World Parkinson's Day 2024: Understanding The 5 Stages Of Parkinson's Disease And Treatment Options

Parkinson's disease is a progressive neurodegenerative disorder that results in unintended or uncontrollable movements such as tremors, stiffness and difficulty with balance and coordination. During the early stages, the symptoms of the disease go unnoticed but with time one can notice the change in body movements. Along with the motor symptoms, Parkinson's disorder can also lead to non-motor symptoms like depression, anxiety, fatigue and sleeping issues. For the unversed, this disease decreases the level of dopamine in the brain which leads to movement disorders. Few factors that are responsible for this are: environmental and genetic issues.

World Parkinson's Day 2024: Stages of Parkinson's disease:

1. Stage I: This is the initial stage when the patient has mild symptoms that generally goes unnoticed. Tremors, changes in walking, posture and facial expressions occur on one side of the body.

2. Stage II: In the second stage, the symptoms start getting worse as both sides of the body starts getting affected. However, the person can live alone but daily tasks start becomes challenging.

3. Stage III: This stage is also known as the mid-stage where the person can experience loss of balance and falls become very common. The person is somewhat restricted in the day-to-day tasks but is still capable of living independently.

4. Stage IV: In this stage, the motor symptoms are fully developed, and the person starts facing difficulty while standing on his own. He/she needs assistance with the daily activities and is unable to live alone.

5. Stage V: This is the last and advanced stage of Parkinson's disorder where stiffness in the legs starts to occur making it totally difficult for the person to walk or even stand. In some cases, the person is bedridden or confined to a wheelchair and needs timely care. Moreover, the medications also stop responding to the body and doctors suggest advance treatment.

Treatment options for end stage

Medications: There are various medications that can help manage the symptoms of Parkinson's disease in the early stages. But in advance stages, powerful medicines are prescribed by the medical expert including levodopa, dopamine agonists, and MAO-B inhibitors which basically increases the dopamine level in the brain or act as a substitute for it.

Deep brain stimulation: Doctors suggest DBS in the advances stages when the medications have stopped responding to the symptoms. DBS is a surgical procedure in which a small electrode is implanted into the affected parts of the brain that help to control movement. It is then connected to a generator which are placed in chest near the collarbone. The generator then sends electrical signals to the brain that can help in decreasing symptoms of Parkinson's disease.

Advanced treatments: In the end stage, more advanced treatment is required to manage the symptoms of the Parkinson's patient. One such procedure is MRI-guided focused ultrasound which is a less invasive treatment that has helped some people to manage the tremors. These ultrasound waves are at a high temperature and burn the areas that are causing tremors.

(Padma Shri Dr. (Prof.) M.V Padma Srivastava, Chairperson - Neurology, Paras Health Gurugram)

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