1. Patient #4 - Parkinson’s Disease
By: Tori Smith and Satya Moolani

2. Scenario and Background
John, 55 years old, comes into your office with his wife, Rita. She is concerned because she has seen some changes in her husband. She reports that at some points he seems to be moving in slow motion. Getting dressed and ready to leave the house in the morning seems to take longer every day. She has also noticed that he often loses his balance and when he thinks she is not looking, he often keeps a hand on the wall for support. John keeps relatively quiet and when asked, claims nothing is wrong, but as he passes you his paperwork, you notice that his hand is shaking. You look down at the paper and notice that his handwriting is so tiny that it’s almost illegible.

3. Diagnosis
After understanding and reviewing the patient and his symptoms, we have came to the conclusion that our patient has Parkinson’s Disease.
There is no particular test to make a definite diagnosis of Parkinson’s, such as brain scan or blood work, doctors check patient’s medical history and perform an exam to see if they have Parkinson’s.
The main purpose of this exam is to see if it is truly Parkinson’s, or if it is another disease that imitates Parkinson's, such as stroke or hydrocephalus.

4. Area of Brain Affected and Communication Error
According to the patient’s symptoms - including slowed movements, shakiness, and loss of balance - we diagnosed him with Parkinson’s Disease. This diagnosis determines that nerve cell damage has occurred, causing dopamine levels to drop.
This affects communication between the cerebellum and the brain stem.

5. Prognosis There is no cure to Parkinson’s disease.
The goal of treatment is to control the symptoms.
Medications control symptoms, mostly by increasing the levels of dopamine in the brain. During the day, the helpful effects of the medications can wear off, causing the return of the symptoms.
John’s life expectancy might decrease with Parkinson’s disease.
Other symptoms that may occur later on include stiff muscles, difficulty rising from a sitting position, and light headedness or fainting may occur.

6. Biomedical Career #1- Movement Disorder Specialist
A movement disorder specialist is a neurologist specializing in diseases that affect how one moves. They will have more in-depth knowledge about the disease, its symptoms, and how to treat it.
A movement disorder specialist will treat the patient by prescribing them anti- Parkinson medicine or recommending them further treatment, such a seeing a physical therapist.

7. Biomedical Career #2 - Physical Therapist
A physical therapist can help John in many ways.
They can help set up a plan, outlining John’s goals and his planned treatments.
Use exercises, hands-on therapy, and equipment to help John increase his ability to move.
Educate John and Rita about what to expect with the recovery from the illness and and how to cope and deal with that.