Parkinson’s Disease Case Study Essay Examples & Outline

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Parkinson’s Disease Case Study


History of Present Illness

S.E is a business manager who explains that he has been experiencing shoulder pains and stiffness. He explains that the problem started six months ago. However, the his condition was previously mistaken for musculoskeletal and he was referred for physical therapist treatment. The patient now presents with a stiffness in the right shoulder extending into the elbow and a resting tremor in the right and left hand. He was referred to a neurologist and he was diagnosed with early Parkinson’s Disease.

Current Medications

Ropinirole 5mg p.o TID.

Parkinson’s Disease

Parkinson’s disease occurs because of loss of dopamine; a chemical produced by the brain that helps in facilitating movement. Furthermore, dopamine also affects one’s mood. Thus, medications for the Parkinson’s disease entail prescription of pills that replace dopamine in the body.

Parkinson’s disease presents with various signs and symptoms. However, symptoms are different among patients. Some patients show early stages symptoms, while others start showing symptoms during the later stages. Normally, symptoms for the disease present in individuals who are aged between 50-60 years. Symptoms develop gradually and the close family may not notice anything wrong with the patient. Parkinson’s disease can cause motor or non-motor symptoms. Motor symptoms involves symptoms that affect movement, whereas non-motor symptoms do not affect movement (Kalat, 2013).

Motor symptoms

Motor symptoms for Parkinson’s disease include tremors. Tremors are the most frequent symptoms of the disease. Tremors in Parkinson’s disease may affect only one leg or arm. Moreover, other patients present with tremors experienced on one side of their body. The tremors can also be felt in the lips, chins and tongues. When the disease progresses, the tremors can be felt on both sides of the body. However, in other patient’s the tremor remains in one side of the body even in the later stages of the disease. Other motor symptoms include aching muscles and stuff muscles, slowed or limited movement, problems with walking and balancing and weakness felt in the face and throat muscles. Furthermore, other patients may experience freezing or a sudden inability to walk (Lavretsky, Sajatovic & Reynolds, 2013).

Non-motor symptoms

Non-motor symptoms for the disease include constipation, depression and sleep problems

Patients who have received a patient diagnosis previously may experience end-of-dose effects, which affect the motor performance. This occurs because the effects of motor improvement by levodopa dosage fluctuate with time and the Parkinsonism reappears. Moreover, these end-of-dose effects may also manifest in other symptoms like anxiety, excessive sweating, akathisia and depression. Moreover, dyskinesias can also hinder the management of the Parkinson’s disease. Dyskinesias is an involuntary movement that occurs in response to dopamine or levodopa agonist intake. Dyskinesias mostly occurs at peak-dosage levels (Lavretsky, Sajatovic & Reynolds, 2013).

The diagnosis or therapeutic management of motor complications depends on the movement complications experienced. Treatment of the Parkinson’s disease can be performed with two approaches. The first approach aims at improving the dopamine levels in the brain. On the other hand, the second approach aims at improving the symptoms caused by the Parkinson’s disease. Patients with the disease can receive medication to eliminate the symptoms experienced. Moreover, if the remedy is redundant after medication, patients can also chose to undergo a safe surgical treatment. The treatment for Parkinson’s Disease is done by neurologists who are movement disorders specialists.

The drugs used to diagnose Parkinson’s disease include levodopa. Levodopa is commonly prescribed to control the symptoms caused by the disease mostly, rigidity and bradykinesia. Once levodopa gets into the body, it is transported to the nerve cells present in the brain that produce dopamine. Levodopa is then converted into dopamine. The side effects for using levodopa include disturbances of the heart rhythm, nausea and vomiting. Consequently, if levodopa is used in the long-term, levodopa can cause abnormal movements, restlessness and confusion (Weiner, Shulman & Lang, 2013).

Further, doctors can prescribe dopamine agonists to manage Parkinson’s disease. Dopamine agonists include bromocriptine, pramipexole and ropinerole. The dopamine agonists are used to produce a dopamine-effect in the brain. However, these agonists do not produce dopamine, they mimic the effect of dopamine. Dopamine agonists cause less motor fluctuations than levodopa or carbidopa. Further, they do not induce any protein effects. Nevertheless, there are many complications caused by the use of dopamine agonists. For instance, dopamine agonists have not yet been proved to slow the progress of Parkinson’s disease. Moreover, these agonists are not as effective as carbidopa and levodopa in treating motor symptoms. Side effects include hallucinations, sexual obsessions and daytime sleepiness (Kalat, 2013).

Sinemet is another drug prescribed to treat Parkinson’s disease. Sinemet is comprised of levodopa and carbidopa. Levodopa gets into the brains cells and is converted into dopamine. On the other hand, carbidopa increases the effectiveness of levodopa. In addition, it reduces the side effects caused by levodopa. Doctors can engage patients in either sinemet immediate-release or controlled-release. Both of these medications are effective in managing the Parkinson’s condition. Although most people prefer the controlled release sinement medication, doctors can advise you on which one is best for you (Lavretsky, Sajatovic & Reynolds, 2013).

Sinemet CR 200mg/50mg The dosage may be split and taken at half the dosage listed. To reduce the motor effects on the patient.
Prolopa 50mg/200mg Should be taken in existing form. Used to add levodopa in the patient.
Tasmar 100mg or equivalents Tasmar should be taken in existing form. Prolongs the effectiveness of levodopa

References

Lavretsky, H., Sajatovic, M., & Reynolds, C. F. (2013). Late-life mood disorders. Oxford: Oxford University Press.
Weiner, W. J., Shulman, L. M., & Lang, A. E. (2013). Parkinson's disease: A complete guide for patients and families.
Kalat, J. W. (2013). Biological psychology. Belmont, CA [etc.: W