Know the basics
What is Parkinson’s disease?
Parkinson’s disease is a progressive disorder of the nervous system that affects cells and produces an important neurotransmitter – dopamine. With less dopamine, movement, body and emotion regulation’s ability of a person will be diminished.
How common is Parkinson’s disease?
People who are more than 60 are prone to have this disease. However, younger people may also have it. It commonly affects more males than females. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
Know the symptoms
What are the symptoms of Parkinson’s disease?
The symptoms of Parkinson’s disease may vary from person to person. There are some mild early sides that can go unnoticed. Symptoms often start at one side of the body and usually go worse even after symptoms affect both sides. Some common signs include:
- Tremor: this often begins with your limbs, especially your hands and fingers. Your hands start shaking when it is at rest.
- Slowed movement: Parkinson’s disease affects your ability to move around, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair.
- Rigid muscles: muscle stiffness may occur in any part of your body, which might limit your motion and induce pain.
- Impaired posture and balance.
- Loss of automatic movements: you can experience difficulty performing unconscious movements, including blinking, smiling or swinging your arms when you walk.
- Speech changes: you may speak softly, quickly, slur or hesitate before talking and you will move to a monotone when speaking.
- Writing changes: Your ability to write might be affected as well.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Know the causes
What causes Parkinson’s disease?
The cause of Parkinson’s disease is still not known and researches are still going on. However, there are some factors that might involve, such as:
- Your genes: researchers have identified specific genetic mutations that can cause Parkinson’s disease. There are certain gene variations that stand a higher risk of Parkinson’s disease.
- Environmental triggers: exposure to certain toxins or environmental factors may increase the risk of later Parkinson’s disease, but the risk is relatively small.
- The presence of Lewy bodies and A-synuclein within Lewy bodies: these are substance in brain cells which can cause Parkinson’s disease.
Know the risk factors
What increases my risk for Parkinson’s disease?
There are many risk factors for Parkinson’s disease, such as:
- Age: Young adults rarely get Parkinson’s disease. It often begins in middle or late life, and the risk increases with age. People usually develop the disease around age 60 or older.
- Heredity: having a close relative with Parkinson’s disease increases the chances that you’ll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson’s disease.
- Sex: men are more likely to develop Parkinson’s disease than are women.
- Exposure to toxins: regular exposure to herbicides and pesticides may put you at a slightly increased risk of Parkinson’s disease.
Having no risks does not mean you cannot have spinal Parkinson’s disease. Risk factors listed above are just for reference. It is always best to discuss with your specialist for more details.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is Parkinson’s disease diagnosed?
There are no specific and accurate tests to diagnose Parkinson’s disease. Your neurologist will make a diagnosis based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.
Your doctor may order tests, such as blood tests, to rule out other conditions that may be causing your symptoms. Imaging tests — such as MRI, ultrasound of the brain, SPECT, and PET scans — may also be used to help rule out other disorders.
In addition to your examination, your doctor may give you carbidopa-levodopa, a Parkinson’s disease medication. You must be given a sufficient dose to show the benefit, as low doses for a day or two aren’t reliable. Significant improvement with this medication will often confirm your diagnosis of Parkinson’s disease.
Sometimes it takes time to diagnose Parkinson’s disease. Doctors may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate your condition and symptoms over time and diagnose Parkinson’s disease.
How is Parkinson’s disease treated?
Parkinson’s disease can’t be cured, but medications can help control your symptoms, often dramatically. In some later cases, surgery may be advised.
Medications may help you manage problems with walking, movement, and tremor. These medications increase or substitute for dopamine. You may have significant improvement of your symptoms after beginning Parkinson’s disease treatment. However, the benefits of drugs will wear off after sometimes, although symptoms usually can continue to be fairly well-controlled. Medications can include:
- Carbidopa-levodopa: Levodopa, the most effective Parkinson’s disease medication, is a natural chemical that passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa (Rytary, Sinemet), which protects levodopa from premature conversion to dopamine outside your brain, which prevents or lessens side effects such as nausea. After years, however, the effect of the drug will wear off. Also, you may experience involuntary movements (dyskinesia) after taking higher doses of levodopa. Your doctor may lessen your dose or adjust the times of your doses to control these effects.
