Parkinson’s Disease

Parkinson’s Disease

A 67-year-old man presents to the HCP with chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair. Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement. The patient states that he has episodes of extreme sweating and flushing not associated with activity. Laboratory data unremarkable and the HCP has diagnosed the patient with Parkinson’s Disease.

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Answer

 

 

Parkinson’s Disease

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Parkinson’s Disease as a neurological movement disorder

Parkinson’s disease refers to a neurological movement disorder that has no cure (In Singer & In Reich, 2019). However, most patients can sustain a good quality life if they abide to prescriptions written down by their health care providers. More so, in some patients, surgery can help improve the symptoms. Some of the common symptoms include tremors, stiff muscles, unsteady walk and balance, coordination problems among other symptoms.

Neurological and Musculoskeletal Pathophysiologic Processes of why the Patient Presents these Symptoms

Parkinson’s diagnosed patients present some of these symptoms as a result of nerve cells found in an area of the brain known as the substantia nigra becoming impaired or dying (In Singer & In Reich, 2019). The work of these cells is to produce a chemical known as dopamine which is a neurotransmitter. This chemical helps the cells of the brain to communicate by transmitting signals between different areas in the brain. When this cells die or become impaired, the remaining cells produce less dopamine. Furthermore, dopamine is especially important for the operation of another area of the brain. This is the basal ganglia. This area of the brain is responsible for organizing the brains command which allows for body movement (In Björklund & In Cenci, 2020). The loss of dopamine therefore causes the movement symptoms as seen with the case of the 67 year old man who has been diagnosed with this disease.

Additionally, people diagnosed with Parkinson’s disease also lose another neurotransmitter called norepinephrine. This chemical is required for proper functioning of the sympathetic nervous system. This system is responsible for some of the body’s autonomic functions such as digestion, blood pressure, breathing and even heart rate (In Singer & In Reich, 2019). Loss of this chemical causes some of the non-movement related symptoms shown by the diagnosed patient such as profuse sweating and flushing.

How the Highlighted Processes Interact to Affect the Patient

Neurological and musculoskeletal pathophysiologic processes interact bringing about the symptoms presented by the patient.  Among the first symptoms are tremors, rigid muscles, slowness of movement, unsteady walk and balance and coordination problems. This is associated with the decrease in production of dopamine which is a necessity for basal ganglia, an area in the brain responsible for organizing the brain’s commands associated with movement (In Björklund & In Cenci, 2020). Other additional symptoms presented by the patient include;  his face exhibiting a mask-like appearance, episodes of extreme sweating and flushing. This is most probably as a result of loss of norepinephrine. This chemical is associated with the non-movement related symptoms (In Björklund & In Cenci, 2020). A combination of the loss of both chemicals results in the patient exhibiting all the symptoms highlighted by the case study. Not only is the man’s movement affected but also non-movement as presented by his symptoms.

Racial/Ethnic Variables that may Impact Physiological Functioning

According to Abbas, Xu & Tan (2018) about 50% more men than women get Parkinson’s disease. Notably, it is most common in persons 60 years of age and older. Abbas, Xu & Tan (2018) state that up to 10% of patients are diagnosed before age 50 and that 60,000 new Parkinson’s related cases are recorded in the United States each year. During diagnosis, the doctor also enquires about your medical history as well as family history of neurologic disorders. This is because Parkinson’s disease can be passed down through genetics hence people who get early-onset of the disease are most likely to have inherited it. In an epidemiological study carried out in the United States, the disease is common in the Midwest and Northeast and is twice likely to strike whites and Hispanics more than blacks and Asians (Abbas, Xu & Tan, 2018).

 

References

Abbas, M. M., Xu, Z., & Tan, L. C. S. (January 01, 2018). Epidemiology of Parkinson’s  Disease—East Versus West. Movement Disorders Clinical Practice, 5, 1, 14-28.

In Björklund, A., & In Cenci, M. A. (2020). Recent advances in Parkinson’s disease.   Amsterdam: Academic Press.

In Singer, C., & In Reich, S. (2019). Parkinson Disease, An Issue of Clinics in Geriatric     Medicine.

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