Parkinson's Disease: Causes, Symptoms & Treatments

This assignment delves into the complexities of Parkinson's disease, encompassing its causes, manifestations, and treatment options. It utilizes research papers from reputable sources like The Lancet Neurology and Jama to provide a comprehensive overview of the condition. Key topics covered include fall prevention strategies, the role of hypothyroidism, pharmacological treatments, cognitive impairments, and the relationship between essential tremor and Parkinson's disease.

Running head: PARKINSON’S DISEASE AND ITS TREATMENT
PARKINSON’S DISEASE AND ITS TREATMENT
Name of the Student:
Name of the University:
Author Note:

1PARKINSON’S DISEASE AND ITS TREATMENT
Executive Summary
The aged people often suffer from a type of chronic neurodegenerative disease
called the Parkinson’s Disease. It has no cure but a combination drug and
physiotherapic treatment can be of much help to increase the life span of the patient.
The main aim of the report is to identify the disease, the history of the patient if there
is any, setting goals, adopting various interventions to support the patient and
discussing the various outcomes that may follow the treatment procedures. In this
report the symptoms and medical history of Mr. Ratin Bhai has been observed
thoroughly and the goals have been set. Various interventions are adopted along
with the medications that he is following. Thus, to conclude the various intervention
may be of much help to the patient and Mr. Bhai also will be benefitted from it and
have a longer life.

2PARKINSON’S DISEASE AND ITS TREATMENT
Table of Contents
Introduction................................................................................................................. 3
Discussion...................................................................................................................3
Conclusion.................................................................................................................. 8
References..................................................................................................................9

3PARKINSON’S DISEASE AND ITS TREATMENT
Introduction
Mr. Ratin Bhai is an octogenerian widower, is diagnosed with both the
Parkinsons disease and hypothyroidism four years back. He is under the medication
for both the diseases and uses thyroxin, cabidopa/levodopa combination drugs and
entacapone. He lives alone as his wife died a year ago and has no children.
Recently, he observed to be suffering from a slight tremor and is facing problems in
carrying out the daily household choirs.
Parkinson’s disease is a chronic neurodegenerative disease, affecting mainly
the older people that have no treatments as such but the patients suffering from it
should be taken great care of (Rodriguez et al., 2015). The symptoms and the
treatment procedures vary greatly with different patients depending on the extent of
the disease they acquire.
The identification of the disease, the history of the patient, the goals of the
treatment and the various interventions that may be taken are the topic of
discussion. The outcome of the actions taken in order to cure the patient is also
discussed here in this report along with the lesson one might get from it.
Discussion
Scenario 1 outlines the social and physical condition of an eighty seven years
old widower. He has been diagnosed with Parkinson’s disease and hypothyroidism.
He uses different medications in order to control his hypothyroidism. Recently, Mr.
Ratin Bhai is observing that his hands are tremoring slightly and this problem is
increasing gradually (Thenganatt & Jankovic, 2016). He is under the medication like
thyroxin, carbidopa/levodopa and entacapone. Neurodegeneration is the outcome of

4PARKINSON’S DISEASE AND ITS TREATMENT
the aging process and this leads to the development of the Parkinson’s disease in
some cases. Hypothyroidism, another disease that Mr. Ratin Bhai is suffering from is
also the result of the aging process.
Hypothyroidism is a genetic problem and is one of the risk factors followed by
any autoimmune disease like type 1 diabetes or rheumatoid arthritis (Cappola,
2016). The anti-thyroid medications if taken can be another risk factor. Parkinson’s
disease has many risk factors which include aging, genetic factors, low levels of
vitamin B foliate and exposure to toxic substances. Parkinson’s disease makes the
daily activities challenging. He is feeling weak and faces trouble in motility.
Mr. Ratin Bhai have been suffering from hypothyroidism for four years and
takes medications in order to control it. He is under the medication of thyroxine for
hypothyroidism, carbidopa/levodopa combination drugs and entacapone combination
drugs for the treatment of Parkinson’s disease (Rascol, 2013). He is experiencing
slight tremor in his hands and this is only becoming worse gradually. He is also
facing problem in mobility, in his daily activities and his restricted mobility prevents
him from going anywhere.
The slight tremor that Mr. Ratin Bhai is experiencing may be drug-induced
tremor. Parkinson’s disease is accompanied by tremor, which also occur in the
hypothyroidism (Hallett, 2014). The tremor spreads to both sides of the body rather
than on just one side of the body and it is one of the most important symptom of
Parkinson’s disease. Slow limited movement being another important sign and is
experienced by Mr. Ratin Bhai and makes it difficult for him to move.
Parkinson’s disease is a non-fatal, degenerative disorder and progresses until
it enfeebles the patient (Pringsheim et al., 2014). It is benign in some cases and

