Parkinson's Triad of Disease

Parkinson's disease is a form of degenerative disease common in the elderly. It has a very distinct triad of symptoms consisting of tremor, rigidity and slowness of movement. Clinical diagnosis for Parkinson's is easy in the presence of these classic triad symptoms.

History

• James Parkinson recognized the classic symptoms of Parkinson's disease, which he also called as Shaking Palsy, in 1817. He described the disease as chronic and progressive, with hallmark of classic symptoms consisting of tremor, rigidity and bradykinesia, which refers to slowness of movement.

Features

• The rigidity in Parkinson's disease is one that shows resistance to passive movement and the muscles are in constant tension when they should normally be in a relaxed state. The tremor is described as pill rolling as characterized by hand movement that looks like rolling a pill, while the slowness of movement is due to the inability to initiate movement.

Causes

• Acetylcholine is a neurotransmitter that activates motor function, while dopamine is another neurotransmitter that controls the excitation of acetylcholine. The lack of inhibitory action of dopamine to acetylcholine results in continuous excitation of motor function, resulting in tremor and rigidity. Genetics, environmental toxins and viral infections are also possible causes.

Diagnosis

• Medical history and neurological examination compose diagnosis, including the clinical symptoms manifested by a person based on the presence of the triad features of Parkinson's.

Management

• Drug administration of levodopa can help relieve the triad classic symptoms, especially for the management of rigidity and bradykinesia. Massage, muscle-retraining exercise, gait and postural training and relaxation techniques are also helpful in the management of the triad symptoms.