INTRODUCTION:
Parkinsonism or parkinson’s disease is a syndrome characterized by tremor at rest,bradykinesia,rigidity and postural unstability.It is a neurological degenerative disease which impairs the motor skills and speech of the patient.
Symptoms begin gradually and aggravates with time, difficulty in walking and talking along with mental, behavioral changes, sleep problems, depression, memory lapse, and fatigue.
EPIDEMOLOGY:
Onset of disease is after age 60,sometimes as early as age 50 is also often seen.Certain genes are also reponsible in some people.
CAUSES OF PARKINSONISM:
The nerve cells in the basal ganglia, an area of the brain that controls gait, function abnormally or die. Dopamine and acetylcholine operate as antagonistic transmitters in corpus striatum of brain. So when the neurons die there is reduction in dopamine, which disturbs the normal balance and equilibrium causing parkinsonism.
There is loss of the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, responsible for proper functioning of heart rate and blood pressure.
SYMPTOMS OF PARKINSONISM:
Rigidity or muscle stiffness
Slow and monotonous speech.
Impaired balance and coordination, sometimes leading to falls
Other symptoms may include:
Depression and mental disturbances
Difficulty swallowing,drooling of saliva,excessive sweating and greasy skin.
Urinary and bladder complaints or constipation
skin problems and infrequent blinking.
A parkinsonian gait is a tendency to lean forward, take small and quick steps,and reduce swinging of arms while walking.
Symptoms may begin unilaterally on one side and as disease progresses, both sides are affected.However one side may still have dominant symptoms.
CHANGES IN COGNITION:
cognitive function, problems with memory, attention, focus, and the ability to plan and implement changes. Stress, depression, mood swings,medications may also bring changes in cognition.
Dementia is the result of a full blown disease labelled as parkinson’s dementia, leading to severe memory and thinking difficulty.
DIAGNOSIS OF PARKINSONISM
Person’s medical history and neurological examination can help in diagnosis and treatment.
Differential diagnosis include
Pseudobulbar palsy,Epilepsy,Wilson’s disease especially seen in young people and Huntington’s chorea.
TREATMENTS:
Medicines for Parkinson’s disease:
Drugs that increases dopaminergic activity in the basal ganglia
Neurotransmitters which help exchange of information between brain cells
Physiotherapy and Rehabilitation.
Homoeopathic management and treatment:
understanding the psychodynamics of Parkinson’s Disease,there is a strong desire to control everything and everyone involving the patient’s environment.Homoeopathy takes into consideration all these mental,emotional and intellectual attributes of the patient along with his family realtionship,work relationship dynamics.This helps to make a good totality of the case based on which a most accurate similimum(remedy) is given.
Homoeopathy is known to fully control and improve the quality of life in such patients.
A case of Parkinson’s Disease
40year old man entered my clinic with a complaint of tremors in his fingers, and his left-hand shivering.
Observation: The patient appeared to be reserved, though he answered when I questioned him.
Doctor: Yes, tell me
Patient: I have had this complaint of tremors for some time, and I think it happened because of arthritis.
Because of this doctor, I have lost confidence and avoided going out to meet relatives or friends.
Doctor: How did this start?
Patient: Actually, I am very unhappy with my professional life because I lost my job. I want to do things my way. Also, I love to travel.
Patient’s wife: Interrupted by saying that actually, he is a very lazy guy who doesn’t like taking any responsibility. He just keeps dictating his terms to us all. He is always very angry and dissatisfied. His wife narrated that his childhood was full of domination by his father.
The patient looked very awkward from his hand tremors. He had many dreams of achieving things in life and sounded quite ambitious.
The case was very short as the patient was in no mood to reveal anything further.
If we understand this case from the psychodynamic aspect of the disease (Parkinson’s) some interesting traits found were an intense desire to
control everything and everyone.
Based on the above information the following rubrics were selected
Rubrics Selected:
Mind;A/F Domination
Anger himself about
Self-depreciation
A/F contradiction
Helplessness feeling about
Remedy selected:Anacardium 200 3 divided doses stat,followed by 0/1…0/4
As this is a complex disease it requires further assessment. The case was followed up to 1 year with great improvement in overall personality of the patient.