Introduction
Parkinson’s disease is a disorder that affects brain areas that control movement, posture and balance. In most cases, it is known as involuntary and uncontrollable tremors. This disease doesn’t kill the patient instantly but the life becomes worse day after day, moment after moment. It is a complex disease that has many different systems, so that not everyone with the condition suffers from the same problems.
Parkinson’s disease is named after the British doctor who wrote the first book about the disease, in 1817. Parkinson called it, “The Shaking palsy,” or “paralysis agitans.” In those times, the term “agitans” referred to tremors. “Palsy” meant weakness and “paralysis” meant paralyzed.
In the early 1960’s doctors understood the importance of the brain chemical, dopamine (di-ortho-phenyl-alanine), followed shortly thereafter by the first substantive treatment for Parkinson’s disease, L-Dopa. The treatment for Parkinson’s Disease was very poor before this. L-Dopa wasn’t very popular at first, even though it had a scientific rationale, because it caused so much nausea and vomiting. Carbodopa was developed soon thereafter, to prevent the vomiting, leading to the combined medication, carbidopa/levodopa, marketed as Sinemet. This drug remains the single best drug we have for treating the symptoms of Parkinson’s disease.
PD is common. After Alzheimer’s disease, it is the second most common progressive, neurological disorder. The more that Parkinson’s Disease is studied, the more intricate our findings are. Although most people think of it as a disorder of movement, posture and balance, it may also affect behaviour of a person. Quality of life has become a central focus as we deal with a disease we cannot yet cure.
When we talk about treating Parkinson’s disease, we currently only mean treating the symptoms. The actual disease is an attack on the nerve cells in the brain, and, to a lesser extent, outside the brain. Current medications have been shown effective to improve symptoms, meaning that by helping to restore a more normal chemical balance in the brain, we improve the tremor, stiffness, slowness, mobility, etc, but we haven’t really altered the process that is causing the damage.
Signs & symptoms
- Tremor (trembling) in hands, arms, legs, jaw, or head.
- Stiffness of the limbs and trunk.
- Slowness of movement.
- Impaired balance and coordination, sometimes leading to falls.
Other symptoms that may be present are:
- Depression or other emotional changes
- Trouble chewing, swallowing, or speaking
- Trouble sleeping
- Constipation
Causes
Exact cause is not yet known.
Pathophysiology
The most prominent pathological findings in Parkinson’s disease are, degeneration of the darkly pigmented dopamine neurons, particularly evident in a part of the substantia nigra called the pars compacta. Significantly, the loss of dopamine in the pars compacta increases the overall excitatory drive in the basal ganglia, disrupting voluntary motor control and causing the characteristic symptoms of PD. There is also loss of dopamine in the neostriatum, and the presence of intracellular inclusion bodies known as Lewy bodies.
No specific test exists to diagnose Parkinson’s disease.
Following methods when combined with signs & symptoms help in diagnosis.
- medical history
- neurological evaluation
- physical examination.
- Single-photon emission computerized tomography (SPECT) scan called a dopamine transporter scan (DaTscan).
- blood tests, to rule out other conditions that may be causing your symptoms.
- Imaging tests, such as an MRI, ultrasound of the brain, and PET scans to rule out other conditions. (Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.)
Treatments
Treatment starts with levodopa (L-dopa). But it can cause stomach upset, so it is combined with another medicine called carbidopa to control these side effects. The combination drug is called carbidopa-levodopa (Parcopa, Rytary, Sinemet).
Prognosis
Parkinson’s disease is not a fatal one, but the condition can cause great strain on the body, and can make some people more vulnerable to serious and life-threatening infections. But with advances in treatment, most people with Parkinson’s disease now have a normal or near-normal life expectancy.
Complications
Cognitive Problems like thinking and reasoning problems.
Depression and Anxiety
Difficulty in Swallowing
Sleep Disorders including difficulty falling asleep and sleep apnoea.
Bladder and Bowel Problems
Positional vertigo
Loss of Sense of Smell
Fatigue without any cause
Pain in local areas or generalised body pain
Lower Sex Drive or sexual dysfunction
Disease & Ayurveda
In Ayurveda, all the diseases affecting the nervous system come under the Vaata dosha vitiation. In normal condition, Vaata is the controller of body & mind, it is responsible for all the movement. Like air, without any visible form, Vaatadosha travels all the body, fills up all the empty spaces and controls & regulates the functions of other doshas and dhatus (bodily tissues). When this Vaata dosha is vitiated, abnormal movements can occur as a symptom. When it happens in the form of tremours, it is called as Kampavaata.
Nidana
Vaatakopa can happen mainly in two ways.
- Dhaatukshaya (degenerative conditions such as in old age)
- Aavarana (obstruction in the channels like in a cyst or tumour)
Other causative factors for the vitiation of Vaata are as follows:
Physical
Dry, cold and old food items
Excess travelling & exertion
Trauma/injury
Exposure to wind
Loss of sleep
Psychological
Trauma or grief
Fear
Anxiety
Stress
Purvaaroopa
Not mentioned
Samprapti
Not mentioned
Lakshana
Kampa – tremours
Divisions
- Saama
- Niraaa(kevalavaata)
Prognosis
Yaapya in chronic cases
Krichrasaadhya in uncomplicated cases in young patients
Chikithsa
The ayurvedic treatment depends upon whether the kampavaata is saama or niraama. If aama is present, only rooksha therapies are done in the beginning. Application of Vaatahara oils and ghee preparations should wait until the aama is completely cleared and the srotas (channels) are open completely. If the Vaatakopa is due to obstruction, the discomfort will be relieved once the channels are open and the movement of Vaata is in normal balanced condition.
Samana
In Saama condition
Aamapachanam
Agnideepanam
Sarvangakashayadhara
Udwartanam
Once, the aama is relieved
Sirodhara
Abhyangam
Swedanam like pindasweda, shashtikapindasweda
Sirovasti
Siropichu
Sodhana
Sneha-sweada
Virechana
Asthapanavasti
Anuvasanavasti
Commonly used medicines
Ashtavargam kashayam
Aswagandharishtam
Drakshadi kashayam
Nirgundyadi Kashayam
Dhanadanayanadi kashayam
Pachanamrutham kashayam
Dhanwantharam Tailam
Ksheerabala Tailam
Kallyanakaghrutam
Dhanwantaram tailam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
No proven home remedy is there to cure Parkinson’s disease. But a healthy diet and lifestyle will improve the quality of life.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil, ragi.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active
Yoga
Exercises are contraindicated in patients with severe pain, imbalance or stiffness.
Regular stretching and mild cardio exercises are advised in other cases. Also, specific yogacharya including naadisuddhi pranayama, vrikshasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
vrukshasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only
Research articles
https://pubmed.ncbi.nlm.nih.gov/31631455/
https://www.ncbi.nlm.nih.gov/books/NBK536722/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2467461/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
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