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[back] Making Life Better Anthony Thanasayan (The Star) - 08 April 2010

Making life better

By ANTHONY THANASAYAN (The Star Newspaper)

Is enough being done for people with Parkinson's disease and their caregivers?

WORLD Parkinson's Day will be celebrated this Sunday. Many events will no doubt be taking place to bring awareness of this insidious disease of the nervous system which causes muscle stiffness and tremors.

"Recent scientific advances have shown that Parkinson's disease is a more complex condition than was originally thought," says Assoc Prof Dr Norlinah Mohamed Ibrahim, Deputy Head of the Department of Medicine at Universiti Kebangsaan Malaysia Medical Centre in Cheras, Kuala Lumpur.

"Previously thought to only affect mobility and movement, we now know that non-movement (non-motor) problems also predominate. Constipation, depression and anxiety may even predate PD," explains Dr Norlinah, a consultant neurologist who specialises in PD and movement disorders.

While therapy was previously geared towards treating the motor problems alone, research has shown that the patient's quality of life is also dependent on the successful treatment of non-motor aspects.

Therapy: Exercise is important for Parkinson's patients.

What is important is how people with Parkinson's (PwP's) and their caregivers are being helped with all the advances made in the understanding of the disease, says Dr Norlinah.

Dr Norlinah points out that patients living in cities will have more access to neurologists than those living in rural areas.

"The lack of neurologists in the country is one thing. Trying to get an expert with a special interest in PD makes the situation even more complicated.

"There are an estimated 10,000 to 15,000 patients with PD in Malaysia. The number is expected to double in the next 30 years, especially with an ageing population."

Dr Norlinah highlighted the case of a patient who came to her whose diagnosis of PD was missed by another neurologist.

The patient couldn't understand why the movements on one side of his body were becoming increasingly difficult and slow.

He was told that he had a stroke. The more he questioned the neurologist, the more he was labelled as being too anxious. He was advised to accept his diagnosis of a stroke.

"The patient went through a lot of anguish and pain, as he couldn't perform his work effectively and he was advised to go for optional retirement by his employer.

"By the time a proper diagnosis of PD was made, it was too late. His career went downhill together with his health."

Dr Norlinah also pointed out cases of patients who were wrongly diagnosed with PD, a situation that can happen because of the many conditions that mimic the clinical features of Parkinson's.

"This is why PwP must have access to the best medical care, especially in the early stages, so that accurate diagnosis can be established," she stresses. But is this achievable in Malaysia?

For that to happen, Dr Norlinah suggests the following measures:

  • An effective referral system between general practitioners and neurologists. All patients suspected to have PD should be referred to a neurologist to ensure that a correct diagnosis is given. After which the patient could be co-managed by a GP and guided periodically by a neurologist.
  • More training for neurologists and physicians in Parkinson's diagnosis and treatment. This will cut the long waiting lists and travelling distances for those in rural areas.
  • More public awareness of the symptoms of PD to ensure that patients come for treatment early on.