Parkinson’s Disease

What is Parkinson’s disease?

Parkinson’s disease (PD) is a movement disorder. It is caused by damage to nerve cells in a part of the brain that makes dopamine (DOE-puh-meen). Dopamine is a chemical that sends signals to other cells in the nervous system. These signals help the muscles in your body to move smoothly. PD occurs when dopamine-making cells die. Doctors and scientists don’t know what causes these cells to die.

Parkinson’s disease is called a progressive disorder. This means that the symptoms of PD are usually mild at first, and they gradually get worse.

Symptoms

Most people with Parkinson’s disease begin to have symptoms when they are about 60 years old. Problems may begin on only one side of the body. Symptoms of PD may include:

  • Shaking, especially in the hands, called tremor (TREH-mer)
  • Stiffness in muscles
  • Slowness of movements
  • Change in handwriting
  • Softness of speech
  • Problems with balance
  • Loss of coordination
  • Dragging a foot or tripping over feet when walking


Later in the disease, other symptoms may appear, such as:

  • Changes in mood (depression or anxiety)
  • Memory loss
  • Problems with concentration
  • Hallucinations
  • Constipation
  • Bladder urgency
  • Changes in blood pressure

Diagnosis

To make a diagnosis, your doctor will ask about your symptoms and medical history. He or she will also do a medical exam. The doctor may need to see you several times before being certain that you have PD. This allows the doctor to see if your symptoms are changing over time.

You might have blood tests, urine tests, or a brain scan. These tests can help show if your symptoms are caused by a different disease, not Parkinson’s disease. There are no laboratory tests or brain scans that can tell for sure if you have PD.

If you have Parkinson’s disease, or if you think that you might, you should talk to your doctor or see a doctor who specializes in nerves and the brain — a neurologist (neh-RAHL-eh-jist). Some neurologists specialize in caring for patients with PD.

Treatment

There are no ways to cure PD or stop it from getting worse. Several different medicines are available to help make the symptoms less severe. Your doctor will decide if any of these are right for you. Some of these medicines are listed here (brand names are in parentheses).

  • Amantadine (Symmetrel)
  • Selegiline (Eldepryl, Carbex)
  • Dopamine agonists (Requip, Mirapex, Permax)
  • Levodopa, also called L-dopa (Larodopa)
  • Levodopa/carbidopa (Sinemet, Stalevo)

Some patients with severe PD may have surgery to help ease symptoms. One type of surgery is deep brain stimulation. In this procedure, the surgeon places electrodes inside the brain. An electric impulse is sent through the electrodes to stimulate parts of the brain. This can help decrease shakiness.

Another procedure is a pallidotomy (pal-id-AH-tuh-mee). In this operation, surgeon creates a tiny scar in a very small part of the brain. This part of the brain becomes too active in some people with Parkinson’s disease. The extra activity in this part of the brain can cause uncontrolled movements, called dyskinesia (diss-keh-NEEZ-yuh). A pallidotomy does not cure PD, but it can help stop some of the abnormal movements.

Doctors and scientists are studying other treatments, such as new medicines and ways to re-grow cells.

Rehabilitation

Exercises such as walking and swimming can help muscle tone, strength, and balance. Sometimes speech therapy can help if your voice becomes soft. Balance and gait therapy may be helpful if unsteadiness or stumbling have caused you to fall. Joining a support group with other people who have PD can also be very helpful.

Resources

Morris K. Udall Parkinson’s Disease Research Center of Excellence at the University of Pittsburgh
412-647-0761

American Parkinson’s Disease Association
1250 Hylan Blvd. Suite 4B
Staten Island, NY 10305-1946
718-981-8001
1-800-223-2732
http://apdaparkinson.com

National Parkinson Foundation
1501 N.W. Ninth Ave.
Bob Hope Research Center
Miami, FL 33136-1494
305-547-6666
1-800-327-4545
http://parkinson.org

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