Parkinson's under-diagnosed in India, says experts
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8 April 2009
With the world set to mark Parkinson’s Day on April 11, the disease, which has a relatively low incidence in India, is significantly under–diagnosed, says a senior neurosurgeon in the city. It is estimated that doctors fail to notice symptoms in at least 25% of patients, even in neurology clinics, says Dr B Chendilnathan, senior neurosurgeon, Apollo Hospitals.
“It’s a complicated disease in the sense that it can be identified only with clinical symptoms. In many cases, the symptoms just don’t show up,’’ he says. Sadly, even in those cases where the symptoms are noticeable, the disease is either untreated or under–treated.
Parkinson’s disease occurs when cells in the substantia nigra region of the brain die, depriving the brain of a chemical called dopamine, a neurotransmitter that keeps alive communication among brain cells (neurons).
When the brain is deprived of dopamine, it leads to a progressive disorder of the nervous system that affects a person’s muscular coordination. Symptoms include tremors, rigidity in some muscles, slow movement and problems with maintaining normal posture, as well as depression, changes in speech, sleep problems, incontinence and dementia.
“There are medicines to treat Parkinson’s, which to some extent help improve the quality of life. If medicines fail, we have deep brain stimulation. All we need to do is give people access to these forms of treatment. Greying hair and wrinkles are normal part of aging. But tremors aren’t. Those who have tremors should visit a doctor for treatment,” says Dr Chendilnathan.
There has been no recent city–based study on Parkinson’s. However, an earlier study by the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore had indicated that 17.8% of people living in old–age homes had Parkinson’s, but less than 4% knew about it.
The success story that Dr Chendilnathan often narrates is of a 40–year–old senior police officer, who was bound to a wheelchair after being affected by Parkinson’s. “For nearly three years, he was on pills that provided the dopamine supplement. Initially he had to take only one pill a day, but soon he needed at least eight pills. The drugs left him with side effects such as violent tremors. But after deep brain stimulation, the patient returned to work. Today, he is one of the tough cops,” he said.