This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

PARKINSON'S DISEASE

Parkinson's disease is a condition in which the chemicals which control movement, posture, and balance in the brain are not functioning correctly. One of the main chemicals, called dopamine, is either not being produced, or not being responded to. Because of this, the brain has trouble communicating messages to the muscles. Individuals with Parkinson’s disease have trouble with muscle coordination and balance, and often have hand tremors or difficulty in moving around.

WHAT CAUSES PARKINSON'S DISEASE?

The cause of Parkinson’s disease is unknown. The symptoms of Parkinson’s disease are caused by the death of certain types of nerve cells, but why this happens to some people is not known.

WHO GETS PARKINSON'S DISEASE?

People throughout the world and of all ethnic backgrounds get Parkinson’s. Most people who get Parkinson's disease are over 50 years old, but occasionally younger people are diagnosed with it. Both men and women are affected, but it seems to be slightly more common in men. 

WHAT ARE THE SYMPTOMS?

Parkinson's disease usually develops slowly over several years so symptoms are often subtle at first and may even go unnoticed, or may be attributed to the normal aging process. Early symptoms include mumbled speech, a stooped posture, muscle stiffness, and fatigue. Later, the most commonly seen symptoms – muscle tremors, muscle stiffness, slowness in starting any movement (called bradykinesis), and difficulty walking may appear. Individuals with Parkinson’s disease may also have difficulty swallowing, limited facial expressions, and infrequent blinking.

The symptoms of Parkinson's disease are not painful or life-threatening, but they can be frustrating.

DIAGNOSING PARKINSON'S DISEASE

There is no specific test for Parkinson's disease, so doctors must make a diagnosis based on your symptoms. You should be evaluated by a neurologist (a specialist in conditions of the nervous system), to determine if you have Parkinson’s and to check for other neurological problems. The most common symptoms are tremors at rest (when you are not using the muscle), unusual muscle stiffness, difficulty starting your movements, and awkward ambulation.

Your doctor will examine you and ask you questions to find out when the symptoms occur and what makes them better or worse. Tremors from Parkinson’s disease usually are worse while resting and improve with movement. Your doctor may also ask you for a sample of your handwriting since Parkinson's disease tends to cause the writing to become small and cramped.

If your symptoms are very mild, your doctor may not be able to make a definite diagnosis right away and many need to monitor your symptoms for several months. Your doctor may ask you to stop taking your medications temporarily since tremors are a common side effect of many medications. Your doctor may have you try a medication used for Parkinson’s disease to see if this helps relieve your symptoms.

TREATMENT

Treatment of Parkinson's disease is aimed at controlling the symptoms so you can remain independent. To avoid potential long-term effects from certain medications, your doctor may not prescribe any medication at all in the early stages of the disease. Later, if the symptoms begin to limit your activities, your doctor may prescribe several medications to help control your symptoms.

A variety of medications are used for treatment. All of them are used to reduce the tremors and make movement easier. One type of medication increases the amount of dopamine in the brain by supplying L-dopa, one of the main parts of dopamine. Another type makes the cells which receive dopamine more receptive. These medications can be used separately or together and can help control the symptoms of Parkinson's disease. There are also many new medications and combinations of medications which are being studied. Your doctor will work with you to find the right dosage and medication for you which gives the least amount of side effects.

Some of the medications become less effective the longer you take them. Keep your doctor aware of how your symptoms are responding. Medications may be added or changed as needed.

For some individuals with advanced disease who are not responding to medication, more invasive or surgical treatment may be considered.

WHAT YOU CAN DO

It is important for you to work closely with your doctor to find the proper medication and dosage combinations. If you notice that your medication wears off before it is due again or the medication seems to work irregularly, talk with your doctor about changing your medication or dosage. Because certain proteins in foods can interfere with the absorption of some of these medications, taking your medication 30-60 minutes before eating may help it work better. Other medications can also interfere with absorption, so be sure to let your doctor know what other medications you are taking.

Continue to be as active as you can. Since Parkinson's disease causes stiff, weak muscles, it is very important that they don't become stiffer and weaker due to lack of use. Daily activity such as walking can help maintain muscle tone and function. Some people include swimming and dancing in their daily routine.

An exercise program can also be tailored for specific problems with speech, swallowing, posture, or walking. Your doctor or physical therapist can help you with these.

Eating a well balanced, healthy diet is important. Constipation is a common problem but one that can be managed with diet, stool softeners, and/or laxatives.

You can also make sure your home or apartment is easier to move around in by installing hand-rails where needed, getting rid of slippery rugs, and installing a raised toilet seat. Using a cane while walking can help prevent falls if you're unsteady on your feet. Try to do one thing at a time, and walk carefully and slowly.

COPING

Learning to live with a chronic illness can sometimes be difficult for both you and your family. Tasks that were once easy may become more difficult. This can lead to depression, anxiety, and guilt. Having a family member, friend, or counselor to talk to about these feelings can help. Many communities have support groups for people who have Parkinson's disease and their families. These groups can help reassure you that you are not alone and can provide information about how others have learned to live with this disorder. Although Parkinson's disease cannot be cured, with proper treatment the symptoms can be controlled or minimized so that you can continue to be active and independent for a long time.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

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