Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually, often starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes a slowing or freezing of movement.
Friends and family may notice that your face shows little or no expression and your arms don't swing when you walk. Speech often becomes soft and mumbling. Parkinson's symptoms tend to worsen as the disease progresses.
While there is no cure for Parkinson's disease, many different types of medicines can treat its symptoms. In some cases, your doctor may suggest surgery.
The symptoms of Parkinson's disease can vary from person to person. Early signs may be subtle and can go unnoticed. Symptoms typically begin on one side of the body and usually remain worse on that side even after symptoms begin to affect both sides. Parkinson's signs and symptoms may include:
When to see a doctor
The exact cause of Parkinson's disease is unknown, but several factors appear to play a role, including:
In addition, numerous changes are found in the brains of people with Parkinson's disease. The role of these factors in the development of the disease, if any, isn't clear, however. These changes include:
Risk factors for Parkinson's disease include:
Parkinson's disease is often accompanied by these additional problems:
Medications for Parkinson's disease also may cause a number of complications, including involuntary twitching or jerking movements of the arms or legs, hallucinations, sleepiness, and a drop in blood pressure when standing up.
Preparing for your appointment
You're likely to first see your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in disorders of the nervous system (neurologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Preparing a list of questions can help you make the most of your time together. For Parkinson's, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
No definitive tests exist for Parkinson's disease, so it can be difficult to diagnose, especially in the early stages. And parkinsonism — the symptoms of Parkinson's disease — can be caused by many other types of problems. For example, other neurological disorders, toxins, head trauma and even some medications — such as chlorpromazine (Thorazine), prochlorperazine (Compazine) or metoclopramide (Reglan) — can cause parkinsonism.
A diagnosis of Parkinson's disease is based on your medical history and a neurological examination:
A diagnosis of Parkinson's is most likely if you have:
Treatments and drugs
There's no cure for Parkinson's disease, but medications can help control some of the symptoms of Parkinson's disease, and in some case, surgery may be helpful. Your doctor may recommend lifestyle changes, such as physical therapy, a healthy diet and exercise, in addition to medications.
Your initial response to Parkinson's treatment can be dramatic. Over time, however, the benefits of drugs frequently diminish or become less consistent, although symptoms can usually still be fairly well controlled.
Examples of medication your doctor may prescribe include:
Deep brain stimulation is most often used for people with advanced Parkinson's disease who have unstable medication (levodopa) responses. It can stabilize medication fluctuations and reduce or eliminate involuntary movements (dyskinesia). Tremor is especially responsive to this therapy.
Serious risks of this procedure are uncommon, but include brain hemorrhage or stroke. Infection is also a risk, and sometimes requires parts of the device to be replaced. Deep brain stimulation isn't beneficial for people who don't respond to carbidopa-levodopa.
Deep brain stimulation
Deep brain stimulation involves implanting an electrode deep within your brain. The amount of stimulation delivered by the electrode is controlled by a pacemaker-like device placed under the ...
Lifestyle and home remedies
If you've received a diagnosis of Parkinson's disease, you'll need to work closely with your doctor to find a treatment plan that offers you the greatest relief from symptoms with the fewest side effects. Certain lifestyle changes also may help make living with Parkinson's disease easier.
If you take a fiber supplement, such as psyllium powder, Metamucil or Citrucel, be sure to introduce it gradually and drink plenty of fluids daily. Otherwise, your constipation may become worse. If you find that fiber helps your symptoms, use it on a regular basis for the best results.
Walking with care
Forms of alternative medicine that may help people with Parkinson's include:
Coping and support
Living with any chronic illness can be difficult, and it's normal to feel angry, depressed or discouraged at times. Parkinson's disease presents special problems because it can cause chemical changes in your brain that make you feel anxious or depressed. And Parkinson's disease can be profoundly frustrating, as walking, talking and even eating become more difficult and time-consuming.
Although friends and family can be your best allies, the understanding of people who know what you're going through can be especially helpful. Support groups aren't for everyone, but for many people, they can be a good resource for practical information about Parkinson's disease, as well as a place to find understanding from people that are going through the same things you are.
To learn about support groups in your community, talk to your doctor, a Parkinson's disease social worker or a local public health nurse. Or contact the National Parkinson Foundation or the American Parkinson Disease Association.
Since the cause of Parkinson's is unknown, definitive ways to prevent the disease also remain a mystery. However, some research has shown that caffeine — which is found in coffee, tea and cola — may reduce the risk of developing Parkinson's disease.
Last Updated: 2011-02-15
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