THE appearance of Muhammad Ali at the Olympics opening ceremony in Atlanta has refocussed attention on Parkinson's disease. The apparent deterioration in the boxing legend's condition is due to the progressive nature of the disease.
The search for a cure for the condition continues, meanwhile the greatest advances are in the area of treatment.
Parkinson's disease, named after the doctor who discovered Fit, James Parkinson, is caused by a shortage of dopamine in the brain. Dopamine is the "messenger" substance that plays a part in signalling various parts of the body to move. A shortened supply of dopamine means that messages from the brain to some parts of the body are interrupted or travel slower than usual. Which parts of the body are affected and how badly differs between people.
The main symptoms of Parkinson's are shaking, stiffness of the limbs and slowness of movement. There is often the associated difficulty with speech.
It is estimated by the Parkinson's Association of Ireland that one in every 100 people aged over 65 suffers from the disease in this country. There are a few cases among younger people, though this is rare.
There is continuing debate among neurologists about the possibility of developing the disease from boxing. Dr Donal Costigan, neurologist in the Mater Hospital in Dublin, does not believe that boxing causes the condition, but suggests that it may speed up the process of acquiring the disease.
Jo Waters, chairman of the Parkinson's Association, says people should be patient with Parkinson's sufferers. "I knew one Parkinson's patient who was in a nursing home. It seemed he was unable to talk but he was actually making words which were just slow in coming. But no one had the time to listen to him."
Dr Costigan, who has worked with Parkinson's sufferers for many years, says his patients are fully alert mentally and he explains that people should not mistake outward restriction for some kind of mental retardation.
Because the disease is caused by a shortage of dopamine, drug research has been directed towards promoting the production of this substance. There are a number of trade name drugs available for treating the condition. Any intake of medicine must be part of an overall package which includes exercise and general activity.
A new treatment for Parkinson's sufferers which involves brain surgery is not currently available in Ireland.
The Parkinson's Association of Ireland advises its members that they must try to avoid depression. Parkinson's patients are often frustrated by their lack of movement compared to people around them. Those who are newly diagnosed as Parkinson's sufferers must be advised straight away that with the help of physiotherapists and speech therapists their quality of life can be greatly improved.
There are no known cases of Parkinson's patients dying from the disease, but having the disease can sometimes cause complications when other conditions arise. Patients' concerns are centred on the daily problem of slowness of movement and general immobility. A large number of doctors will prescribe drugs for the disease and will advise their patients on the best way to keep active and physically challenged.
Dr Costigan, who has researched the disease in the US, says people's perceptions about the disease are all wrong. "When people look at Parkinson's patients they see that their limbs may be all bent up or that they have a blank expression. This may lead to considerable fright in people, but that is unnecessary.
Jo Waters picks the example of a Parkinson's sufferer who when out walking may suddenly freeze and seem to be totally motionless. This leads to obvious panic and fear among onlookers. He believes if more people knew about the condition it would lead to greater understanding of these situations.