Parkinson's Disease Information

Parkinson’s Disease

What Is Parkinson’s Disease

Parkinson’s disease is a medical condition that affects the brain and the nervous system. Parkinson’s disease kills brain cells that help your brain control movement. This can lead to stiffness, shaking, tremors, and other problems with the way your body moves. Over time, the disease can also affect other brain cells, leading to symptoms such as fainting, confusion, and dementia.

In the United States, 60,000 new cases of Parkinson’s disease are diagnosed each year, and many more go undetected. Parkinson’s disease affects about 1 million Americans and 7 to 10 million people around the world.

There is no cure for Parkinson’s disease, but medical treatment can help you get your symptoms under control.

What Causes Parkinson’s Disease

Risk Factors For Parkinson’s Disease

Diagnosing Parkinson’s Disease

Symptoms of Parkinson’s Disease

Parkinson’s disease affects different people in different ways. For many, the main symptom is tremor or shaking, but about 3 out of 10 people with Parkinson’s disease don’t have any tremors at all. Parkinson’s disease often starts with only mild symptoms. Your symptoms may progress slowly, or they could worsen very quickly.

Symptoms of Parkinson’s disease can be divided into motor symptoms, which affect the way you move, and nonmotor symptoms, which affect your mind or body in different ways.

The main motor symptoms of Parkinson’s disease are:

Resting tremor, which may cause shaking in your hands or feet, or a facial tic, when your muscles are otherwise relaxed. Tremor affects about 7 out of 10 people with Parkinson’s disease.
Bradykinesia, which may make it hard for you to move normally. Bradykinesia can slow you down and make it harder to do day-to-day tasks such as buttoning a shirt. It may also affect your facial expressions or make it hard for you to speak.
Rigidity, or stiffness in your arms, legs, neck, or torso. Rigidity can affect your elbows or knees, making you swing your arms or walk with your legs straight.
Postural instability, which can make it hard for you to balance when standing upright.

Other motor symptoms may include:

Momentarily freezing in place while walking
Micrographia (small handwriting)
A masklike expression or frozen face
Sudden fast movements
Cramps
Trouble swallowing
Drooling
Other problems with movement or coordination

Early nonmotor symptoms of Parkinson’s disease include:

Constipation
Changes in your sense of smell
Orthostatic hypertension, which is a sudden dizziness or low blood pressure when you stand up
Mood disorders, such as depression or anxiety
REM behavior disorder, which can make you act out your dreams when you sleep

As Parkinson’s disease worsens, new nonmotor symptoms may develop, such as:

Bladder control trouble
Problems with your eyes or teeth
Low energy
Depression
Anxiety
Sexual problems
Unwanted changes to your weight
Skin problems
Trouble thinking clearly
Memory loss or dementia

The medicines you take to control Parkinson’s disease may also cause side effects, such as involuntary movements, or making you act impulsively.

Prognosis

Living With Parkinson’s Disease

Screening

Prevention

Common Treatment

At present, there is no cure for Parkinson’s disease. The goal of treatment is to keep symptoms under control for as long as possible.

The most powerful medicine to control Parkinson’s disease is levodopa, which converts into dopamine in your brain. Because levodopa causes unpleasant side effects, such as nausea and vomiting, it is almost always given in combination with carbidopa, which helps levodopa get to your brain, so that patients can get the same effect with a smaller dose. Carbidopa/levodopa can be taken as a pill (Sinemet), as a tablet that dissolves in the mouth (Parcopa), or in other formulations.

Long-term levodopa use can cause new problems, such as dyskinesia (muscles moving on their own), or the medicine may stop working, without warning, from time to time. However, waiting too long to start treatment may put you at risk for other problems, such as injuries from falling. Talk to your doctor about the risks and benefits, and when you should start treatment.

Some treatments are taken with levodopa to help it work. These include:

MAO-B inhibitors, such as rasagline (Azilect), to slow the breakdown of levodopa and reduce symptoms
COMT inhibitors, such as entacapone (Comtar) to keep levodopa from wearing off too quickly
Amantadine (Symmetrel) to prevent dyskinesia caused by levodopa. Amantadine can also be used in early treatment to reduce tremors.

Other medicines your doctor may prescribe include:

Dopamine agonists, such as pramipexole (Mirapex) and ropinirole (Requip) to stimulate your brain as if it were receiving dopamine
Anticholinergic medicines such as benztropine mesylate (Cogentin) to reduce tremors
Rivastigmine (Exelon) to treat dementia

Parkinson’s disease can also be treated with a technique called deep brain stimulation, in which a surgeon implants a device like a pacemaker, called an impulse generator, under your collarbone. You can use a controller to send an electric impulse from the impulse generator to the part of your brain that controls motion. This electric impulse can help:

Tremors
Dyskinesia
Problems with medication wearing off

Another type of surgery may attempt to remove or destroy the brain tissue that causes Parkinson’s disease. Scientists are also studying newer techniques involving stem cell transplants for Parkinson’s disease.