- Carbidopa-levodopa infusion: this medication is made up of carbidopa and levodopa, but administered through a feeding tube that delivers the medication in a gel form directly to the small intestine. This approach is for patients with more advanced condition but still respond to carbidopa-levodopa, but who have a lot of fluctuations in their response. Placement of the tube requires a small surgical procedure. Risks associated with having the tube include the tube falling out or infections at the infusion site.
- Dopamine agonists: unlike levodopa, dopamine agonists don’t change into dopamine. Instead, they mimic dopamine effects in the brain. They aren’t as effective as levodopa. However, they last longer and may be used with levodopa to smooth the sometimes off-and-on effect of levodopa.
- Dopamine agonists include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (given as a patch, Neupro). A short-acting injectable dopamine agonist, apomorphine (Apokyn), is used for quick relief.
- MAO-B inhibitors: these medications include selegiline (Eldepryl, Zelapar) and rasagiline (Azilect). They help prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B (MAO-B). This enzyme metabolizes brain dopamine. When added to carbidopa-levodopa, these medications increase the risk of hallucinations. These medications are not often used in combination with most antidepressants or certain narcotics due to potentially serious but rare reactions. Check with your doctor before taking any additional medications with an MAO-B inhibitor.
- Catechol-O-methyltransferase (COMT) inhibitors: Entacapone (Comtan) is the primary medication from this class. This medication mildly prolongs the effect of levodopa therapy by blocking an enzyme that breaks down dopamine. Tolcapone (Tasmar) is another COMT inhibitor that is rarely prescribed due to a risk of serious liver damage and liver failure.
- Anticholinergics: these medications were used for many years to help control the tremor associated with Parkinson’s disease. Several anticholinergic medications are available, including benztropine (Cogentin) or trihexyphenidyl.
- Amantadine: doctors may prescribe amantadine alone to provide short-term relief of symptoms of mild, early-stage Parkinson’s disease. It may also be given with carbidopa-levodopa therapy during the later stages of Parkinson’s disease to control involuntary movements (dyskinesias) induced by carbidopa-levodopa.
For patients with advanced Parkinson’s disease who have unstable medication (levodopa) responses, surgical procedures known as deep brain stimulation might be required. In deep brain stimulation (DBS), surgeons implant electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest near your collarbone that sends electrical pulses to your brain and may reduce your Parkinson’s disease symptoms. However, DBS isn’t helpful for problems that don’t respond to levodopa therapy apart from tremor. A tremor may be controlled by DBS even if the tremor isn’t very responsive to levodopa. Although DBS may provide sustained benefit for Parkinson’s symptoms, it doesn’t keep Parkinson’s disease from progressing.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage Parkinson’s disease?
The following lifestyles and home remedies might help you cope with Parkinson’s disease:
- Healthy diet: while there’s no food or combination of foods proven to help in Parkinson’s disease, some foods may help ease some of the symptoms. For example, eating foods high in fiber and drinking an adequate amount of fluids can help prevent constipation that is common in Parkinson’s disease. A balanced diet also provides nutrients, such as omega-3 fatty acids, that may be beneficial for people with Parkinson’s disease.
- Exercise may increase your muscle strength, flexibility, and balance because the disease can disturb your sense of balance, making it difficult to walk with a normal gait. Also, it can improve your well-being and reduce depression or anxiety. Parkinson’s
- Avoiding falls: make a U-turn instead of pivoting your body over your feet. Distribute your weight evenly between both feet, and don’t lean. Avoid carrying things while you walk. Avoid walking backward.
- Daily living activities: some activities such as dressing, eating, bathing and writing can be difficult for people with Parkinson’s disease. An occupational therapist can show you techniques that make daily life easier.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Ferri, Fred. Ferri’s Netter Patient Advisor. Philadelphia, PA: Saunders / Elsevier, 2012. Download version.
Porter, Robert. Kaplan Justin. Homeier Barbara. The Merck manual home health handbook. New Jersey: John Wiley & Sons, Inc, 2009. Printed version. Page 771.
Understand Parkinson’s. http://www.parkinson.org/understanding-parkinsons/what-is-parkinsons. Accessed September 22, 2016.
Parkinson's disease. http://www.mayoclinic.org/diseases-conditions/parkinsons-disease/basics/definition/con-20028488. Accessed September 22, 2016.
Parkinson's Disease Health Center. http://www.webmd.com/parkinsons-disease/guide/parkinsons-treatment-care. Accessed September 22, 2016.
Review Date: January 4, 2017 | Last Modified: January 4, 2017