Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (
) and
.
Nerve cells use a brain chemical called dopamine to help control muscle movement. With Parkinson disease, the brain cells that make
slowly die. Without enough dopamine, the cells that control movement can't send proper messages to the muscles. This makes it hard to control the muscles. Slowly, over time, this damage gets worse. No one knows exactly why these brain cells waste away.
Parkinson disease most often develops after age 60. It is one of the most common nervous system problems in older adults.
The disease affects men more often than women, although women also develop the disease. Parkinson disease sometimes runs in families.
The disease can occur in younger adults. In such cases, it is often due to the person's genes.
Parkinson disease is rare in children.
Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg is stiff and dragging. Jaw tremor has also been an early sign of Parkinson disease. Symptoms may affect one or both sides of the body.
General symptoms may include:
Problems with balance and walking
Rigid or stiff muscles
and pains
Low blood pressure when you stand up (
)
Stooped posture
Sweating and not being able to control your body temperature
Slow or infrequent blinking
Slowed, quieter speech and monotone voice
No expression in your face (like you are wearing a mask)
Unable to write clearly or handwriting is very small (micrographia)
Movement problems may include:
Difficulty starting movement, such as starting to walk or getting out of a chair
Difficulty continuing to move
Slowed movements
Loss of fine hand movements (writing may become small and difficult to read)
Difficulty eating
Symptoms of shaking (tremors):
Usually occur when your limbs are not moving. This is called resting tremor.
May occur when your arm or leg is held out.
Go away when you move.
May be worse when you are tired, excited, or stressed.
Can cause you to rub your finger and thumb together without meaning to (called pill-rolling tremor).
Eventually may occur in your head, lips, tongue, and feet.
Other symptoms may include:
Anxiety, stress, and tension
Cognitive changes
Disturbed sleep
Low blood pressure
Your health care provider may be able to diagnose Parkinson disease based on your symptoms and a physical exam. But the symptoms may be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse.
The exam may show:
Difficulty starting or finishing a movement
Jerky, stiff movements
Shaking (tremors)
Changes in your heart rate
Abnormal muscle reflexes
Your provider may do some tests to check for other conditions that can cause similar symptoms. A DaTscan can show abnormalities suggesting Parkinson, but is only necessary in some situations.
There is no cure for Parkinson disease, but treatment can help control your symptoms.
MEDICINE
Your provider may prescribe medicines to help control your shaking and movement symptoms.
At certain times during the day, the medicine may wear off and symptoms can return. If this happens, your provider may need to change any of the following:
Type of medicine
Dose
Amount of time between doses
The way you take the medicine
You may also need to take medicines to help with:
Mood and thinking problems
Pain relief
Sleep problems
Drooling (botulinum toxin is often used)
Parkinson medicines can cause side effects that may be severe, including:
Confusion
Seeing or hearing things that are not there (
)
, or diarrhea
Feeling lightheaded or fainting
Behaviors that are hard to control, such as gambling
Tell your provider right away if you have these side effects. Never change or stop taking any medicines without talking with your provider. Stopping some medicines for Parkinson disease may lead to a severe reaction. Work with your provider to find a treatment plan that works for you.
As the disease gets worse, symptoms such as stooped posture, frozen movements, and speech problems may not respond to the medicines.
SURGERY
Surgery may be an option for some people. Surgery does not cure Parkinson disease, but it may help ease symptoms. Types of surgery include:
-- This involves placing electric stimulators in areas of the brain that control movement.
Surgery to destroy certain brain tissues in order to reduce Parkinson symptoms.
Stem cell transplant and other procedures are being studied.
LIFESTYLE
Certain
may help you cope with Parkinson disease:
Stay healthy by eating nutritious foods and
.
Make changes in what you eat or drink if you have
.
Use speech therapy to help you adjust to changes in your swallowing and speech.
Stay active as much as possible when you feel well. Do not overdo it when your energy is low.
Rest as needed during the day and avoid stress.
Use physical therapy and occupational therapy to help you stay independent and reduce the risk of falls.
Place handrails throughout your house to help
. Place them in
and along stairways.
Use assistive devices, when needed, to make movement easier. These devices may include special eating utensils, wheelchairs, bed lifts, shower chairs, and walkers.
Talk to a social worker or other counseling service to help you and your family cope with the disease. These services can also help you get outside help, such as Meals on Wheels.
Parkinson disease support groups
can help you cope with the changes the disease causes. Sharing with others who have common experiences can help you feel less alone.
Medicines can help most people with Parkinson disease. How well medicines relieve symptoms and for how long they relieve symptoms can be different in each person.
The disease may get worse until a person is totally disabled, although in some people, this can take decades. Parkinson disease may lead to a decline in brain function and early death. Medicines may prolong function and independence.
Parkinson disease may cause problems such as:
Difficulty performing daily activities
Difficulty swallowing or eating
Disability (differs from person to person)
Injuries from falls
from breathing in saliva or from choking on food
Side effects of medicines
Effects from loss of strength and mobility (debilitation):
Breathing food, fluid, or mucus into the lungs (aspiration)
Blood clot in a deep vein (
)
Malnutrition
Breakdown of skin (bed sores)
Contact your provider if:
You have symptoms of Parkinson disease
Your symptoms get worse
New symptoms occur
If you take medicines for Parkinson disease, tell your provider about any side effects, which may include:
Changes in alertness, behavior, or mood
Delusional behavior
Hallucinations
Involuntary movements
Loss of mental functions
Severe confusion or disorientation
Also contact your provider if the condition gets worse and home care is no longer possible.
Paralysis agitans; Shaking palsy; Parkinson's disease
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.
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.
Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.