Dr. Bhupalam, thank you for talking with me. I’d like to start by asking you to please
explain how the body develops Parkinson’s Disease.
Parkinson’s Disease appears due to the loss of dopaminergic neurons of the midbrain. These neurons
“ project
orders to the Basal Ganglia, which relays messages to the body and controls our movement. As
these neurons disappear, the signals from our brain to our body do as well. This creates Parkinson’s
Disease. In general, Parkinson’s Disease is more common in men and can be related to exposure of
organic or industrial pollutants including MPTP and Agent Orange. Causes of the disorder may be
genetic, environmental or a combination of the two.
”
What are the symptoms of Parkinson’s Disease?
symptoms of the disease, and they fall into three categories: cognitive/
“ There are many potential psychiatric,
autonomic/motor and sensory/pain.
The cognitive and psychiatric symptoms include anxiety, depression, fatigue, slow thinking,
hallucinations, sleep disturbance and REM sleep behavior disorder.
The autonomic/motor system symptoms include drenching sweats, shortness of breath, hypotension,
sexual dysfunction, excessive salivation, constipation and urinary urgency.
Finally, the sensory and pain symptoms include loss of smelling ability, tingling, burning, pain and
numbness, hot and cold sensations, and even restless leg syndrome.
”
If a person doesn’t go to the doctor regularly, how will they recognize their Parkinson’s
Disease symptoms?
“
A patient will typically go to the doctor when they start noticing symptoms of tremors, sleep
disturbance and loss of smell. Although these seem like very different symptoms, they’re all related to
the loss of dopaminergic neurons which forms the basis of Parkinson’s Disease.
Some autonomic and motor symptoms including constipation, increased salivation and sexual
dysfunction can predate cognitive symptoms by several years. But, patients often don’t recognize these
symptoms as the start of something larger. Tremors is the one which brings patients most commonly
to the doctor.
”
When a patient comes in to your office with these deficiencies, what do you do first?
First, we learn each patient’s family history and do a thorough physical examination. There are
“
classic symptoms 90 percent of the time. Say, for example, we see neurologic tremors and slowness.
That indicates Parkinson’s Disease. Many times, the patient will complain about difficulty getting into
and out of a bed or a car, or frequent falls.
”
VITAL SIGNS Volume 13 • Issue 1
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