability appearing in some individuals (Trist et al., 2019). The purpose of this assignment is to analyze the provided case and discuss the diagnosis and treatment of PD.
Etiology of PD
In PD, certain neurons in the brain gradually die or break. Many of the PD symptoms are due to the loss of dopamine-producing neurons. Dopamine is a chemical messenger that regulates movement. When it decreases, brain activity will reduce, leading to movement problems and other signs of PD. The exact cause of PD is not known. However, Kouli et al. (2018) noted that factors such as genes and environmental triggers play a huge role in the development of PD. The authors noted that genes linked to PD are known as PARK. To date, researchers, link 23 PARK genes to PD (Bryois et al., 2020).
Bryois et al. (2020) noted that 10%-15% of people with PD report a family history of the disease. Apart from genes, PD is also linked to environmental triggers. One of the triggers of PD is cigarette smoking. Kouli et al. (2018) noted that cigarette smokers are more likely to develop PD than people to do not smoke cigarettes. Another risk factor is 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Kouli et al. (2018) found that 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is associated with nigrostriatal degeneration increasing people’s chances of developing PD.
Neurological Exam
One of the neurological exams that should be performed for the patient is motor function and balance. PD affects motor and balance, and this is why it should be assessed. The motor function may be tested by asking the patient to pull and push against the nurse’s hands with his legs and arms. Balance may be checked by asking the patient to stand and walk. The nurse will then assess how he stands or walks.
The second examination is speech. PD affects speech and makes one speak slowly or quickly. The patient’s speech can be examined by having a conversation with him. The third examination is assessing the patient’s reflexes such as smiling, blinking, or swimming hands when walking. The nurse can make a joke to see whether the patient smiles. Blinking will be assessed by observing how the patient responds to light.
Diagnostics
Bloem et al. (2021) noted that there are no specific tests to diagnose PD. A neurologist can diagnose a patient based on presenting symptoms, a neurological exam, and a patient’s medical history. However, one of the tests that can be used to diagnose the patient is a dopamine transporter (DAT) scan. This test shows the level of dopamine in the brain (Bloem et al., 2021). Second, magnetic resonance imaging of the brain (MRI brain) can be used to rule out other medical problems.
Diagnosis
One of the treatments for PD is levodopa. It reduces symptoms of PD by being converted to active dopamine by nigrostriatal nerve terminals in the brain (Gray et al., 2022). Gray et al. (2022) noted that once converted to dopamine, it increases the level of domine in the brain, thus reducing PD symptoms. Another medication is monoamine oxidase type B inhibitor (MAO-B inhibitor). This medication works by preventing the breakdown of dopamine in the brain, thus reducing symptoms of PD (Binde et al., 2021). According to Binde et al. (2021), the medication can be taken in conjunction with levodopa to improve its therapeutic effects.
Referrals
The referrals will be to a neurologist, a neurologist will examine the patient and determine the stage of PD. The neurologist can also determine if the patient needs medications or not. Second, I would refer the patient to a physical therapist. A physical therapist will help with his movement and motor activity. The physical therapist will provide a plan to help the patient walk and improve balance. The last referral is to a nutritionist. A nutritionist will help develop a diet plan that can help improve the patient’s muscle strength.
Follow-Up