THE MASK OF PARKINSON’S

By Sarah Malcolm

There are many secondary symptoms of Parkinson’s disease (PD), such as swallowing difficulties, drooling, sleep disturbances, dementia, confusion and constipation. One of the symptoms that we don’t often see addressed is hypomimea, commonly known as “the mask of Parkinson’s.”

A prime example of the masked effect is Mohammad Ali. When Ali was in his boxing prime, he tormented his opponents with his handsome, expressive face and verbal teasing. Tragically, PD has rendered his face almost immobile and slurred and softened his speech. PD patients often come across to others as sad, disinterested or even rude or mentally incompetent because of their dour expression. They are often left out of conversations or ignored completely.

Body language and gestures are a part of communication. The American Parkinson Disease Association has recommended that you practice and remember the following:

v Eye contact is probably the most important type of non-spoken communication. Always make eye contact when talking. Making eye contact shows you are interested in communicating and in the listener.

v Practice exaggerating facial expressions. What does the face feel and look like when expressing emotions such as happiness, sadness, worry or concern? Practice these facial expressions: raise the eyebrow, wrinkle the forehead, open the eyes widely, squint the eyes, smile broadly, purse the lips. Use these movements of facial muscles when talking.

v Keep the lips closed when listening. Having lips closed indicates concentration and attention.

v Use body posture to show feelings when talking. Lean slightly forward in the chair shows interest; leaning back in the chair may show a state of relaxation and comfort. Leaning back and breaking eye contact can show a lack of interest in communicating or that the communication should stop.

v Use gestures to add to the spoken message. Shrug the shoulders, clasp the hands, turn the head, raise the arms.

v Simply pointing to what is being talked about can be an effective way to add to the spoken message.

Source: The PFHC Bulletin, Houston, Texas –

April 2006

FDA approves Rasagiline

The Food and Drug administration (FDA) announced on May 17^th that it had approved Azilect (rasagiline) for the treatment of Parkinson’s disease (PD). First synthesized and developed by the Iranian-born Israeli researcher, Professor Moussa Youdim, the drug is a monoamine oxidase type-B (MAO-B) inhibitor that blocks the breakdown of dopamine. It is licensed for sale by Teva Pharmaceutical Industries of Jerusalem. Azilect was approved for use as an initial single drug therapy in early PD and as an addition to levodopa in more advanced patients. The safety and effectiveness of Azilect was demonstrated in three 18 to 26 week controlled trials.

One of the studies compared the effects of Azilect with the effects of placebo in 404 patients with early PD. Compared with patients on placebo, the condition of patients on Azilect showed significantly less worsening on a rating scale that measures the ability to perform mental and motor tasks, as well as daily living activities. The other two studies compared the effects of Azilect with placebo when taken together with levodopa by over 1100 patients with more advanced PD. In these studies, patients using Azilect together with levodopa had significantly less time per day with relatively poor function and mobility as compared with patients on levodopa and placebo.

The drug does not cure PD, but is described as a “breakthrough” because it has been shown to slow degeneration of dopamine neurons in the brain and to improve cognitive ability. The tablets are taken once daily and have shown only minimal side effects in some patients.

Source: The PFHC Bulletin/June 2006

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