Parkinson's Disease
What is Parkinson's disease?
Parkinson's disease occurs when some of the nerve centers
in the brain lose the ability to regulate muscle movements.
As a result, you may have rigid muscles, tremors, and
difficulty walking and swallowing.
Parkinson's disease is one of the most common diseases
affecting movement in people over age 55. It is chronic,
meaning you will have it the rest of your life. It also is
progressive, which means the symptoms grow worse over time.
The disease may become disabling after many years. However,
proper treatment should make it possible for you to lead a
fulfilling, productive life.
How does it occur?
Parkinson's disease results when nerve cells in a certain
part of the brain die or stop working properly. These cells
stop producing an important brain chemical called dopamine.
Dopamine normally transmits signals to another part of the
brain that allows controlled muscle movement. Without enough
dopamine, the cells in this part of the brain fire out of
control. As a result, you are unable to control your
movements normally.
No one knows why the nerve cells die or become impaired.
Theories include:
-
damage by chemical reactions in the body, such as
oxidation
-
brain infection
-
toxins in the environment such as carbon monoxide
-
inherited tendencies.
What are the symptoms?
A major symptom of Parkinson's disease is tremors. A
tremor is a rhythmic shaking over which you have no control.
Tremors of the hands and sometimes the head often occur
along with a constant rubbing together of thumb and
forefinger.
Over time you may stop making some movements that are
normally automatic, such as the natural swinging of arms
that makes walking smooth. It may become harder to:
In the earliest stages of the disease, symptoms may be
very slight or may not be noticed. Someone close to you
might notice a slight limp, stooped posture, or a mild hand
tremor.
Other symptoms may include drooling and abdominal cramps.
You may have trouble swallowing. In later stages, there is
often a decline in the ability to think and remember.
How is it diagnosed?
Accurate diagnosis can be difficult. Your doctor will ask
about your medical history and examine you. He or she will
look for the physical signs of tremor, rigid muscles, and
slow movements that suggest Parkinson's disease.
There are no tests that can confirm the diagnosis.
However, tests are sometimes used to rule out other
diseases.
How is it treated?
There is no cure yet for Parkinson's disease. However, a
variety of medications can give dramatic relief from the
symptoms. In mild cases of Parkinson's disease, your doctor
may not prescribe medicine to avoid the side effects it can
cause. Your doctor will want to see you regularly to keep
track of your symptoms and determine when you might benefit
from medication.
Your doctor may prescribe medication to help restore the
balance of chemicals in your brain. The main goal of
treatment is to keep your movements as normal as possible
with the smallest amount of medicine. It may not be possible
to get rid of all your symptoms.
Your treatment may also include speech therapy and
physical therapy. In severe cases not helped by medication,
surgery may help prevent uncontrollable tremors.
Medication:
Several different drugs are used to treat Parkinson's
disease. Your doctor will try to use the smallest effective
dosage to reduce the chance of unpleasant side effects.
Levodopa is the main medicine used to treat Parkinson's
disease. The brain can make dopamine from levodopa. Possible
side effects of this medication are:
Eating less protein may help to make levodopa work
better. However, do not begin a low-protein diet without
first talking to your doctor. A major risk with a
low-protein diet is weight loss and malnutrition. If you
have closed- angle glaucoma, you should not take levodopa.
Some of the other medications your doctor may prescribe
are:
-
dopaminelike drugs such as bromocriptine and
pergolide
-
amantadine, a drug used to treat flu
-
anticholinergic drugs, such as benztropine (Cogentin),
trihexyphenidyl (Artane), and orphenadrine (Norflex)
-
selegiline, a drug that slows the breakdown of
dopamine and may help slow down the worsening of
symptoms over time, especially in the early stages of
the disease.
Exercise:
A program of daily exercise will help you have better use
of your muscles. Exercise can help prevent problems that
occur when muscles are not used. It will increase your
muscle strength and improve coordination. You will have less
muscle rigidity. Physical therapy can teach you how to walk
and move in a way that will reduce your risk of falling.
How long do the effects last?
As a result of treatment that relieves symptoms, many
people with this disease remain in fairly good health for
years. The disease progresses despite treatment, however,
and can become disabling over time.
What can I do to prevent Parkinson's disease?
Doctors do not know how to prevent this disease.
How can I take care of myself?
To cope with Parkinson's disease and to relieve your
symptoms:
-
Be sure you and your family know how your
medications work. Know what the side effects are and
which side effects should prompt you to call your
doctor.
-
Do not take any medicines, including nonprescription
products, without letting your doctor know.
-
Make your house safer:
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Put up handrails along walkways.
-
Remove anything that might cause falls.
-
Use chairs with high arms.
-
Use carpeting to help cushion falls.
-
Be sure seats (including shower seats) have sturdy
backs.
-
Put handrails in the bathroom.
-
Consider installing a device that raises the toilet
seat.
-
Use an electric shaver to avoid cuts from razors.
-
Try to make it easy for you to dress yourself:
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Wear loafers or shoes that close with Velcro strips
instead of shoes with laces.
-
Wear clothing that is easy to get on and off.
-
When possible, use Velcro strips on clothing instead
of zippers or buttons.
-
If you have problems swallowing:
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Take as much time as you need to eat meals.
-
Sit upright.
-
Thick liquids are easier to swallow than thin
liquids.
-
Use an electric warming tray to keep food hot during
the long time it may take to finish a meal.
-
Weigh yourself once a week to make sure that you are
not losing too much weight.
-
Reduce constipation by drinking more water and
eating more foods that are high in fiber. High-fiber
foods include whole-grain breads and cereals, beans,
fruits, and vegetables.
-
If you have speech problems, work on other ways to
make your needs known. Practice speech exercises your
doctor or speech therapist may give you.
-
Stay as active as possible. Keep involved in your
work, hobbies, and other activities.
-
Get support from family and friends. Keeping a
positive attitude can be quite helpful.
-
For more information contact:
Parkinson's Disease Foundation
William Black Medical Research Building
Columbia Presbyterian Med. Ctr.
710 W. 168th St.
New York, NY 10032-9982
Phone: 800-457-6676
Web site:
http://www.pdf.org
National Parkinson Foundation, Inc.
1501 NW 9th Avenue/Bob Hope Road
Miami, Florida 33136
Phone: 800-327-4545
Web site:
http://www.parkinson.org
When should I call the doctor?
Your doctor will want to see your progress and check on
how well your treatment is working. Keep your follow-up
appointments on the schedule your doctor recommends. Discuss
any questions and concerns you have at these visits.
Call your doctor if:
-
You have side effects from your medicine, such as
nausea, dizziness, and mental changes.
-
Your weight drops 3% to 5% in any month.
-
You develop fever.
-
Swallowing becomes harder.
-
You become depressed. (Your doctor may be able to
prescribe medicines to help.)
-
You begin to have hallucinations, which can be a
side effect of your medicines. (Your doctor may be able
to adjust the dosages of your medicines.)
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