What is Parkinson’s disease?
Parkinson’s disease (PD) is a movement disorder where a vital chemical in the brain called dopamine is gradually reduced. This causes tremors, slowness in movement, stiff limbs and walking or balance problems. PD progresses slowly but a treatment can reduce the symptoms and improve quality of life.
What causes Parkinson’s disease?
The cause of PD is still unknown. Researchers think that both genes and environment may play a role. The disorder is due to a loss of nerve cells in an area deep within the brain called the substantia nigra where the chemical dopamine is produced. Dopamine helps to send signals within the brain. Without the right amount of dopamine, movement can be impaired.
What are the symptoms?
Symptoms vary from person to person and usually appear gradually. The main symptoms of PD are:
- Rigidity or stiffness in arms and legs
- Tremor that is often most noticeable when the affected limb is at rest
- Poor balance and coordination
- Bradykinesia or slowness in starting a movement which may lead to less facial expressions, changes in speaking and voice quality, shuffling gait, smaller handwriting or trouble with fine finger movements, such as buttoning a shirt
How is Parkinson’s disease diagnosed?
No laboratory test or brain scan can definitively diagnose PD. Your physician who is experienced in treating the disorder will make a diagnosis based on your symptoms and neurological examination.
What are the treatment options?
Treatment is symptomatic. The treatments available today have been proven to relieve bothersome symptoms of the disease and improve everyday function.
- No currently available medication has been proven to adequately slow the progression of PD, but many medications can control symptoms.
- Medication side effects include nausea, vomiting, light-headedness, restlessness, sleepiness, bad dreams and hallucinations.
- Some drugs may cause changes in behaviour such as obsessive gambling or shopping.
- Changing the dosage or discontinuing certain drugs usually improves these side effects. PD can change over time, it is important to have regular evaluations so that medications can be adjusted to address changing symptoms.
Deep brain stimulation (DBS)
The main non-drug treatment for PD is DBS. Tiny electrodes are surgically implanted in the brain. The electrodes are connected to a small control unit implanted under the skin in the upper chest. DBS is an option for only about 10-20% of people with PD.
Your neurologist can tell you if this treatment might be helpful for you. In addition to movement problems, PD can affect other functions. Some people experience problems with depression, anxiety, apathy, memory, hallucinations, sleep, pain, speech, drooling, urinating or constipation. Treatments for these non-motor problems are available.
Living with Parkinson’s disease
- Many find that lifestyle changes can help control their symptoms.
- Eating a well balanced diet helps maintain health and strength.
- Exercise helps maintain muscle tone and strength and also improves mobility.
- Swimming and walking are especially helpful. Ask your physician to work with you to develop an exercise regimen.
- Eating healthy foods, staying active and exercising can help you maintain a good quality of life.
- Physical therapy may also be beneficial. For people who develop speech problems, speech therapy may be helpful.
Partnering with your neurologist
To provide the best care, your neurologist needs to know all about your symptoms and medical history. Likewise, you need to get answers to your questions. Keeping a notebook about your condition and bringing a few well-organised questions to your appointments can be helpful.