Parkinson's Disease

What is Parkinson’s Disease?

Parkinson’s disease is a progressive disorder of the nervous system that affects about 1 million people in the United States. The primary symptom is a progressive loss of motor control, first manifesting as tremors, stiffness, or slowing of movement. However, there are many non-motor symptoms as well.

While there is currently no cure for Parkinson’s disease, medications, surgical, and behavioral interventions are available to improve symptoms.

What are the symptoms of Parkinson’s disease?

Patients with early Parkinson’s Disease may present with decreased facial expression, decreased arm swing when walking, and soft speech. These symptoms often get worse with progression of the disease.

Symptoms often vary with each patient – and may not be noticed during the early stages. Signs of Parkinson’s usually start on one side of the body and over time progress to the opposite side. If you experience any of the following symptoms, it is important to see your doctor for evaluation. Symptoms may include:

Movement (Motor) Symptoms

• Tremor or shaking
• Freezing or slowed movement (bradykinesia)
• Lack of facial expression
• Stiffness or rigidity of the arms, legs or trunk
• Trouble with balance and falls
• Loss of automatic movements
• Speech changes such low voice volume or muffled speech
• Stooped posture
• Writing changes
• Decreased ability to swallow (dysphagia) and drooling

Non-Motor Symptoms

• Depression and emotional changes
• Anxiety
• Constipation
• Cognitive decline, dementia, or thinking difficulties
• Impulse control disorders
• Orthostatic hypotension
• Pain
• Hallucinations and psychosis
• Sleep disturbances
• Sexual dysfunction
• Urinary dysfunction and bladder problems
• Decreased sense of smell

What causes Parkinson’s disease?

Parkinson’s disease is associated with the breakdown of neurons (nerve cells) in the brain that produce a neurotransmitter called dopamine. Reduced dopamine levels cause movements and other body systems to move slower. We don’t know the cause of Parkinson’s disease, but research indicates that genetic factors play a role as well as environmental factors.

 What are the risk factors for Parkinson’s disease?

• Age – Parkinson’s typically begins in middle or old age.
• Heredity – Having a close relative with Parkinson’s increases the chances a patient with develop the disease
• Sex – Men are more likely to develop Parkinson’s disease than women
• Environmental toxins – Continuous herbicide and pesticide exposure as well as exposure to agent orange may slightly increase the risk of Parkinson’s
• Occupational exposure to manganese such as in welding

How is Parkinson’s diagnosed?

There is not a specific test for Parkinson’s Disease, so your neurologist will make a diagnosis based on:

• Medical history
• Review of your signs and symptoms
• Neurological and physical examination

Other possible diagnostic steps include:

• A dopamine transporter scan (DaTscan), helps determine how much dopamine is available in a person's brain
• Lab tests to rule out other conditions that might be causing the symptoms

• Imaging tests such as MRI, ultrasound and PET scans to help rule out other disorders
• Detecting improvement with Parkinson’s disease medications to confirm diagnosis

What is Erlanger’s treatment approach to Parkinson’s?

While there is currently no cure for Parkinson's disease, medications can help control symptoms, often dramatically. Some more advanced cases may call for surgical intervention.

We may also recommend lifestyle changes shown to improve symptoms. These include:

• Aerobic exercise
• Physical therapy to help with balance
• Stretching to help with stiffness
• Speech therapy to help improve speech problems