PARKINSON'S DISEASE

 Basic information

description

Parkinson's disease is a chronic disorder of the central nervous system that affects the movements of the body. It usually starts after age 50, but can occur in younger ages. It is named for the doctor who first described it.

FREQUENT SIGNS & SYMPTOMS

• Tremors (worse with rest and better with moving).
• General muscle stiffness (rigidity) and slowness.
• Shuffling, wide-based walk, and balance problems.
• Stooped posture. Loss of facial expression.
• Voice changes. It becomes weak and high pitched.
• Swallowing difficulty, drooling.
• Mental functioning can slowly decease.
• Handwriting becomes small, cramped, and shaky.
• Depression and nervousness.
• "Freezing" (sudden, but temporary inability to move).

causes

• Dopamine is a brain chemical that helps control normal muscle movement. With primary (or idiopathic) Parkinson's disease, less dopamine is produced due to a loss of nerve cell function. It is unknown why this loss of nerve cell function occurs. It is thought to be a combination of genetic and environmental factors.
• Secondary Parkinson's disease can be due to drugs, brain injury, tumors, encephalitis, slow-virus infection, some toxins, or carbon-monoxide poisoning.

risk increases with

• Primary type: family history of Parkinson's, older age, or toxin exposure (all may play a role).
• Secondary type: risk factors are listed in Causes.

PREVENTIVE MEASURES

No preventive measures for primary type. For secondary type, avoid risk factors, where possible.

expected outcomes

• There is no cure for primary type. It is progressive, but unpredictable. There may be good days and bad days. It is not a fatal disease in itself. Symptoms can generally be relieved or controlled with treatment.
• Outcome for secondary type depends on the cause.

possible complications

Weakness and loss of strength, balance difficulty, depression, sleep problems, urinary problems, weight loss, constipation, sexual dysfunction, or dementia.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and activities. There is not a specific test to diagnose the disorder. Medical tests may be done to rule out other disorders. If symptoms get better after taking the drug levodopa, it usually means a person has Parkinson's disease.
• Treatment will vary for each person. It is based on a person's age, stage of the disease, and symptoms. Treatment options can include exercise, drug therapy, other special therapies, self-care, or surgery.
• Physical therapy, occupational therapy (help with daily activities), and speech therapy may be helpful.
• Surgery may be an option for severe symptoms or when drugs are not helping. It is not a cure, but it may relieve symptoms.
• Counseling can help treat emotional symptoms such as depression, anxiety, stress, anger, and frustration.
• Accident-proof your home to help prevent falls and injuries. Install handrails, remove area rugs, keep cords out of the way. Carry a cordless or cell phone with you.
• Getting dressed can be a problem. Choose clothes that are easy to slip on. Wear clothes and shoes that have Velcro fasteners. Allow plenty of time to dress.
• To learn more: National Parkinson Foundation, 1501 NW 9th Ave., Miami, FL 33136; (800) 327-4545; website: www.parkinson.org.

medications

• One or more of a variety of drugs can be prescribed to treat the symptoms. Your health care provider will discuss the options and the risks and benefits. If one does not help or stops being effective or has unwanted side effects, others can be tried.
• Vitamins or other supplements may be prescribed.

activity

Exercises will help maintain mobility, balance, range of motion, and well-being. Follow instructions provided by your physical therapist or health care provider.

diet

Eat a healthy diet. Add fiber to the diet and increase fluid intake to prevent constipation. If chewing is a problem, take small bites, eat slowly, and chop up food.

 notify our office if

• You or a family member has symptoms of Parkinson's disease or symptoms worsen during treatment.
• New, unexplained symptoms develop.

Special Notes: