Parkinson's Disease Overview
Parkinson’s disease (PD) is a chronic and progressive movement disorder that involves the malfunction and death of neurons, essential nerve cells in the brain. Some neurons produce dopamine, a chemical that sends messages to the brain that control movement and coordination. Less dopamine is produced as the disease progresses. The result is more difficulty controlling movement, a condition known as neurodegeneration.
When approximately 60-80% of dopamine-producing cells are damaged motor-related symptoms begin to appear. People experience the disease in very different ways; some are severely disabled while others have only minor motor problems.
Wellstar physicians, including top neurologists and neurosurgeons, are expert at diagnosing and treating Parkinson’s disease and in helping patients and families live with this challenging condition.
The causes are not known and, at present, there is no cure. Treatment options include medication and surgery to manage symptoms. A great deal of research is underway to better understand PD, identify the causes and stop the progression of the disease.
Parkinson's Disease Symptoms
Parkinson’s disease is associated with a variety of motor-related symptoms including the following:
- Trembling of the hands, arms, legs, jaw and face when at rest
- Stiffness of the arms, legs and trunk as muscles are unable to relax
- Slow and incomplete movement, which can affect speaking and swallowing
- Balance and coordination problems
Some research suggests that a variety of non-motor symptoms precede the onset of the movement-type symptoms. These include a decrease in the ability to smell, sleep problems and constipation. Because these early symptoms can also be due to other causes it is important to visit your Wellstar physician to rule out or confirm a diagnosis. The goal is to diagnose PD as early as possible.
While a primary cause for Parkinson’s disease has not yet been found, a number of risk factors have been identified.
- Advancing age. PD usually appears during middle to late adulthood and the risk increases with age.
- Sex. Men are more likely to get PD than women. A reason may be that men have greater exposure to factors like head trauma and exposure to certain toxins. Some people believe that the female hormone estrogen helps protect against the disease.
- Declining estrogen levels. Women with lower levels of estrogen due to menopause or other causes are at greater risk.
- Family history. Having one or more close relatives with PD increases the chance that you will get it.
- Occupation. Exposure to pesticides, herbicides or other toxins can prevent the production of dopamine.
- Genetic factors. Current research suggests that the alpha-synuclein gene may play a role in developing Parkinson’s.
- Low levels of B vitamin folate. There is a possible link between a deficiency in this vitamin and Parkinson’s disease symptoms.
- Head trauma. Damage to the head, neck or upper cervical spine has been linked to Parkinson’s.
Parkinson’s Disease Prevention
Because the cause of PD is not fully understood there are no definitive ways to prevent it. Wellstar neurologists agree that there are certain lifestyle changes that may reduce the risk. Among these:
- Eat a diet rich in fresh, raw vegetables
- Avoid exposure to pesticides and solvents like paints and glues
- Wear proper safety gear to avoid head injury
Parkinson’s Disease Diagnosis
Diagnosing Parkinson’s disease can be challenging, especially in the early stages. Wellstar neurologists use their experience and diagnostic skill, as well as some tests, to develop the most precise diagnosis possible. In some cases an internist or family physician may make a diagnosis of Parkinson’s, which is typically confirmed by a neurologist.
The neurologist will conduct an in-depth examination and neurological history, and will carefully review all symptoms. Your doctor will also look for signs including the following:
- An animated expression
- Tremor in the arms when at rest or extended
- Stiffness in the limbs or neck
- The ability to rise easily from a chair
- Normal walking with arms swinging symmetrically
- Ability to quickly regain balance
The absence of these may be a result of other conditions that are not Parkinson’s disease. That’s why it is so important to talk with an experienced neurologist who can confirm or rule out a diagnosis.
Tools and Tests
There are no standard diagnostic tests for Parkinson’s disease. Researchers are currently working to develop a blood test or imaging scan that can help with an objective diagnosis.
Some specialized brain scanning techniques that can measure the dopamine system and brain metabolism.
Your doctor may recommend other types of tests to rule out other causes of your symptoms.
Parkinson’s Disease Treatment
The two primary treatment options for people with Parkinson’s are medication and surgery to modify the progression of the disease. Your neurologist may also recommend non-medical treatments like rest and exercise, physical therapy, occupational therapy, speech therapy and support groups.
A number of medications have proven highly effective in providing relief from the symptoms of PD. One is a combination of two drugs—levodopa and carbidopa to increase and control the production of dopamine.
A group of drugs known as dopamine argonists “trick” brain into thinking it is receiving the dopamine it needs. Another class of drugs, anticholinergics, may be prescribed for tremor, especially in younger patients.
Your Wellstar neurologist will discuss these and other medications in the context of your specific symptoms and preferences. You will want to ask questions about adverse side effects, the degree to which the drugs wear off and other concerns.
In patients who are not well served by available medications, surgery may be an option. The current procedure for PD is known as deep brain stimulation (DBS).
During the procedure your neurosurgeon, guided by magnetic resonance imaging (MRI), inserts electrodes into the affected region of the brain. A device called an impulse generator, which is similar to a pacemaker, is implanted under the collarbone. It provides an electrical impulse to the part of the brain involved in movement.
The treatment is most effective in people whose Parkinson’s disease causes disabling tremors, medication-related involuntary movements and wearing-off spells. These are periods when symptoms return before the next dose of medicine can be taken.
Although the procedure does not cure the disease or stop its progression, DBS can significantly relieve some symptoms and improve quality of life for several years following treatment.
Your Wellstar neurologist will help you learn more about the benefits and risks associated with deep brain stimulation and help you decide if it might be the right choice.
Ongoing Care for Parkinson’s Disease
Living with PD can be frustrating because it often brings a loss of control over your body. Despite the challenges many people with the disease find ways to manage their symptoms and enjoy relatively uninterrupted lives. Others face more pronounced symptoms and disabilities.
The Wellstar neuroscience team helps patients and their families move beyond diagnosis to manage symptoms and regain control of their lives.
Wellstar neurologists recommend the following steps to living successfully with Parkinson’s:
- Be vigilant about taking your medication and work with your doctor to achieve the best combination of drugs.
- Eat a healthy balanced diet and plenty of water.
- Get adequate sleep. Although sleep is very important for people with PD, some patients have problems sleeping. Talk with your doctor about your patterns and habits.
- Monitor your mental health. People with PD may experience depression or anxiety. These can worsen symptoms of the disease, which is why it’s important to get help in the form of medications and/or counseling.
- Ask your doctor about seeking assistance from a specially trained WellStar occupational therapist who can provide tools and techniques to make daily life easier and less painful.