April is Parkinson’s Disease Awareness Month

To raise awareness of this debilitating neurological disease – its symptoms,
diagnosis and treatments

What is Parkinson’s Disease & Who Is At Risk of Getting It?

Parkinson’s disease is a brain disorder that can affect both men and women, but 50% more men than women are affected. Most people develop Parkinson’s disease at about age 60, with 5-10% of people developing “early-onset” Parkinson’s which begins before the age of 50.

Early-onset forms of Parkinson’s are often, but not always, inherited, and some forms have been linked to specific gene mutations.

What Are The Symptoms of Parkinson’s Disease?

Parkinson’s disease has four main symptoms:

  • Tremor (trembling) in hands, arms, legs, jaw, or head
  • Stiffness of the limbs and trunk
  • Slowness of movement
  • Impaired balance and coordination, sometimes leading to falls

What Is At The Root of Parkinson’s Disease?

Parkinson’s disease occurs when nerve cells or neurons in an area of the brain that controls movement become impaired and/or die and they produce less dopamine, which causes the movement problems of Parkinson’s. Scientists still do not know what causes cells that produce dopamine to die. Also people with Parkinson’s lose the nerve endings that produce norepinephrine, the main chemical messenger of the sympathetic nervous system, which controls many automatic functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain some of the non-movement features of Parkinson’s, such as fatigue, irregular blood pressure, decreased movement of food through the digestive tract, and sudden drop in blood pressure when a person stands up from a sitting or lying-down position.

Although some cases of Parkinson’s appear to be hereditary, and a few can be traced to specific genetic mutations, in most cases the disease occurs randomly and does not seem to run in families. Many researchers now believe that Parkinson’s disease results from a combination of genetic factors and environmental factors such as exposure to toxins.

What Are The Early Symptoms & How Do They Progress Overtime?

Early symptoms of Parkinson’s disease are subtle and can occur gradually. Symptoms often begin on one side of the body or even in one limb on one side of the body. People may feel mild tremors or have difficulty getting out of a chair. They may notice that their speech is low and soft, or that their handwriting looks cramped or small. Family or friends may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person
does not move an arm or leg normally.

People with Parkinson’s often have a tendency to lean forward when they walk, and take small quick steps as if hurrying forward, with no or reduced swinging of the arms. They also may have trouble initiating or continuing movement. As the disease progresses, it eventually affects both sides of a person’s body. The rate of progression of symptoms differ among individuals. People can sometimes mistake early symptoms of Parkinson’s as normal aging. Many people with Parkinson’s note that prior to experiencing stiffness and tremor, they had sleep problems, constipation, decreased ability to smell and restless legs.

Diagnosis of Parkinson’s Disease

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s disease. Diagnosis is based on a person’s medical history and a neurological examination. Improvement after initiating medication is another important hallmark of Parkinson’s disease.

Treatment of Parkinson’s Disease

Although there is no cure for Parkinson’s disease, medicines, surgical treatment, and other therapies can often relieve some symptoms. Medicines prescribed for Parkinson’s include:

  • Drugs that increase the level of dopamine in the brain
  • Drugs that affect other brain chemicals in the body
  • Drugs that help control non-motor symptoms

The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapy—such as nausea, vomiting, low blood pressure, and restlessness—and reduces the amount of levodopa needed to improve symptoms.

Other medicines used to treat Parkinson’s symptoms include:
Dopamine agonists to mimic the role of dopamine in the brain
MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain COMT inhibitors to help break down dopamine Amantadine, an old antiviral drug, to reduce involuntary movements Anticholinergic drugs to reduce tremors and muscle rigidity Other therapies are employed to help with the symptoms of Parkinson’s disease including physical, occupational, and speech therapies, which help with gait and voice disorders, tremors and rigidity, and decline in mental functions. Other supportive therapies include a healthy diet and exercises to strengthen muscles and improve balance.

Get Help

If you are concerned about specific symptoms you are having that may be related to Parkinson’s disease, the best first step is to talk to your primary care provider.

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