The prevalence of Parkinson’s disease has seen a significant rise over the past 25 years. According to the World Health Organization (WHO), the number of people living with Parkinson’s reached over 8.5 million in 2019, a number that is expected to continue growing as the population ages. While there is no cure for Parkinson’s disease, advances in treatment and management strategies are offering hope for those affected.
Parkinson’s is primarily a neurodegenerative disorder that commonly affects older individuals. It is often characterized by movement-related issues such as tremors, stiffness, and slowness of movement. However, as Associate Professor Dr. Tan Ai Huey, a consultant neurologist at UM Specialist Centre, explains, some patients may also experience non-motor symptoms, including sleep disturbances, memory decline, hallucinations, constipation, urinary problems, fluctuations in blood pressure, pain, and sensory issues. Not all patients will experience the same symptoms, and some may find certain challenges more difficult to manage than others.
Growing Incidence and Risk Factors
Dr. Tan highlights that only about 10 to 15 percent of Parkinson’s cases have a clear genetic link, with approximately one in ten patients having a family history of the condition. Despite this, the number of cases has dramatically increased in the past two decades, with projections indicating a continued rise in the coming years. Malaysia is no exception to this global trend, as the country moves toward becoming an ageing nation, with Parkinson’s primarily affecting older individuals.
Environmental factors, such as exposure to pesticides, chlorinated solvents, and air pollution, have also been linked to a higher risk of developing Parkinson’s disease, further contributing to the rising incidence of the disorder.
Diagnosis and Treatment Options
Diagnosing Parkinson’s disease involves clinical criteria and often requires a specialist’s assessment for accuracy. Dr. Tan emphasizes the importance of consulting a neurologist to ensure proper diagnosis, as some conditions can mimic Parkinson’s symptoms. Additional tests, such as brain imaging, may be conducted to rule out other potential causes.
There is no one-size-fits-all approach to treating Parkinson’s. Treatment typically involves medications aimed at replacing dopamine levels in the brain, as Parkinson’s disease causes degeneration of dopamine-producing nerve cells. Dopamine is a crucial neurotransmitter for motor function, and its loss leads to the movement-related symptoms seen in Parkinson’s patients. However, treatment is multifaceted, addressing both motor and non-motor symptoms. The choice of medication and the treatment plan must be personalized based on the patient’s specific needs and preferences.
In addition to medication, various therapies can help improve quality of life. Physiotherapy, occupational therapy, speech therapy, and even psychiatric support may play important roles in managing the condition.
Surgical Intervention: Deep Brain Stimulation
For some Parkinson’s patients, surgical intervention may offer significant relief from motor symptoms. One such option is Deep Brain Stimulation (DBS), a procedure that has been available in Malaysia since 2003. According to Associate Professor Dr. Kalai Arasu Muthusamy, a consultant neurosurgeon at UM Specialist Centre, DBS involves the implantation of electrodes in the brain that provide electrical stimulation to help control movement-related symptoms.
DBS can lead to substantial improvements in motor function, with some patients experiencing an 80 percent reduction in symptoms. However, Dr. Kalai stresses that DBS is not a cure for Parkinson’s disease and does not address non-motor symptoms. Typically, DBS is most beneficial for patients who experience motor complications, such as tremors, that are not well controlled by medication.
The procedure is not suitable for all Parkinson’s patients, and neurologists specializing in movement disorders carefully assess whether a patient is a good candidate for DBS. It is typically recommended for patients whose symptoms have not been adequately managed with medication or those who experience “on-off” fluctuations in symptom control.
While DBS involves advanced technology and can be costly, it offers a valuable treatment option for patients seeking improved symptom management. After surgery, most patients continue to take Parkinson’s medication, but in smaller doses, as DBS helps reduce the need for medication by improving motor function.
Although DBS does not cure Parkinson’s disease or resolve all of its symptoms, it can significantly enhance a patient’s quality of life, enabling them to better manage daily activities and maintain a greater level of independence.
A Better Quality of Life Despite the Diagnosis
While Parkinson’s disease remains a chronic and progressive condition, advancements in both medical treatment and surgical options like DBS provide new hope for patients. While they may not fully return to their pre-diagnosis state, these treatments help ensure that patients can lead a fulfilling life and continue to engage in everyday activities, despite the challenges they face.
As the number of Parkinson’s cases continues to rise, ongoing research and improved management strategies offer optimism for those living with the disease, and for those working to support them.
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