Parkinsonism

The commonest form of Parkinsonism occurs in older people. The disease is linked to decreased levels of a chemical called dopamine that is involved in transmission of nerve impulses. This leads to a chemical imbalance in the brain. Certain drugs can induce Parkinsonism, and this type is usually reversible. Long-term exposure to some industrial chemicals (like manganese or mercury) or carbon monoxide poisoning may result in the disease. In rare cases there is a hereditary link. In others no link factors are identifiable. Common symptoms include tremor at rest (like 'pill rolling' of the fingers) that often starts in one limb, rigidity, 'mask like' immobility of the face, body imbalance, paucity and slowness of movements, slurred speech, and a shuffling gait. (Note: A mild tremor is commonly associated with old age, but it occurs only when the person reaches out to hold an object.) Though treatment may relieve symptoms the disease tends to progress. Apart from drugs like levodopa and physiotherapy, surgery may be considered. Consult early.

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