Parkinson disease (or, simply, Parkinson) is the most common form of Parkinsonism, a group of motor system disorders. It is a slowly progressing, degenerative disease caused by the loss of dopamine-producing brain cells. Dopamine is a substance made in the body that helps with smooth and coordinated muscle movement. Parkinson is usually associated with these symptoms:
The cause of Parkinson is unknown. Medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Parkinson is chronic, and symptoms grow worse over time.
Although the disease may appear in younger people (even teenagers), it usually affects people in late middle age. It is not contagious.
Environmental causes are being researched. Findings have shown that rural living, exposure to well water, and exposure to agricultural pesticides and herbicides are related to Parkinson. It is important to remember, however, that these factors do not guarantee the development of the disease, nor does their absence prevent it. Currently researchers believe that in most people, the cause of Parkinson’s is a mix of genetics and environmental exposure.
In the other forms of Parkinsonism, either the cause is known or suspected, or the disorder occurs as a secondary effect of another neurological disorder. These forms, described as Parkinson syndrome, atypical Parkinson, or, simply, Parkinsonism, may be caused by the following:
The biggest risk factor for Parkinson is advancing age. The average age for the onset of Parkinson is 60 years. In addition, men are affected more than women. However, the reason for this is unclear.
Family history is another important risk factor. A person with an affected parent or sibling, when compared to the general population, has a 4% to 9% increased chance of developing Parkinson. This increased risk is most likely because of a combination of environmental and genetic factors. Having 1 or more close relatives with Parkinson increases the risk of developing the disease. But, unless there is a known genetic mutation for Parkinson present, the increased risk is 2% to 5%.
These are the most common symptoms of Parkinson:
Symptoms of Parkinson vary from person to person. The symptoms may appear slowly and in no particular order. Early symptoms may be subtle and may progress over many years before reaching a point where they interfere with normal daily activities.
Other symptoms are divided into motor (movement-related) and non-motor symptoms.
As the disease progresses, walking may become affected, causing the person to stop in mid-stride or "freeze" in place, and maybe even fall over. People also may start walking with a series of quick, small steps as if hurrying forward to keep balance, a practice known as festination.
The symptoms of Parkinson may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.
Diagnosing Parkinson in the early stages can be difficult. At first, signs and symptoms may look like other conditions or the effects of normal aging. For this reason, your doctor may want to monitor your symptoms for some time until they are consistently present.
Currently, there are no blood or lab tests to diagnose Parkinson. Diagnosis of Parkinson is based mainly on a medical history and thorough neurological exam. Brain scans or lab tests may be done to help rule out other diseases or conditions, but brain scans generally will turn out to be normal with Parkinson.
Methods to diagnose Parkinson include:
So far, there is no cure for Parkinson. However, your doctor can plan appropriate treatment based on the severity of the symptoms and other factors. Treatment may include:
Once the diagnosis has been made, the next decision is whether medicine is an option. This depends on:
No 2 people react the same way to a given drug. It takes time and patience to find the right medicine and dosage to relieve symptoms.
In some cases, your doctor may recommend surgery for Parkinson disease.
Several types of surgery may be done that can help people with Parkinson disease. Most of the treatments are aimed at helping the tremor or rigidity that comes with the disease. In some people, surgery may decrease the amount of medicine needed to control the symptoms of Parkinson.
There are 2 types of surgeries for Parkinson disease:
Although Parkinson is a chronic, progressive disease, treatment can help relieve symptoms. It is also important to eat a healthy diet and maintain mobility with the use of assistive devices, if needed. Regular exercise, physical therapy, occupational therapy, and speech therapy can promote independence. Talk with your healthcare provider about depression, anxiety, or other mental health issues that may arise.
Tips to help you get the most from a visit to your healthcare provider: