Often referred to as a movement disorder, Parkinson’s disease (PD) is marked by tremors and difficulty with gait or balance. In honor of Parkinson’s Disease Awareness Month, this post describes the symptoms, diagnosis, and treatment of Parkinson’s disease.
What Is Parkinson’s Disease?
Parkinson’s disease is a neurodegenerative condition affecting the nervous system. This chronic condition develops over many years and gets worse over time. While PD is incurable, it is treatable with medications, surgical interventions, and lifestyle changes.
According to the Parkinson’s Foundation, around 60,000 new PD diagnoses occur in America each year. Incidence increases with age; only around 4 percent of patients are under age 50. The condition is also more prevalent in men than in women.
What Are the Symptoms of Parkinson’s Disease?
There is no Parkinson’s diagnosis unless the patient experiences two of the four most common symptoms.
Bradykinesia means slowness of movement and it is present in every PD patient. In addition, the patient must also experience at least one of the following:
- Tremor: Slight shaking in the hand, finger, thumb, or chin
- Rigidity: Stiffness in the arms or legs not attributed to arthritis
- Postural instability: Falling or trouble with balance
Although at least two of these issues affect every patient with Parkinson’s disease, additional symptoms vary widely. They are categorized as either movement or non-movement.
In addition to bradykinesia, tremor, rigidity, and postural instability, movement symptoms include:
- Sialorrhea: Excess saliva or drooling
- Dyskinesia: Involuntary, erratic movements in the face, arms, trunk, or legs
- Masked face: Looking serious, depressed, or angry even when not in a bad mood
- Festination: Short, rapid steps while walking
- Micrographia: Small, cramped, or messy handwriting
- Hypophonia: Speaking in a soft or hoarse voice
- Difficulty walking: Stooped posture and issues with gait such as shuffling and short steps
- Dystonia: Sustained or repetitive muscle cramping
- Freezing: Temporary inability to walk or initiate movement
Movement symptoms are caused by reduced production of the neurotransmitter dopamine.
Although PD is most commonly associated with changes in motor movement, most patients develop non-movement symptoms as well. These include:
- Anxiety, depression, apathy, or other mood disorders
- Cognitive issues including dementia, language, memory, attention span, and planning
- Delusions or hallucinations
- Erectile dysfunction or other sexual issues
- Excessive sweating (may be due to medications)
- Incontinence or increased frequency or urgency with urination
- Insomnia, excessive daytime sleepiness, restless legs syndrome, vivid dreams, and other sleep disorders
- Loss of taste or smell
- Orthostatic hypotension, aka lightheadedness, typically due to a drop in blood pressure
- Seborrheic dermatitis, aka dandruff
- Vision problems, particularly when reading up close
- Weight loss, often due to feeling full even after eating only a small amount
Please note that these symptoms may not present until years after the patient receives a Parkinson’s diagnosis.
How Is Parkinson’s Disease Diagnosed?
There are multiple means of diagnosing Parkinson’s disease. However, before your doctor even considers further testing, you must present at least two of the four common movement symptoms listed above. In addition, you must experience these symptoms over time. That’s due in part to the fact that many of PD’s symptoms mimic those of other conditions.
Most patients’ initial diagnosis comes from their primary care physician. However, patients should then consult with a neurologist, preferably a movement disorder specialist. These doctors receive highly-focused training on a variety of movement disorders, including Parkinson’s disease.
How Do You Treat Parkinson’s Disease?
Treating PD depends on the individual patient. As the disease is not curable, treatment is designed to manage symptoms. Options include medications, surgical procedures, and lifestyle changes.
Medications to treat Parkinson’s
Prescription medications depend entirely on the patient’s unique condition. Choosing the right medications depends on the symptoms – both movement and non-movement – as well as the patient’s other conditions and medications. For example, levodopa, which the body converts into dopamine in the brain, is often prescribed to control movement symptoms.
As lack of dopamine plays a large role in movement symptoms, doctors often prescribe dopaminergic medications that either mimic or replenish the hormone. If you take any other medications – whether over-the-counter or prescription – talk to your doctor to minimize risk of drug interactions.
Medical marijuana and Parkinson’s disease
Medical marijuana is legal in 33 states plus Washington, D.C. Anecdotal evidence regarding the drug’s efficacy in treating Parkinson’s has led to a great deal of research into cannabis as a treatment option. For full details, please see the Parkinson’s Foundation’s page on medical marijuana.
Surgical treatment options
Surgery is only ordered when the patient’s tremors no longer respond to medication or if they experience significant changes in their ability to move. There are currently (as of 2019) two surgical options.
Deep brain stimulation involves inserting a wire into the area of the brain that controls movement. An external device sends electrical pulses through this wire to stimulate the area.
In the second procedure, the surgeon inserts a tube in the small intestine. The tube is used to deliver a medication called carbidopa, which supplements the levodopa so the patient can receive a smaller dose without decreasing the benefit received from the drug.
Lifestyle changes to treat Parkinson’s disease
The Parkinson’s Foundation conducted research to determine whether exercise improved quality of life for Parkinson’s patients. The answer? Patients who exercise at least 2.5 hours per week experienced a slower decline. And the earlier they began exercising, the better.
Recommended exercises include stretching, aerobics, and strength-training or resistance exercises. Tai chi, dance, yoga, Pilates, qi gong, jogging, biking, and weight training are all good choices. As always, talk to your doctor before beginning any exercise program.
Parkinson’s Disease and Medicare
If you are under the age of 65 and living with Parkinson’s, you may qualify for Medicare benefits if you receive Social Security Disability. The licensed agents at Medicare Solutions can help you understand your options. Just call us toll-free at 855-350-8101 to get started.