5PARKINSON’S DISEASE AND ITS TREATMENT
severe in some with shorter life span. The other serious complications that may arise
due to the Parkinson’s Disease are pneumonia, choking, falls that may lead to
serious injury and sometimes death also. It also causes severity in movements to the
persons suffering from Parkinson’s Disease. The symptoms and response to the
medications varies with different patients.
Hypothyroidism on the other hand also has other severe health outcomes.
Body metabolism, altered mental functions and fatigue can occur as a result of
hypothyroidism (Carlé et al., 2014). Joint pain, myxodema, a condition of
unconsciousness and obesity may also contribute to the symptoms associated with
hypothyroidism.
Mr. Ratin Bhai has been diagnosed with Parkinson’s Disease and
hypothyroidism four years back. He is also detected with slight tremor recently that is
proceeding to worse. The slight tremor that Mr. Bhai has started to suffer from is the
mere outcome of the Parkinson’s Disease. Mr. Bhai is not able to perform his regular
activities as his strength is decreased due to the onset of the tremor. Bradykinesia
and poor balance may be observed in him (Bank et al., 2016). Mr. Bhai has gradually
developed tremor, a most noticed symptom of Parkinson’s Disease. Inspite of being
under the medication of carbidopa and levodopa combination, Mr Bhai’s tremor is
proceeding to worsen the situation. The anxiety that he is suffering as a result of the
increased tremor may only worsen his condition (Lin et al., 2015). He is gradually
losing control on his muscle and coordination. The weakness or intolerance and in
the activity can be diagnosed in a patient with hypothyroidism.
The most significant problem that he is now suffering is the Parkinson’s
Disease and the tremor in his limbs. This problem has been discussed with priority.

6PARKINSON’S DISEASE AND ITS TREATMENT
The dopamine producing neurons in the brain is degenerated slowly which
results in the disability to produce dopamine and as a result the ability to move
(Robbins & Cools, 2014). Parkinsonian tremor is a major problem faced by the
patients. So the goals should be established keeping this fact in mind. The primary
goal in the treatment of the Parkinson’s disease is to keep the person busy in regular
activities and allow themselves to be independent as long as they can. The goals for
the treatment can be set according to the needs of the patients and varies with them.
The treatment of the motor symptoms such as tremor and trouble in
movement of the Parkinson’s disease should be treated and is established as
another goal for its treatment (Connolly & Lang, 2014). Non-motor systems like
depression and anxiety would also get the priority in setting the goal of the treatment.
Moreover, the nurses should be trained and their knowledge about this disease must
be taught. The nurse should gain the confidence in treating and caring the patient
with this disease.
Parkinson’s disease is the problem associated with the nerves present in
brain any disorder in these nerves may eventually lead to the loss of the ability to
move and parkinsonian tremor.
There are few interventions that can be adopted by the nurses in order to
provide support to these patients. The nurses must administer the medicines
properly maintaining the schedule and the drug levels. They should encourage the
patients suffering from this disease to work independently and perform all the daily
choirs as much as they can (Sturkenboom et al., 2014). They should be given rest
between each work they perform on their own. This would make them to feel less
weak and prevent them from facing any accident. A frequent warm bath and

7PARKINSON’S DISEASE AND ITS TREATMENT
physiotherapy should be carried out on them which would help in relaxing the muscle
and prevent any chance of muscle cramp.
The parkinsonian tremor may sometime result in the fall and as a result the
patient may get seriously injured. The nurse should protect the patient from facing
any such injuries (Canning, Paul & Nieuwboer, 2014). They should be provided with
semi-solid foods which is easier to swallow and make him sit upright while eating.
The drugs that is used to treat the disease should be monitored and any kind of
adverse situation, if occur should be reported immediately. The weight of the patients
should be regularly monitored and evaluate the patients nutrition.
Mr. Bhai would gradually gain the ability to perform his daily household choirs
independently and would gain confidence and doing so. The rest that is provided
would make him less weak and he would be capable to do work with more
confidence. He should be given frequent warm bath and physiotherapy that may help
in the improvement of the parkinsonian treatment (Tomlinson et al., 2014). This may
cure the tremor that Mr. Bhai is experiencing to some extent and he would not find
any difficulty to move. The improved motility would prevent him from falling and
reduce the risk of facing any accident that lead to any severe injury or even death.
Mr. Bhai would also be provided with semi-solid food. The semi-solid food
helps him to swallow the food without difficulty. The various interventions that are
adopted to provide neuroprotective benefits to the patients are capable of changing
the disease course. The neurological care should be provided to Mr. Bhai would
save his life. The encouragement of performing various daily works increases his
physical activity and in turn helps to prevent the deterioration in the quality of the life.

