Parkinson's disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults. It affects both men and women.
In some cases, Parkinson's disease runs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.
Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why these brain cells waste away is unknown.
Parkinson's is rare in children. It may occur because the nerves are not as sensitive to dopamine.
The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (called secondary parkinsonism) or certain medications.
Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, and can include:
Your health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. They become more clear as the illness gets worse.
A doctor's examination may show:
Difficulty starting or finishing voluntary movements
Tests may be needed to rule out other disorders that cause similar symptoms.
There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.
Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wears off, and symptoms can return. If this happens to you, your health care provider may need to change the:
Type of medication
Amount of time between doses
How the medicine is taken
Work closely with your doctors and therapists to find a treatment program that works best for you. Never change or stop taking any medications without talking with your doctor.
Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.
Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.
Medications used to treat movement-related symptoms of Parkinson's disease include:
Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
Also tell the health care provider about medication side effects, which may include:
Changes in alertness, behavior or mood
Loss of mental functions
Nausea and vomiting
Severe confusion or disorientation
Also call your health care provider if the condition gets worse and home care is no longer possible.
Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.
Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.
Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, et al. Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Mar 16;74(11):924-31.
A.D.A.M. Health Solutions Editorial Team, Ebix, Inc.: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network (9/26/2011).