Disorders of Motor Function
John is 63 years old and receives home care by an occupational therapist twice a week. His therapist is currently working with John on maintaining joint flexibility and balance. John demonstrates resting tremor, so his therapist is also working on adaptive techniques, so John can continue to use his hands to write, use the computer, and cook simple meals. John’s wife assists with his mobility and saunters beside him, holding his arm. Sometimes she needs to help him open his prescription bottles, so he can take his medicine, a combination of levodopa and carbidopa.
- What motor disease does John demonstrate? One of his signs is a resting tremor. What is the difference between a resting tremor and an intentional tremor?
- What is the advantage of combining levodopa with carbidopa? What is the benefit of anticholinergic drugs in managing Parkinson’s disease?
- Parkinson’s disease involves the destruction of the substantia nigra and the nigrostriatal pathway. Where are these structures anatomically?
- The patient with Parkinson’s disease typically presents with a masklike facial expression. Why does he or she have a masklike facial expression? How are the eyes, mouth, and laryngopharynx affected by this disease?
Disorders of Motor Function
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Disorders of Motor Function
With each intricate movement we make, we often take for granted the delicate symphony of neurons and muscles orchestrating our motor function; however, when infirmities impede this harmonious cooperation, the outcomes are far-reaching and require our attention. Disorder of motor function entails a broad spectrum of conditions, disrupting the regular operation of the human body’s movement system. These infirmities can manifest in numerous ways, affecting coordination, muscle strength, balance, and overall motor control. One ordinary example is cerebral palsy, a neurological infirmity frequently arising in infancy or early childhood, impairing muscle tone and coordination, resulting in difficulties in voluntary movement (Gulati & Sondhi, 2018). Another great infirmity is Parkinson’s disease, a progressive degenerative status distinguished by the loss of dopamine-producing cells in the brain, leading to tremors, rigidity, and bradykinesia (Bloem et al., 2021). These infirmities not only interfere with an individual’s ability to perform everyday duties but also influence their quality of life and social interactions. Comprehending the underlying procedures and creating an effectual treatment for a disorder of motor function is essential for enhancing the lives of those impacted by the conditions. This essay will explore a case study of John, who is 63-year-old, receiving home care from an occupational therapist twice a week, eventually discussing the type of motor disease that John is demonstrating, the difference between a resting tremor and an intention tremor, the advantage of combining levodopa with carbidopa, the benefit of anticholinergic drugs in the management of Parkinson disease, the substantia nigra and the nigrostriatal pathways and why they are anatomically, and why does the patient have a masklike facial expression.
The Type of Motor Disease that John Demonstrate and the Difference Between a Resting Tremor and an Intention Tremor
Based on the case study, John demonstrates manifestations of Parkinson’s infirmity, a neurodegenerative motor disorder. The resting tremor mentioned suggests one of the features of symptoms of Parkinson’s disorder, where involuntary shaking or trembling happens while the muscles are at rest, customarily impacting the hands, arms, or legs. The critical difference between a resting and an intentional tremor lies in their event during distinct states of muscle activity. As indicated in the case study, a resting tremor happens when the muscles are at rest and tends to subside or reduce during voluntary movement (Deuschl et al., 2022). In comparison, an intentional tremor manifests during purposeful movements or when an individual tries to act on a particular action, like reaching for an object or writing. Unlike a resting tremor, an intentional tremor generally becomes more pronounced with motions and can impact the accuracy and control of fine motor skills (Benito‐León et al., 2019). In John’s scenario, his occupational therapist is engaging adaptive methods to assist him in coping with the resting tremor so that he can progress to perform activities requiring using his hands, like writing, using the computer, and cooking simple meals. In addition, his wife equips support for his mobility and helps him in duties like opening prescription bottles to ensure he can take his directed medication, including a combination of levodopa and carbidopa customarily used to handle manifestations of Parkinson’s infirmity.
The Advantages of Combining Levodopa with Carbidopa
Combining levodopa with carbidopa offers a crucial advantage in treating Parkinson’s infirmity. Levodopa is a medication that assists in replenishing the levels of dopamine in the brain, equipping relief from motor manifestations like tremors, stiffness, and bradykinesia (SHAH et al., 2020). Moreover, levodopa is metabolized into dopamine outside the brain, leading to restricted amounts reaching the aimed target. This results in undesirable side effects and the need for higher doses, causing complications over time. Conversely, Carbidopa, an enzyme inhibitor called DOPA decarboxylase, converts levodopa into dopamine outside the brain (Lenka et al., 2022). By combining levodopa with carbidopa, the peripheral metabolism of levodopa is crucially lessened. This means more levodopa can cross the blood-brain barrier and be changed into dopamine within the brain, improving its therapeutic effects. In addition, carbidopa permits lower doses of levodopa, minimizing the likelihood of side effects and improving tolerability. The combination of levodopa and carbidopa enhances the effectiveness, duration of action, and tolerability of levodopa therapy, making it a cornerstone treatment for Parkinson’s infirmity.
The Satisfactions of Anticholinergic Drugs in the Superintendence of Parkinson’s Disease
Anticholinergic drugs over various benefits in the management of Parkinson’s infirmity. Parkinson’s infirmity is distinguished by the loss of dopamine-producing cells in the brain, resulting in motor manifestations like tremors, stiffness, and bradykinesia. Anticholinergic drugs work by hindering the exertion of acetylcholine, an overzealous neurotransmitter in Parkinson’s infirmity (Barrett et al., 2021). By lessening the undertaking of acetylcholine, these drugs assist in restoring the stability between acetylcholine and dopamine in the brain. This led to a reduction of some motor manifestations, specifically tremors, and rigidity. Anticholinergics can be valuable when combined with other medications, like levodopa, to improve their success and equip more inclusive symptom control. In addition, anticholinergics may enhance inevitable non-motor manifestations linked to Parkinson’s disorder, like drooling and excessive sweating. Moreover, it is essential to note that anticholinergics may have side effects involving cognitive impairment, memory challenges, dry mouth, and constipation, which must be accurately considered and observed by healthcare professionals when prescribing those medications.