8PARKINSON’S DISEASE AND ITS TREATMENT
Parkinson’s Disease is the neurodegenerative disorder and the patients
suffering from this needs a good care from the nurses and the care givers. I feel that
Mr. Bhai should be allowed to be independent so that he would gain the confidence
to work in his own and overcome his fear. I believe that by doing this, Mr. Bhai would
not suffer from anxiety as it can cause more harm to them by increasing the
Parkinsonian tremor. I believe that he should undergo a speech and swallow therapy
from the very beginning so that he would not lose the ability to swallow when the
muscle coordination would get disturbed.
According to me, a regular physiotherapeutical approach may help to cure the
Parkinsonian tremor to a certain extent and increase his life span. I should have
asked Mr. Bhai to use antichollnergic agents as these agents are mainly used by the
patients who is suffering from restricted motility due to the tremor. I believe that the
medical management is an important for the cure of this disease and from the next
time onwards I would adopt this method as one of the steps for treatment.
Conclusion
Parkinson’s disease being the fatal and incurable neurodegenerative disease
occurs frequently among the older people. The people suffering from this disease
require extra care as the disease progresses to worsen the condition. The symptoms
and the responses to different medications and treatments vary greatly with the
patient and the extent of the disease. Parkinsonian tremor is one of the important
symptoms associated with it. A combination drug is used for the treatment of the
Parkinson’s Disease.
The patient should be allowed to work independently and physiotherapic
treatment is carried out to the patient as a part of the treatment. The patient is given

9PARKINSON’S DISEASE AND ITS TREATMENT
rest in between the works that he performs daily. It can be concluded from the above
discussion that by adopting various steps the patient with Parkinson’s Disease can
be treated to a certain extent. The above discussion makes us to conclude that the
patient must also be made to overcome his fear and anxiety and help him to gain
confidence to work on his own and take his medications accordingly.

10PARKINSON’S DISEASE AND ITS TREATMENT
References
Bank, P., Marinus, J., de Groot, J. H., Meskers, C., & van Hilten, J. J. (2016).
Objective, unobtrusive assessment of bradykinesia in Parkinson's
disease. Movement Disorders, 31, S505.
Canning, C. G., Paul, S. S., & Nieuwboer, A. (2014). Prevention of falls in
Parkinson's disease: a review of fall risk factors and the role of physical
interventions.
Cappola, A. R. (2016). Hypothyroidism in the Elderly. In 2016 Meet-The-Professor:
Endocrine Case Management (pp. 355-358). The Endocrine Society.
Carlé, A., Pedersen, I. B., Knudsen, N., Perrild, H., Ovesen, L., & Laurberg, P.
(2014). Hypothyroid symptoms and the likelihood of overt thyroid failure: a
population-based case–control study. European journal of
endocrinology, 171(5), 593-602.
Connolly, B. S., & Lang, A. E. (2014). Pharmacological treatment of Parkinson
disease: a review. Jama, 311(16), 1670-1683.
Hallett, M. (2014). Tremor: pathophysiology. Parkinsonism & related disorders, 20,
S118-S122.
Lin, C. H., Lin, J. W., Liu, Y. C., Chang, C. H., & Wu, R. M. (2015). Risk of
Parkinson's disease following anxiety disorders: a nationwide population‐
based cohort study. European journal of neurology, 22(9), 1280-1287.

11PARKINSON’S DISEASE AND ITS TREATMENT
Pringsheim, T., Jette, N., Frolkis, A., & Steeves, T. D. (2014). The prevalence of
Parkinson's disease: A systematic review and meta‐analysis. Movement
disorders, 29(13), 1583-1590.
Rascol, O. (2013). Extended-release carbidopa-levodopa in Parkinson's
disease. The Lancet Neurology, 12(4), 325-326.
Robbins, T. W., & Cools, R. (2014). Cognitive deficits in Parkinson's disease: a
cognitive neuroscience perspective. Movement Disorders, 29(5), 597-607.
Rodriguez, M., Rodriguez‐Sabate, C., Morales, I., Sanchez, A., & Sabate, M. (2015).
Parkinson's disease as a result of aging. Aging cell, 14(3), 293-308.
Sturkenboom, I. H., Graff, M. J., Hendriks, J. C., Veenhuizen, Y., Munneke, M.,
Bloem, B. R., ... & OTiP Study Group. (2014). Efficacy of occupational therapy
for patients with Parkinson's disease: a randomised controlled trial. The
Lancet Neurology, 13(6), 557-566.
Thenganatt, M. A., & Jankovic, J. (2016). The relationship between essential tremor
and Parkinson's disease. Parkinsonism & related disorders, 22, S162-S165.
Tomlinson, C. L., Herd, C. P., Clarke, C. E., Meek, C., Patel, S., Stowe, R., ... & Ives,
N. (2014). Physiotherapy for Parkinson's disease: a comparison of
techniques. The Cochrane Library.