Parkinson's disease - Highlights
- Risk Factors
- Levadopa (L-dopa)
- Other Medications
- Lifestyle Changes
DescriptionAn in-depth report on the causes, diagnosis, and treatment of Parkinson's disease
What Is Parkinson‚ ' s Disease?
Parkinson‚ ' s disease is a neurological disorder that affects movement, muscle control, and balance. Parkinson‚ ' s disease usually affects people 55 - 75 years old, but it can also develop in younger people. The disease is progressive, with symptoms becoming more severe over time.
Symptoms of Parkinson‚ ' s Disease
Parkinson‚ ' s disease is difficult to diagnose in its early stages. The disease is diagnosed mostly through symptoms, which may include:
- Tremors (shaking) in the hands, arms, legs, and face
- Slowness of movement, especially when initiating motion
- Muscle rigidity
- Difficulty with walking, balance, and coordination
- Difficulty eating and swallowing
- Digestive problems
- Speech problems
- Depression and difficulties with memory and thought processes
There is no cure for Parkinson‚ ' s disease. Treatments focus on controlling symptoms and improving quality of life.
- Medications. Because Parkinson‚ ' s disease symptoms are due to a deficiency of the brain chemical dopamine, the main drug treatments help increase dopamine levels in the brain. Levadopa, usually combined with carbidopa, is the standard drug treatment. For patients who do not respond to levadopa, dopamine agonists(drugs that mimic the action of dopamine) may be prescribed. Other types of medication may also be used. Unfortunately, many of these drugs can cause side effects and lose effectiveness over time.
- Physical Therapy. Physical therapy is an important part of Parkinson‚ ' s treatment. Rehabilitation can help patients improve their mobility, speech, and functional abilities.
- Surgery. In some cases of advanced-stage Parkinson‚ ' s disease, surgery may help to control motor problems. Deep brain stimulation is currently the preferred surgical method.
- www.ninds.nih.gov -- National Institute of Neurological Disorders and Stroke
- www.aan.com -- American Academy of Neurology
- www.apdaparkinson.org -- American Parkinson's Disease Association
- www.pdf.org -- Parkinson's Disease Foundation
- www.parkinson.org -- National Parkinson Foundation
- www.michaeljfox.org -- Michael J. Fox Foundation for Parkinson's Research
- www.wemove.org -- Worldwide Education and Awareness for Movement Disorders
- www.parkinsonsaction.org -- Parkinson's Action Network
Benabid AL, Chabardes S, Mitrofanis J, Pollak P. Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease. Lancet Neurol. 2009 Jan;8(1):67-81.
Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K, et al. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med. 2006 Aug 31;355(9):896-908.
Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis. Mov Disord. 2008 Apr 15;23(5):631-40.
Katzenschlager R, Head J, Schrag A, Ben-Shlomo Y, Evans A, Lees AJ; Parkinson's Disease Research Group of the United Kingdom. Fourteen-year final report of the randomized PDRG-UK trial comparing three initial treatments in PD. Neurology. 2008 Aug 12;71(7):474-80. Epub 2008 Jun 25.
Lang A. Parkinsonism. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 433.
Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009 Feb 17;72(7 Suppl):S39-43.
Lewitt PA. Levodopa for the treatment of Parkinson's disease. N Engl J Med. 2008 Dec 4;359(23):2468-76.
Miyasaki JM, Shannon K, Voon V, Ravina B, Kleiner-Fisman G, Anderson K, et al. Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 Apr 11;66(7):996-1002.
Olanow CW, Stern MB, Sethi K. The scientific and clinical basis for the treatment of Parkinson disease (2009). Neurology. 2009 May 26;72(21 Suppl 4):S1-136.
Pahwa R, Factor SA, Lyons KE, Ondo WG, Gronseth G, Bronte-Stewart H, et al. Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 Apr 11;66(7):983-95.
Poewe W. Treatments for Parkinson disease--past achievements and current clinical needs. Neurology. 2009 Feb 17;72(7 Suppl):S65-73.
Schade R, Andersohn F, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac-valve regurgitation. N Engl J Med. 2007 Jan 4;356(1):29-38.
Storch A, Jost WH, Vieregge P, Spiegel J, Grelich W, Durner J, et al. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q10 in Parkinson disease. Arch Neurol. 2007 July;64(7):938-944. Epub 2007 May 14.
Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner WJ; Quality Standards Subcommittee of the American Academy of Neurology. Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 Apr 11;66(7):968-75.
Thurman DJ, Stevens JA, Rao JK; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: Assessing patients in a neurology practice for risk of falls (an evidence-based review): report of the Quality Standards Subcommittee of theAmerican Academy of Neurology. Neurology. 2008 Feb 5;70(6):473-9.
Weaver FM, Follett K, Stern M, Hur K, Harris C, Marks WJ Jr, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009 Jan 7;301(1):63-73.
Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Valvular heart disease and the use of dopamine agonists for Parkinson's disease. N Engl J Med. 2007 Jan 4;356(1):39-46.
- Reviewed last on: 8/4/2009
- Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.