The Substantia Nigra and the Nigrostriatal Pathways
The substantia nigra and the nigrostriatal promenades are anatomical configurations within the brain. The substantia nigra is a tiny cluster of neurons in the midbrain, particularly in the basal ganglia. It is divided into the pars compacta and the pars reticulata (Rezai Amin et al., 2019). The pars compacta are mainly included in the production and regulation of dopamine, a neurotransmitter playing an essential role in movement control. The nigrostriatal pathways are the neural pathways connecting the substantial nigra to another area called the striatum. The striatum is found in the forebrain and is included in motor coordination and control. The destruction of substantial nigra and the nigrostriatal pathways is a significant feature of Parkinson’s infirmity, a neurodegenerative condition leading to impaired motor function.
The Masklike Facial Expression in Parkinson’s Infirmity and the Causes and Impact on Facial Features
In Parkinson’s disease, a masklike facial expression or hypomania, is a common manifestation. This expression happens because of the degeneration of nerve cells in the brain, controlling facial movements, specifically the muscles accountable for facial expression (Khan et al., 2019). The loss of these cells results in a lessened ability to control the muscles of the face, leading to a lack of facial movement and expression. Parkinson’s infirmity also impacts the eyes, mouth, and laryngopharynx. The muscles around the eyes may become rigid, losing their normal blinking reflex, resulting in infrequent or incomplete eye blinking. This can cause dryness, discomfort, and an elevated risk of eye infections. The mouth muscles may become stiff and rigid, leading to difficulties in swallowing and chewing. This can cause drooling, traduce, and a monotonous or mushy voice. The laryngopharynx, which is the vocal cords and the back of the throat, can also be impacted, resulting in hoarseness and challenges with articulation. These symptoms can severely influence an individual’s ability to communicate successfully, subscribing to the masklike facial expression linked with Parkinson’s infirmity. Individuals with Parkinson’s disorder need to work with healthcare professionals, like speech and occupational therapists, to manage these manifestations and enhance their quality of life.
Conclusion
John’s scenario suggests the difficulties encountered by individuals with a disorder of motor function, particularly demonstrating resting tremors. By getting home care and working with an occupational therapist, John can maintain joint flexibility and stability and adapt to his condition. The combination of levodopa and carbidopa is beneficial in his treatment, assisting him to handle manifestations successfully. In addition, anticholinergic drugs offer benefits in handling Parkinson’s infirmity. The destruction of the substantia nigra and the nigrostriatal pathways in Parkinson’s infirmity happens anatomically in specific structures. The feature masklike facial expression observed in patients with Parkinson’s infirmity results from facial muscle rigidity. The infirmity also impacts the eyes, mouth, and laryngopharynx, leading to challenges in their operation. Comprehending the elaborateness of motor function conditions is essential for equipping effectual care and support to individuals like John.
References
Barrett, M. J., Sargent, L., Nawaz, H., Weintraub, D., Price, E. T., & Willis, A. W. (2021). Antimuscarinic Anticholinergic Medications in Parkinson’s Disease: To Prescribe or Deprescribe? Movement Disorders Clinical Practice, 8(8), 1181-1188. https://doi.org/10.1002/mdc3.13347
Benito‐León, J., Serrano, J. I., Louis, E. D., Holobar, A., Romero, J. P., Povalej‐Bržan, P., … & Rocon, E. (2019). Essential tremor severity and anatomical changes in brain areas controlling movement sequencing. Annals of Clinical and Translational Neurology, 6(1), 83-97. https://doi.org/10.1002/acn3.681
Bloem, B. R., Okun, M. S., & Klein, C. (2021). Parkinson’s disease. The Lancet, 397(10291), 2284-2303. https://doi.org/10.1016/S0140-6736(21)00218-X
Deuschl, G., Becktepe, J. S., Dirkx, M., Haubenberger, D., Hassan, A., Helmich, R. C., … & Elble, R. J. (2022). The clinical and electrophysiological investigation of tremor. Clinical Neurophysiology, 136, 93-129. https://doi.org/10.1016/j.clinph.2022.01.004
Gulati, S., & Sondhi, V. (2018). Cerebral palsy: an overview. The Indian Journal of Pediatrics, 85, 1006-1016. https://doi.org/10.1007/s12098-017-2475-1
Khan, A. U., Akram, M., Daniyal, M., & Zainab, R. (2019). Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder. International Journal of Neuroscience, 129(1), 55-93. https://doi.org/10.1080/00207454.2018.1486837
Lenka, A., Di Maria, G., Lamotte, G., Bahroo, L., & Jankovic, J. (2022). Practical pearls to improve the efficacy and tolerability of levodopa in Parkinson’s disease. Expert Review of Neurotherapeutics, 22(6), 489-498. https://doi.org/10.1080/14737175.2022.2091436
Rezai Amin, S., Gruszczynski, C., Guiard, B. P., Callebert, J., Launay, J. M., Louis, F., … & Gautron, S. (2019). Viral vector‐mediated Cre recombinase expression in substantia nigra induces lesions of the nigrostriatal pathway associated with perturbations of dopamine‐related behaviors and hallmarks of programmed cell death. Journal of Neurochemistry, 150(3), 330-340. https://doi.org/10.1111/jnc.14684
SHAH, A. A., KASHYAP, K., & GUPTA, A. (2020). Parkinson’s Disease: An Introduction to the Causes and Management Strategies. International Journal of Pharmaceutical Research, 12(4).
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