Overview: Parkinson's disease is a progressive neurodegenerative disorder that affects movement and coordination. It occurs when nerve cells in the brain that produce dopamine (a neurotransmitter responsible for smooth movement) gradually die or become impaired. Parkinson's disease typically develops slowly over many years.

Prevalence

  • Affects approximately 1 million people in the United States
  • More common in people over 60 years old
  • Slightly more common in men than women

Cardinal Symptoms (The "Big Four")

  • Tremor: Shaking, usually starting in hands, often at rest
  • Rigidity: Stiffness in muscles, resistance to movement
  • Bradykinesia: Slowness of movement
  • Postural Instability: Difficulty with balance and coordination

Other Symptoms

  • Stooped posture
  • Reduced facial expressions (mask-like face)
  • Soft, monotone speech
  • Difficulty swallowing
  • Sleep disturbances
  • Depression and anxiety
  • Cognitive changes (in advanced stages)
  • Constipation
  • Urinary problems

Stages of Parkinson's Disease

  • Stage 1 (Mild): Symptoms on one side of body; minimal functional impairment
  • Stage 2 (Moderate): Symptoms on both sides; some functional impairment
  • Stage 3 (Moderate-Severe): Significant functional impairment; balance problems begin
  • Stage 4 (Severe): Severe functional impairment; may require assistance with daily activities
  • Stage 5 (Advanced): Complete dependence; may be bedridden or wheelchair-bound

Risk Factors

  • Age (typically after 60)
  • Male gender
  • Family history
  • Environmental toxin exposure
  • Head injury

Diagnosis

  • Clinical evaluation based on symptoms
  • Neurological examination
  • Response to dopamine medication (positive response supports diagnosis)
  • Brain imaging (MRI, PET scan) to rule out other conditions
  • No definitive blood test or imaging for Parkinson's

Treatment Options

  • Medications:
    • Levodopa (L-DOPA): Most effective medication for motor symptoms
    • Dopamine agonists: Mimic dopamine in the brain
    • MAO-B inhibitors: Slow dopamine breakdown
    • COMT inhibitors: Extend levodopa effectiveness
    • Anticholinergics: Help with tremor and rigidity
  • Deep Brain Stimulation (DBS): Surgical procedure for advanced cases
    • Electrodes implanted in specific brain areas
    • Electrical stimulation helps control symptoms
    • Effective for tremor, rigidity, and bradykinesia
  • Physical Therapy: Improves mobility, balance, and flexibility
  • Occupational Therapy: Helps with daily activities and adaptive strategies
  • Speech Therapy: Addresses speech and swallowing difficulties
  • Lifestyle Modifications:
    • Regular exercise (improves motor function)
    • Healthy diet
    • Adequate sleep
    • Stress management
    • Social engagement

Prognosis

Parkinson's disease is progressive but not immediately life-threatening. Life expectancy is similar to general population. With appropriate treatment and support, many people with Parkinson's maintain good quality of life for many years.

Support and Resources

Our comprehensive Parkinson's program includes medication management, surgical consultation, rehabilitation services, and support groups for patients and caregivers.