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Parkinsons & more
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What you should know about the 5 stages of parkinsons disease
The symptoms of Parkinsons disease and the extent of disability gets worse with each stage. The neurologist will consider the stage of the illness while deciding on the treatment. Stage 1: At this stage, only one side of the body is affected by the symptoms. Hence it is termed unilateral disease. Some early signs of Parkinsons disease like occasional mild tremors may be seen. This initial stage can last for many years. This is the least troublesome of the 5 stages of Parkinsons disease. Neuroprotective treatment is generally used which is intended to halt further damage to the patient's nervous system. A drug called Rasigiline, which is a selective MAO-B inhibitor, seems to be promising at Stage 1. Vitamin E was used earlier, but many doctors say it is not particularly effective. Stage 2: Now the disease has spread to both parts of the body and is called bilateral disease. If symptoms of Parkinsons disease show up even to a small extent on the side of the body that used to be free of symptoms earlier, the illness is said to have progressed to Stage 2. That includes even insignificant signs like a mild tremor on the other side once in a while. Many doctors prescribe dopamine agonists at this stage. It used to be thought that these drugs are useful only at advanced stages. But researchers say that using dopamine agonists earlier can help prevent some of the side effects of using medication like Levodopa at later phases. Stage 3: At this stage, the signs of Parkinsons disease have progressed further. They may now include problems in maintaining body posture. Falling down is fairly common at this stage. This used to be the stage at which the patient started taking Levodopa or dopamine agonists, but as pointed out above, the latter is now prescribed at an earlier stage. Stage 4: The symptoms including falling and general postural instability worsen at this stage. Doctors recommend surgery for some patients, which can alleviate the symptoms partially. But surgery is an option only for those who are relatively young and in good general health. Stage 5: This is the end stage of Parkinsons disease. The patient can usually walk only with assistance and is bound to a wheelchair most of the time. The patient is usually on Levodopa. It may be combined with a COMT inhibitor to make the effects of Levodopa's last longer. Surgery might be an option too, particularly a type of surgery called pallidotomy which is performed to destroy a small set of brain cells. Pallidotomy may help in stopping tremors as well as controlling the rigidity associated with Parkinson's disease. A specialized form of treatment called deep brain stimulation may be an option too. Brain tissue is stimulated with electric currents (of a low grade) through implanted electrodes. There are new drugs being developed and other methods like stem cell implants are being investigated. There is hope that the coming years may see far more effective treatments for this condition than what is available today. Those are the 5 stages of Parkinsons disease.
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