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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 is associated with a variety of motor-related symptoms including the following:
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.
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:
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:
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.
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.
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.
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: