Parkinson's disease (PD) is a progressive movement disorder. PD is characterized by: Slowing down of movements (bradykinesia)Tremor at restMuscle rigidityLoss of reflexes that maintain posture and equilibrium
Part of the Brain Affected by PD—Yellow Section
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PD is caused by a loss of certain nerve cells in the brain. The loss of these cells causes a decrease in the amount of a brain chemical called dopamine. Low dopamine levels cause PD symptoms.
The brain cells may be lost because of genetic defects, the environment, or some combination of the two. A small amount of people with PD have an early-onset form. This type is caused by an inherited gene defect.
Symptoms of PD begin mildly. They will worsen over time.
PD may cause: Problems with dexterityDifficulty with activities of daily livingFatigueStiffness and rigidity of muscles, usually beginning on one side of the bodyTremors are present at rest, improve with movement, and are absent during sleepSlowness of purposeful movements
Neuropsychiatric symptoms, such as:
DepressionAnxietyDementiaHallucinationsDifficulty and shuffling when walkingPoor balanceTendency to fallLoss of smellSleep problemsFlat, monotonous voiceStutteringTrouble speaking (often speaking with a low volume)Increasingly mask-like face, with little variation in expressionDrooling and excessive salivationShaky, spidery, or small handwritingSeborrhea (a skin problem that causes a red rash and white scales)Trouble chewing and swallowingUrinary symptoms (frequency and urgency)Bowel movement symptoms (straining, constipation)
The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no tests to definitively diagnose PD. The doctor will ask many questions. This will help to rule out other causes of your symptoms.
Tests to rule out other conditions may include: Blood testsUrine tests
Imaging tests take pictures of internal bodily structures. This can be done with: CT scanMRIPET scanA special kind of PET scan called a DAT scan may be used in the evaluation of PD
Currently, there are no treatments to cure PD. There are also no proven treatments to slow or stop its progression. Some medications may help to improve symptoms. Over time, the side effects of the medication may become troublesome. The medications may also lose their effectiveness.
Medications that may be used to treat PD include: Levodopa-carbidopaDopamine agonistsMonoamine oxidase inhibitorsAnticholinergicsCOMT inhibitorsAntivirals
Depression or hallucinations may also occur with PD and its treatment. Medications may be prescribed to attempt to treat these conditions. The drugs may include: Selective serotonin reuptake inhibitors (SSRIs)Tricyclic antidepressantsAntipsychotics
are common in those with PD. Bisphosphonates are medications that may help reduce this risk.
, drooling, and
lightheadedness when standing
are common and may improve with medications or other treatments.
Different brain operations are available, and many more are being researched including: Deep brain stimulation (DBS)—implanting a device to stimulate certain parts of the brain; can decrease tremor and rigidityThalamotomy and pallidotomy—destroying certain areas of the brain to improve tremor when medication does not work (not as common as deep brain stimulation)Nerve-cell transplants (research only)—to increase amount of dopamine made in the brain
Therapy can improve muscle tone, strength, and balance. It includes exercises and stretches. There is also evidence that tai chi may be beneficial.
Consider joining a support group with other people with PD. It will help to learn how others are learning to live with the challenges of PD.
If you are diagnosed with PD, follow your doctor's
There are no current guidelines to prevent PD.
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Last reviewed September 2013 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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