About Movement Disorders
Movement disorders encompass a range of neurological conditions that affect the ability to control bodily movements. Among the most common movement disorders are Parkinson's disease and tremors. Parkinson's disease is a progressive neurodegenerative disorder primarily affecting the motor system. Tremors, which can occur independently or as part of other neurological conditions, involve rhythmic shaking movements in various parts of the body.
Parkinson's disease is characterized by the degeneration of dopamine-producing neurons in the brain's substantia nigra region. This loss of dopamine results in impaired movement coordination and a range of motor and non-motor symptoms. Tremors, on the other hand, can be classified into different types, including essential tremors, which are benign and not linked to other diseases, and Parkinsonian tremors, which are specifically associated with Parkinson's disease.
Parkinson's Disease
Parkinson's disease manifests through a combination of motor and non-motor symptoms. The motor symptoms, often referred to as the cardinal signs of Parkinson's, include:
- Tremors (rhythmic shaking movements) which often start in one hand and can spread to other parts of the body as the disease progresses.
- Bradykinesia (a slowness of movement) which makes routine tasks such as walking, dressing and eating difficult.
- Rigidity (or muscle stiffness) that can limit the range of motion and cause discomfort.
- Balance issues that can lead to falls and injuries.
Non-motor symptoms of Parkinson's disease are diverse and can significantly affect the quality of life. These include:
- Sleep disturbances: insomnia, restless legs syndrome (RLS) and rapid eye movement (REM) sleep behavior disorder.
- Cognitive impairment: memory problems, difficulty concentrating and, in some cases, dementia.
- Mood disorders include depression, anxiety and apathy.
- Issues such as constipation, urinary problems and low blood pressure.
Although uncurable, treatment for Parkinson's disease aims to manage symptoms and improve the quality of life. Ideal medications for Parkinson’s patients are those designed to help replenish dopamine levels in the brain, dopamine agonists, MAO-B inhibitors and anticholinergics. Additional Parkinson’s treatments include a surgical procedure called Deep Brain Stimulation (DBS) that involves implanting electrodes into specific areas of the brain; physical therapy to improve mobility, balance and flexibility; occupational therapy to help with daily activities and maintain independence; and speech therapy to assist with any speech and swallowing difficulties.
Tremors
Tremors can vary in their presentation and underlying causes. The primary types of tremors are essential tremors, Parkinsonian tremors, cerebellar tremors and physiological tremors.
Essential are the most common type of tremors and primarily affect the hands, head, and voice. They are not typically associated with other neurological conditions and can be exacerbated by stress, fatigue and stimulants like caffeine. Parkinsonian tremors are a hallmark of Parkinson's disease and usually occur at rest. They often begin all on one side and can later spread to both sides of the body. Cerebellar tremors surface when there is damage to the cerebellum; these tremors occur during voluntary movements, such as reaching for an object. Lastly, physiological tremors, which tend to be mild, normal and occur in all individuals; physiological tremors usually caused by stress, fatigue or metabolic conditions.
The treatment of tremors depends on their type and severity. Essential tremors, for example, may be managed with a variety of medications based on tremor severity, Botox injections which can target specific muscles affected by tremor activity, physical therapy, which can strengthen and improve muscle control and there are even surgical solutions in some cases. Parkinsonian tremor treatment generally follows the same principles as those outlined for Parkinson's disease, with adjustments based on individual needs and responses to therapy.