February 22, 1999 06:27 AM
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In his Essay on the Shaking Palsy, Parkinson's disease was first described by an English physician named James Parkinson back in 1817. The disease was named after him because of the masterful way he described his observations of the disease. "Involuntary tremulous motion, with lessoned muscular power, in parts not in action and even when supported, with a propensity to bend the truck forward ........ ; the senses and intellect being uninjured. " Parkinson's Disease or PD for short was a killer. Until the 1950's those afflicted with the disease would eventually become so incapacitated that death generally followed. Today 177 years since James Parkinson's essay the disease is still of unknown origin and is still best described by its visual characteristics which are: - Tremor or shaking in the limbs - Rigidity in the muscular systems of the body and - Bradykinesia or a slowness of movement. The tremor is often described as "pill rolling". Imagine holding an aspirin between your thumb and index finger and try to roll it back and forth between those fingers. Rigidity might be described by imagining yourself in a full body cast or by imagining your flexor muscles tightening so much that your spine begins to curve. The latin words for these two phenomenon are Paralysis Agitans - a paralysis of controlled body movement combined with an agitated uncontrolled movement of the limbs and head. (Kind of like a car stuck in neutral that has a misfiring spark plug.) The slowness of movement is often accompanied by a masked facial expression and a softening of the voice. Until recently these three conditions tremor, rigidity, and slowness of movement were about the only symptoms physicians could observe before making their diagnosis. Today there is one more important test, that is how the patient responds to the drug called LEVADOPA. LEVADOPA has been the miracle drug for Parkinsons Disease much like Insulin is for Diabetes, and Penicillin is for Syphilis. LEVADOPA, which is usually taken as a pill, is converted by an enzyme in the body, to the brain chemical called Dopamine. The drug was serendipitously or accidently discovered in the 1940's when a flu medicine was given to a person with the flu who also had Parkinson's disease. The persons flu symptoms were relieved and so were the Parkinsons symptoms. This medicine had the chemical called LEVADOPA in it. In the Oliver Sacks book which was made into the movie Awakenings Robert Di Nero played the role of a man who had Encephalitis and later in life developed Parkinsonism, and Robin Williams played the klutsy, but determined, doctor who finally proved that there was hope through Levadopa drug therapy for those afflicted with PD. |
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