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Parkinson's disease

Definition

Parkinson's disease causes certain brain cells to die. They are the cells that help control movement and coordination. The disease leads to shaking (tremors) and trouble walking and moving.

Alternative Names

Paralysis agitans; Shaking palsy

Causes

Nerve cells use a brain chemical called dopamine to help control muscle movement. With Parkinson's disease, the brains cells that make dopamine slowly die. Without dopamine, the cells that control movement can’t send messages to the muscles. This makes it hard to control your muscles. Slowly over time, this damage gets worse. No one knows what causes these brain cells to waste away.

Parkinson's disease most often develops after age 50. It is one of the most common nervous system problems in older adults.

Symptoms

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. Symptoms may affect one or both sides of the body.

General symptoms may include:

Movement problems may include:

Symptoms of shaking (tremors):

Other symptoms may include:

Exams and Tests

Your health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical exam. But the symptoms can be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse.

The examination may show:

Your doctor may do some tests to rule out other conditions that can cause similar symptoms.

Treatment

There is no cure for Parkinson's disease. However, treatment can help control your symptoms.

MEDICINE

Your health care provider will prescribe medicines to help control your shaking and movement symptoms. These drugs work by increasing dopamine in your brain.

At certain times during the day, the medicine often wears off and symptoms can return. If this happens, your health care provider may need to change the:

You may also need to take medicines to help with:

Parkinson’s medicines can cause severe side effects. They may include:

Tell your doctor right away if you have these side effects. Never change or stop taking any medicines without talking with your doctor. Work with your doctors and other providers 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’s disease, but may help ease symptoms. Types of surgery include:

LIFESTYLE

Certain lifestyle changes may help you cope with Parkinson's disease:

Support Groups

Parkinson’s disease support groups can help you cope with the changes caused by the disease.

Outlook (Prognosis)

Medicines can help most people with Parkinson’s disease. How well medicines relieve symptoms and for how long can be different in each person.

If not treated, the disorder gets worse until a person is totally disabled. Parkinson’s disease may lead to a deterioration of all brain functions and an early death.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if:

If you take medicines for Parkinson's disease, tell your health care provider about any side effects, which may include:

Also call your health care provider if the condition gets worse and home care is no longer possible.

References

American Parkinson Disease Association. Be independent: a guide for people with Parkinson disease. Staten Island, NY: American Parkinson Disease Association, Inc. 2009. Accessed September 26, 2013.

Jankovic J. Movement disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 71.

Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.

Suchowersky O, Gronseth G, Perlmutter J, et al. Practice parameter: neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66;976-982.

Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301:63-73.

Zesiewicz TA, Sullivan KL, Arnulf I, et al. Practice parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74:924-931.



Review Date: 9/25/2013
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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