Parkinson’s disease is a progressive nervous system disorder that affects physical movement and eventually cognitive function. It has been linked to low dopamine levels in the brain. The disease develops on a gradual basis, and often begins with a hand tremor that is almost undetectable at first. However, even though shaking and tremors are the most recognized sign of the disorder, in many cases it also causes a slowing of movement and stiffness in the muscles. The disease typically begins in middle or late life, and it rarely afflicts young adults. The average age of initial manifestation is 65, and the risk for developing Parkinson’s increases with age.
The cause of Parkinson’s disease is not yet known and is not considered hereditary, but having a close relative with Parkinson’s may slightly increase the chance of developing it after age 60. For reasons unknown, men are at a higher risk for Parkinson’s disease than women. The sooner treatment is sought, the better the chances of delaying the progression of the disease.
Symptoms of Parkinson’s
Symptoms of Parkinson’s disease vary considerably from one individual to the next. Early symptoms are often mild and typically go unnoticed and are sometimes misdiagnosed. Initial symptoms usually occur on only one side of the body, and even after both sides are affected, the side where the symptoms first manifested usually remains the worst.
In addition to shaking and tremors, something referred to as a “pill rolling tremor” is quite common. This is a back-and-forth rubbing of the forefinger and thumb and typically occurs when the hand is at rest.
Over time, the ability to move fast is lost, which makes simple tasks time-consuming and difficult. A person may be unable to stand up quickly, and his or her steps may become shorter and stilted. Some patients described this symptom as feeling like their feet are anchored to the floor.
In a variation of the disease called Rigid Parkinson’s, muscle stiffness may be the first symptom to manifest. This sometimes leads to a longer period between initial symptoms and diagnosis, as there are a high number of causes for muscle stiffness, most of which are much more common than Parkinson’s disease.
Impaired balance and posture is common among Parkinson’s patients, as well. A stooped posture eventually emerges, and it is usually at this point that the “Parkinson’s shuffle” manifests. As its name implies, the person appears to be shuffling his or her feet across the floor, rather than the normal tandem gait that is seen in healthy individuals. Stiffly hanging arms rather than a normal swing is another common sign of the disease.
Often, a masked expression appears, which is noticeable to others. Speech problems occur as well, and these may manifest as stilted talking, slurred speech, or even speaking in a jumbled fashion. Handwriting may appear particularly small and writing may have a distinct wavy appearance. Additional symptoms are listed below which almost always worsen over time:
• Difficulty swallowing
• Difficulty thinking and reasoning
• Bladder problems such as difficulty urinating.
• Changes in blood pressure
• Muscle and joint pain
• Sexual dysfunction
Treatment for Parkinson’s Disease
There is no cure for Parkinson’s disease; however, symptoms can be controlled or reduced by specific drugs. In certain cases of advanced Parkinson’s, surgery may be recommended.
The medications prescribed for Parkinson’s disease were developed to increase dopamine, as dopamine deficiencies play a major role in the development of the disease. Significant improvement is seen in most patients shortly after beginning treatment. Below are the most common drugs prescribed for Parkinson’s:
• Dopamine agonists
• MAO-B inhibitors
• Tolcapone (Tasmar)
In cases of advanced Parkinson’s disease, treatment may include surgery called Deep Brain Stimulation–DBS. This is considered one of the newest treatments for the disorder and has had good outcomes regarding lessening the severity and frequency of symptoms. During the procedure, surgeons implant electrodes into a specific area of the brain and a generator implanted near the collarbone sends impulses to the electrodes which then travel to the brain. Sustained relief from symptoms is often experienced by those who undergo this surgery, although it does not completely stop the progression of the disease.
Some doctors also recommend occupational therapy. Physical therapists offer a wealth of advice to make life easier for Parkinson’s patients. Such therapy is typically focused on stretching, balancing and tips on how to avoid falls, which is of vital importance. Speech language pathologists are sometimes consulted as well, who can suggest exercises to improve speech problems. Although Parkinson’s cannot be cured, the appropriate treatment is available. Therefore, anyone experiencing symptoms of Parkinson’s disease should contact a medical professional for evaluation.