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Parkinson's disease occurs when there is a problem with certain nerve cells in the brain that control movement. The disease affects the way you move. The most common symptom is tremors. Parkinson's disease gets worse over time. But usually this happens slowly, over many years.
Low levels of dopamine, a brain chemical that helps control movement, cause symptoms of Parkinson's disease. Low levels happen when nerve cells in a part of the brain that makes dopamine break down. The exact cause of this breakdown isn't known. Scientists are studying possible causes, such as aging and poisons in the environment.
The main symptoms of Parkinson's are tremors, stiff muscles, slow movement, problems with balance or walking, and pain. Symptoms differ from person to person. In time, the disease affects muscles all through your body. This can lead to problems like trouble swallowing or constipation.
Your doctor will ask questions about your symptoms and your past health and will do a neurological exam. This exam checks to see how well your nerves are working. There are no lab or blood tests that can diagnose Parkinson's. But you might have tests to find out what's causing symptoms.
At this time, Parkinson's disease can't be cured. But you may not need treatment if your symptoms are mild. Medicines can help control the symptoms. You may also get occupational, physical, or speech therapy to help you function better. Brain surgery, for example deep brain stimulation, may be an option.
Parkinson's disease happens when there is a problem with certain nerve cells in the brain.
Normally, these nerve cells make an important chemical called dopamine. Dopamine sends signals to the part of your brain that controls movement. It lets your muscles move smoothly and do what you want them to do. When you have Parkinson's, these nerve cells break down. Then you no longer have enough dopamine, and you have trouble moving the way you want to.
No one knows for sure what makes these nerve cells break down. But scientists are doing a lot of research to look for the answer. They are studying many possible causes, including aging and poisons in the environment.
Symptoms of Parkinson's disease differ from person to person. Tremor (shaking) may be the first symptom you notice. It's one of the most common signs of the disease, although not everyone has it.
Tremor often starts in just one arm or leg or on only one side of the body. It may be worse when you're awake but not moving the affected arm or leg. It may get better when you move the limb or you're asleep.
Other common symptoms include:
In time, Parkinson's affects muscles all through your body. It can lead to problems like trouble swallowing or constipation.
Some people with Parkinson's have depression. In the later stages of the disease, they may have a fixed or blank expression, trouble speaking, and other problems. Some people also lose mental skills (dementia).
Tremor is often the first symptom. It appears in just one arm or leg or on only one side of the body. With time, the tremor usually—but not always—spreads to both sides of the body. Joint pain, weakness, and fatigue may occur.
As the disease gets worse, some people may have slow movement, stiff muscles, and poor coordination. They may have problems with tasks such as writing, shaving, or brushing teeth. Changes in handwriting are common.
Problems with posture and balance develop. A person with Parkinson's tends to walk in a stooped manner with quick, shuffling steps. Sometimes the person may freeze. This is a sudden, brief inability to move. It most often affects walking.
The disease can affect many of the muscles used for chewing and swallowing. This can lead to problems with eating, drooling, and choking. It can also affect the muscles that are used for speech. This can lead to low or soft speech, unclear speech sounds, and other problems.
Problems with sexual function are common in people with Parkinson's disease. It can affect arousal in both men and women. Muscle stiffness may make sexual activity difficult. Men may have trouble getting or keeping an erection.
After several years, as muscle stiffness and tremors increase, the person may need more care and may be confined to a wheelchair or bed.
People who take medicine for several years may notice that their symptoms get worse. And they may have other movement problems. These problems can get somewhat better by making changes to the person's medicine. But medicine can be hard to manage and can make treatment more difficult.
Dementia may develop in many people who have late-stage Parkinson's disease. Dementia symptoms may include confusion and memory loss. Treatment for Parkinson's disease can also make this problem worse.
Urgent medical care isn't needed if you've had a tremor—shaking or trembling—for some time. But you should discuss the tremor at your next doctor's appointment.
If a tremor is affecting your daily activities or if it's a new symptom, see your doctor sooner.
A written description will help your doctor make a correct diagnosis. In writing your description, consider the following questions:
If you have been diagnosed with Parkinson's, call your doctor if:
Your doctor will ask questions about your symptoms and your past health and will do a neurological exam. This exam includes questions and tests that show how well your nerves are working. For example, your doctor will watch how you move, check your muscle strength and reflexes, and check your vision.
