Parkinson’s

older man with nurse

Did You Know That…  Michael J. Fox has Parkinson’s.  He explained to everyone in 1998 that he had Parkinson’s disease.  In 2000, he established his Michael J. Fox Foundation for Parkinson’s Research.  Michael is one of those actors that everyone automatically loves.  The diagnosis of Young-Onset Parkinson’s Disease was made in 1991 when he was only 29 years old.  His research foundation has grown to be the world’s largest source of funding for medication development for Parkinson’s, and despite ongoing fluctuations in his medical condition and abilities, he remains a strong advocate for more research.  He went back to acting full-time in 2012, playing the character Mike Henry on his The Michael J. Fox Show.  He also makes many guest appearances in movies and TV, usually playing clever attorneys.  In the spring of 2019 he let people know that his health had taken a turn for the worse.  He began having difficulty feeling his legs, and as a result, had frequent falls.  Frequent falling is always a dangerous sign.  To preserve the function of his legs and his mobility he needed spinal surgery, followed by a period of intense physical therapy.  At one point after his surgery and physical therapy he slipped in his kitchen, fell, and badly fractured his arm.  After his surgeon put in a plate and 19 pins, Michael is soldiering onward.  In retrospect he thinks he tried to push himself too far and too fast after the spinal surgery.

Articles related to Parkinson's Disease:

Really Common Condition

Parkinson disease is common.  Each of us probably knows someone who has or had it.  It’s one of the most common diseases of the nervous system.  About 1 out of every 100 people over age 60 will get Parkinson’s.

Young Onset Before Age 50

Parkinson’s is not that unusual in younger individuals.  For every 20 people with Parkinson’s one of the 20 might well be under age 50.  Said another way, about 5% of people with Parkinson’s have the onset before age 50.

What Are the First Signs of Parkinson’s?

Probably tremor, a mild shakiness.  It’s usually a shaking of one hand or the other but the shaking could be in an arm or leg instead.  It’s a tremor at rest.  That is, the shaking stops when the person actually uses his hand, such as reaching to pick up an object.  The tremor is there when the person’s hand is relaxed and at rest.  The usual description is called a “pill-rolling” tremor.  The person’s hand rests there and, all by themselves, the thumb and forefinger move as though the person is rolling a pill or a pea between them.

Gradually other things change.  Walking (“gait”) might change, or how a person stands (“station”).  The look on their face might be different, more fixed, less mobile (“masked facies”).

The Stages

As time goes by more symptoms appear.  The arms don’t swing in quite the same way when the person walks.  Their face moves less when they talk, or smile, or frown.  Their voice gets quieter.  Parkinson’s experts talk of several stages of the condition.  The links below will give a great deal more information on these stages and the evolution of Parkinson’s over time.

Signs You Don’t See

In addition to the visible changes, there are medical changes that are not obvious to the observer.  The person’s sense of smell may diminish.  His thought processes might be slowed as compared to his previous quick-minded self, and he might feel generally physically weak.  The person might feel “general malaise”, a bit sick and ill all the time.  The experience of life is not enjoyable, setting the stage for the possible onset of depression.

Unpredictable

Physicians don’t have a crystal ball predicting any single patient’s experience of and course of Parkinson’s.  There’s no way to tell prospectively how Parkinson’s will affect a person.  It’s a chronic condition.  Once it starts it continues the rest of the person’s life.  And it’s progressive, that is, as time goes by it gradually but continually gets worse.  Some people are lucky in that they have only minor medical effects.  And tremor is not the worst problem for everyone with Parkinson’s.

Intense International Push for Research on Treatments and Cures

Thanks to the efforts of well-known celebirty advocates of research for Parkinson’s, like Michale J. Fox, there is increasing public interest in finding answers.  Public interest pushes public funding sources.  The result is a major, worldwide push to beat Parkinson’s.  The research is across many areas, even straightforward areas like the types of exercise one can do to slow the progression of Parkinson’s.  Pharmaceutical industry and academic studies search for new chemical entities for new medications.  Various institues search for effective non-medicinal treatments.  Molecular biologists look for intracellular mechanisms relevant to treating and/or curing Parkinson’s.  Pre-clinical labs use various genetic animal models to find new treatments.  Genetically-modified animals have been made that behave as people do when they have Parkinson’s.  Researchers can test trial medications using these highly-specialized animal models to see if they are safe to give to people.

And Now for a Bit of Medical History… In Egypt a description from 3200 years ago was found about an elderly king drooling.  The king might have had what we now call Parkinson’s.  There are many mentions of elderly with tremor in ancient texts in India and China.  It’s a hard call to say these texts described Parkinson’s, though, because there are so many disorders, especially in the elderly, that might involve tremor or drooling.  More specific is a document from 3000 years ago describing a disorder with tremor, lack of movement, drooling, and other Parkinsonian symptoms.  Even more specific, this patient was given drugs from a tropical legume, the mucuna plant family, that is high in L-dopa content.  About 2000 years ago that most well-known physician of antiquity, Galen, also gave a description specific enough to have really been Parkinson’s, saying that the patient had resting tremors, changes in posture, and paralysis.  As usual, during the Dark Ages, no descriptions are found.  Good medical histories appear in the 1600s and 1700s with the typical signs and symptoms mentioned, tremor at rest, odd festinating gait, other abnormal movements, and rigidity.  Then came James Parkinson in 1817 with his six cases of paralysis agitans, the first reliable, specific description of what is now known as Parkinson’s disease.  These past 200 years have seen better understanding, more helpful treatments, and defining Parkinsonian subtypes, but no change in the broad clinical description of Parkinson’s disease.

Helpful links:

ClinicalTrials.gov – National Library of Medicine (United States) – 943 studies found for Parkinson’s

https://clinicaltrials.gov/ct2/results?cond=Parkinson+Disease&term=&cntry=US&state=&city=&dist=

National Institutes of Health, National Institute of Neurological Disease and Stroke

https://www.ninds.nih.gov/Disorders/All-Disorders/Parkinsons-Disease-Information-Page

National Institutes of Health, National Institute on Aging

https://www.nia.nih.gov/health/parkinsons-disease

National Library of Medicine (United States)

https://medlineplus.gov/parkinsonsdisease.html

Parkinson’s Foundation

http://www.parkinson.org/understanding-parkinsons/

The Michael J. Fox Foundation for Parkinson’s Research

https://www.michaeljfox.org/understanding-parkinsons/i-have-got-what.php?navid=diagnosis&smcid=ag-a30U0000000OXAo&s_subsrc=what_is_parkinsons

The Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055