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Finding the cure

Learn about Parkinson’s disease - its symptoms, impact, and management options. Find support resources and information on available treatments. Get insights on the causes, diagnosis, and medication guidelines for Parkinson’s. Discover ways to help those living with Parkinson's.

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Finding the cure

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  1. Parkinson’s Education & Training – South West Finding the cure Presentation 23.02.10

  2. Our Programme………… What is Parkinson’s? Symptoms and Impact of Parkinson’s Managing Parkinson’s Information & Support Available / Resources

  3. Dr James Parkinson (1755 – 1824) Essay on the Shaking Palsy “….involuntary tremulous motion, with lessened muscular power, in parts not in action …… with a propensity to bend the trunk forward, and to pass from a walking to a running pace …… the senses and intellect being uninjured.” 1817 Hoxton Square Shoreditch, London

  4. Parkinson’s is a progressive & fluctuating neurological condition – non-terminal Parkinson’s occurs when 80% of dopamine producing cells are lost from the part of the brain that controls movement What is Parkinson’s……. Dopamine

  5. Pill Rolling Tremor (70%)

  6. Gait, Shuffling, Short Steps, Freezing, Festination

  7. Genes Environmental Factors What causes Parkinson’s……. • We don’t know why nerve cells die in Parkinson’s, but research has uncovered some pieces of the puzzle Genes Lifestyle ? Ageing ?

  8. 127,000 in UK in 2012 > 162,000 in UK by 2020 Average age of diagnosis 55 - 74 years Does not discriminate – all ethnic groups Parkinson’s is rarely a hereditary condition (5% of cases) Parkinson’s – Incidence General Practice Research Database (GPRD) 2009

  9. NICE (New Guidelines – Due October 2016) If Parkinson’s is suspected, patients should quickly be referred (untreated) to a neurologist or to a geriatrician with a special interest in Parkinson’s Follow up every 6 -12 months to optimise treatment and reassess the diagnosis

  10. Slowness & Poverty of Movement (bradykinesia) (hypokinesia) Ability to start a movement (initiation) Reduced size of movements (amplitude) Coordination of movements (sequencing) Stiffness (rigidity) difficulty with fine movements: fastening buttons, handwriting etc - often painful Pill Rolling Tremor (worse when rushed or excited) Diagnosis - Signs and Symptoms

  11. Terry & Jean Kavanagh Finding the cure Presentation 23.02.10

  12. Put Yourself In My Shoes…..

  13. Impact of Parkinson’s (Slower & Smaller) Communication problems Mask - Bradyphrenia - Voice Micrographia Eating & drinking difficulties Saliva, swallowing issues Mobility problems Hypotension Falls & “Freezing” Bladder & bowel problems MDT Approach Needed • Pain / Dystonia • Anxiety/Depression • Dementia • Sleep problems • Tiredness / Tremor • Deterioration • Loss of choice • General health • Complex medication

  14. Medication & GIOT (Day & Night) Levodopa Dopamine agonists MAO-B inhibitors COMT inhibitors Glutamate antagonist Anticholinergics DBS – Deep Brain Stimulation Parkinson’s Medications

  15. NICE Medication Guidelines Given at appropriate times (for hospital, may mean allowing self-medication) Adjusted only after discussion with a Specialist in Parkinson’s Do not withdraw Parkinson’s medicines abruptly or allow medication to fail suddenly due to poor absorption (gastroenteritis or abdominal surgery)

  16. Can bring on Parkinson’s-like symptoms: Chlorpromazine (Largactil) Fluphenazine (Modecate) Fluphenazine with nortriptyline (Motival) Perphenazine (Fentazin / Triptafen) Trifluoperazine (Stelazine) Flupenthixol (Fluanxol / Depixol) Haloperidol (Serenace / Haldol) Metoclopramide (Maxolon) Prochlorperazine (Stemetil) * Domperidone (Motilium) is the anti-sickness drug of choice to prevent and treat nausea and vomiting caused by levodopa Drugs to avoid…………

  17. Fluctuations in response - “On/Off” effect Hallucinations, nightmares, confusion Impulsive / Compulsive Behaviour (ICB’s) Dyskinesia (involuntary movement) Challenges of Medication

  18. Dyskinesia (Involuntary Movement)

  19. Freephone Confidential Helpline (0808 800 0303) Local Parkinson’s Nurse Specialists Local Information & Support Workers (ISW) Website & Website Forum (www.parkinsons.org.uk) Peer Support Service (Telephone Service) Local Group Network (See Website) Information Resources / Publications Local Information Events Parkinson’s UK Membership - £4.00 per year Social Media – Twitter, Facebook etc.. Join our Parkinson’s Mailing List Parkinson’s Information & Support

  20. Please GIVE MORE TIME Understand communicating can be difficult Please don’t make assumptions Ask how you can help Take a little time to understand Parkinson’s What you can do to help

  21. Parkinsonism Classic - Idiopathic Parkinson’s Atypical - Parkinson’s Plus syndromes Multiple-System Atrophy (MSA) Progressive Supranuclear Palsy (PSP) Other causes – Drug Induced Parkinson’s – Block the action of Dopamine Anti-emetics – Stemetil, Maxolon, prochlorperazine Neuroleptics – chlorpromazine, haloperidol, trifluoperazine

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