Your doctor also may check your sense of smell and ask you questions about your mood.
In some cases, your doctor will have you try a medicine for Parkinson's disease. If that medicine helps your symptoms, it may help the doctor find out if you have the disease.
There are no lab or blood tests that can help your doctor diagnose Parkinson's. But you may have tests to help your doctor rule out other diseases that could be causing your symptoms. For example, you might have an MRI to look for signs of a stroke or brain tumor.
There is no cure for Parkinson's disease. But there are many treatments that can help your symptoms and improve your quality of life. You may not need treatment if your symptoms are mild.
Your age, work status, family, and living situation can all affect decisions about when to start treatment, what types of treatment to use, and when to make changes in treatment. As your medical condition changes, you may need regular changes in your treatment to balance quality-of-life issues, side effects of treatment, and treatment costs.
You'll need to see members of your health care team regularly (every 3 to 6 months, or as directed) to adjust your treatment as your condition changes.
Treatments for Parkinson's include:
Levodopa and dopamine agonists are the most common treatment for Parkinson's disease. But these drugs can cause problems if you use them for a long time or at a high dose. So doctors sometimes use other medicines to treat people in the early stages of the disease.
Brain surgery, for example deep brain stimulation, may be an option. It may be used when medicine can't control symptoms of Parkinson's disease or causes severe or disabling side effects. For this treatment, a surgeon places wires in your brain. The wires carry tiny electrical signals to the parts of the brain that control movement. These little signals can help those parts of the brain work better.
Speech therapists use breathing and speech exercises to help you overcome speech problems like the soft, imprecise speech and monotone voice that develop in advanced Parkinson's disease. They can also help you improve problems with eating, swallowing, and drooling.
Therapists may help you improve your walking and reduce your risk of falling. They can also give you exercises to improve your posture, strength, and flexibility.
Therapists can help you learn new ways to do things for yourself so you can stay independent longer. For example, they can help you make simple changes so you can move around your house more easily. They can also help you make daily activities easier. These may include things like bathing and dressing.
You or your family members may notice that you start to have problems with memory, problem solving, learning, and other mental functions. When these problems keep you from doing daily activities, it is called dementia. There are medicines that can help treat dementia in people with Parkinson's.
Your doctor, other health professionals, or Parkinson's support groups can help you get emotional support and education about the illness. This is important both early and throughout the course of the disease.
These conditions are common in people with Parkinson's disease. Being aware of them and getting help is important. There are medicines that can help with the symptoms of these problems. Parkinson's support groups can help you learn ways to cope with them as well.
Early on, Parkinson's disease may not greatly disrupt your life. But for most people, the disease becomes more disabling over time. Home treatment can help you adjust as time goes on and help you stay independent for as long as possible. Home treatment may include making changes to your home and lifestyle, improving your motor skills, and improving your mood and memory.
Medicines are the most common treatment for Parkinson's disease. The goal is to correct the shortage of the brain chemical dopamine. This shortage causes the symptoms of Parkinson's.
Medicine is often started when your symptoms become disabling or disrupt your daily activities. Symptoms change as the disease gets worse. Because of this, your doctor will adjust your medicine as symptoms appear.
Medicines often improve symptoms. But they also may cause side effects. It may take some time to find the best medicines for you.
Several medicines may be used at different stages of the disease. They include:
Levodopa is thought to be the most effective drug for controlling symptoms. But many doctors prescribe dopamine agonists in the beginning of the disease. That's because after a few years, levodopa can cause motor problems like uncontrollable jerking movements. It also may suddenly stop working.
Brain surgery to treat Parkinson's disease may be considered when drugs:
The types of surgery include:
Surgery isn't a cure. Drugs are usually still needed after surgery. But you probably won't need as much medicine as before. This means you may have fewer side effects.
People who have very advanced Parkinson's or who have other serious health problems usually aren't good candidates for surgery.
Current as of:
December 13, 2021
Author: Healthwise StaffMedical Review: Anne C. Poinier MD - Internal MedicineMartin J. Gabica MD - Family MedicineElizabeth T. Russo MD - Internal MedicineKathleen Romito MD - Family MedicineG. Frederick Wooten MD - Neurology
Current as of: December 13, 2021
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Kathleen Romito MD - Family Medicine & G. Frederick Wooten MD - Neurology
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