Parkinson’s disease is a complex and often misunderstood movement disorder that affects over 11 million people worldwide. It is characterized by a combination of both excessive movement (tremors) and insufficient movement (slowness, rigidity), leading to difficulties with walking, speaking, balance, and coordination. While it is commonly associated with tremors and stiffness, the disease also subtly alters the way a person experiences life.
Parkinson’s disease arises from the gradual death of dopamine-producing cells in the brain. Dopamine is a critical chemical messenger responsible for controlling movement. The loss of these cells doesn’t happen suddenly; it can begin as much as 20 years before symptoms become noticeable. Early on, the brain compensates for this loss, hiding the symptoms until a critical number of cells have died. What triggers this cell death remains a mystery, though researchers know that misfolded proteins accumulate in the brain and disrupt normal cell function.
Certain risk factors are known to increase the likelihood of developing Parkinson’s, including exposure to pesticides, advancing age, and genetic mutations. However, the complete cause of the disease is still unclear. One of the most concerning aspects of Parkinson’s is how subtly it begins. Long before tremors or stiffness set in, early symptoms may go unnoticed or be attributed to other conditions.
A loss of the sense of smell is often an early sign that can precede the diagnosis by years. This symptom is distinct from the temporary loss of smell seen in conditions like COVID-19. Another early indicator is “dream enactment disorder,” where individuals physically act out their dreams, a behavior typically noticed by bed partners. Other early signs include constipation, though this is a common issue that doesn’t always indicate Parkinson’s.
Diagnosing Parkinson’s disease is largely a clinical process, relying on a patient’s history and physical examination. Classic symptoms such as tremors at rest, slowness of movement, rigidity, and postural instability help doctors confirm the diagnosis. While brain imaging such as MRI or CT scans can rule out other conditions, more specialized scans like the DaTscan can provide additional confirmation by showing dopamine activity in the brain.
Managing Parkinson’s requires a holistic approach, though treatment options in many regions, including Kenya, can be limited. Exercise and physical therapy are essential but underused tools in managing the disease. Regular exercise can alleviate symptoms and slow disease progression. Speech therapy, occupational therapy, and psychological support also play vital roles, but the scarcity of specialized therapists in Kenya means access is often limited to major cities.
The primary treatment for Parkinson’s is medication that helps replace the lost dopamine. Levodopa, a common drug, significantly improves symptoms for many patients. However, availability is inconsistent, with many pharmacies unable to stock the necessary medications, and costs can be prohibitive for many patients.
Parkinson’s disease is progressive, meaning symptoms worsen over time. Everyday tasks, such as dressing or eating, can become increasingly challenging. While medications can improve quality of life, they do not stop the disease’s progression, and their effectiveness may diminish as the disease advances. New complications, like involuntary movements or medication side effects, may emerge, but early diagnosis and comprehensive management can significantly improve outcomes.
Although there is no cure for Parkinson’s disease, the right support can allow individuals to lead fulfilling lives. Raising awareness about early warning signs can lead to earlier diagnoses and better management. Enhancing access to medications and specialist services is crucial, as is expanding training for healthcare professionals.
The global burden of Parkinson’s disease is rising, and Dr. Hooker calls for a collective effort from the medical community, families, and society to support those affected. As with any chronic condition, a Parkinson’s diagnosis should not define a person’s worth or limit their potential. With continued education, research, and support, there is hope that one day the progression of this silent, debilitating disorder can be halted.
