Hello again!
I guess in my haste trying to introduce this project, I failed to mention the cardinal traits of Parkinson's disease. When shadowing Dr. Kasoff, I was able to see first hand a few of these PD symptoms.
1.) Resting tremor: This cardinal trait is what we widely associate with Parkinson's Disease patients. Patients present with an involuntary shaking in their arms and/or legs (it's uncommon for tremors to occur in the jaw, face, or trunk, but still possible) when the muscles are relaxed, hence the term "resting tremor". The resting tremor can be emphasized when the patient is distracted. In other words, sometimes the doctor will ask the patient to perform simple arithmetic problems in their head so the resting tremor can be "brought out" more (Ms. K you were right; mental math is always lurking around the corner). The tremor usually starts in one finger then progresses to the hand etc before passing to the other side. If the tremor is only present on one side of the body, then only one hemisphere of the brain will be implanted with an electrode (unilateral DBS, one burr hole). And if the patient experiences tremors on both sides, then both sides of the brain will be stimulated (bilateral DBS, two burr holes).
2.) Rigid movement: The term "cog-wheel rigidity" is often coined to describe the motion of Parkinson's patients. Similar to how a cog-wheel spins, the movement of a PD patient is a series of frequent pauses and jerky quick movements. The muscle tone of PD patients is always stiff which reduces their range of motion (ex. not swinging arms when walking). As you can imagine, this is extremely uncomfortable and in some cases can be painful.
3.) Bradykinesia: This is a fancy term for slow movement, but can also mean a general reduction of spontaneous movement. Patients presenting with bradykinesia are often abnormally still and struggle with repetitive movements like brushing their teeth, tapping their fingers, and walking (they walk in short shuffling steps).
4.) Postural Instability: Postural instability is exactly what it sounds like: the tendency for a patient to lose balance when standing, getting up, turning, or being pushed. I realize that pushing a PD patient sounds absolutely cruel, but in order to test for postural instability, doctors will pull (with some force) the patient and see how he/she recovers. A person without PD will adjust his footing when pulled but a PD patient will topple backwards (safely into the arms of the doctor).
Those are the four cardinal traits of Parkinson's Disease, but there are many other symptoms you can look for. The list is quite long, so I will only mention the two that I saw.
Hypophonia: soft speech can be a result of bradykinesia
Hypomimia: masked face (little to no facial expressions) can also be a result of bradykinesia
Now you must be wondering, how do you get Parkinson's Disease? We don't know exactly. There is a very very small genetic component, but we do know that patients with PD have fewer dopamine cells.
Image Source: http://www.doctortipster.com/10064-parkinson-disease-symptoms-and-diagnosis.html
http://blogs.brandeis.edu/flyonthewall/files/2014/08/Post4_1.jpeg
Sources: http://www.pdf.org/symptoms_primary
I guess in my haste trying to introduce this project, I failed to mention the cardinal traits of Parkinson's disease. When shadowing Dr. Kasoff, I was able to see first hand a few of these PD symptoms.
 |
| A patient presenting with some symptoms of Parkinson's Disease (PD). |
1.) Resting tremor: This cardinal trait is what we widely associate with Parkinson's Disease patients. Patients present with an involuntary shaking in their arms and/or legs (it's uncommon for tremors to occur in the jaw, face, or trunk, but still possible) when the muscles are relaxed, hence the term "resting tremor". The resting tremor can be emphasized when the patient is distracted. In other words, sometimes the doctor will ask the patient to perform simple arithmetic problems in their head so the resting tremor can be "brought out" more (Ms. K you were right; mental math is always lurking around the corner). The tremor usually starts in one finger then progresses to the hand etc before passing to the other side. If the tremor is only present on one side of the body, then only one hemisphere of the brain will be implanted with an electrode (unilateral DBS, one burr hole). And if the patient experiences tremors on both sides, then both sides of the brain will be stimulated (bilateral DBS, two burr holes).
2.) Rigid movement: The term "cog-wheel rigidity" is often coined to describe the motion of Parkinson's patients. Similar to how a cog-wheel spins, the movement of a PD patient is a series of frequent pauses and jerky quick movements. The muscle tone of PD patients is always stiff which reduces their range of motion (ex. not swinging arms when walking). As you can imagine, this is extremely uncomfortable and in some cases can be painful.
3.) Bradykinesia: This is a fancy term for slow movement, but can also mean a general reduction of spontaneous movement. Patients presenting with bradykinesia are often abnormally still and struggle with repetitive movements like brushing their teeth, tapping their fingers, and walking (they walk in short shuffling steps).
4.) Postural Instability: Postural instability is exactly what it sounds like: the tendency for a patient to lose balance when standing, getting up, turning, or being pushed. I realize that pushing a PD patient sounds absolutely cruel, but in order to test for postural instability, doctors will pull (with some force) the patient and see how he/she recovers. A person without PD will adjust his footing when pulled but a PD patient will topple backwards (safely into the arms of the doctor).
Those are the four cardinal traits of Parkinson's Disease, but there are many other symptoms you can look for. The list is quite long, so I will only mention the two that I saw.
Hypophonia: soft speech can be a result of bradykinesia
Hypomimia: masked face (little to no facial expressions) can also be a result of bradykinesia
Now you must be wondering, how do you get Parkinson's Disease? We don't know exactly. There is a very very small genetic component, but we do know that patients with PD have fewer dopamine cells.
That's all for now. Stay tuned for some surgery experiences in the next post!
Holly
Image Source: http://www.doctortipster.com/10064-parkinson-disease-symptoms-and-diagnosis.html
http://blogs.brandeis.edu/flyonthewall/files/2014/08/Post4_1.jpeg
Sources: http://www.pdf.org/symptoms_primary
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