What is Parkinson's disease?

Parkinson's disease (PD or, simply, Parkinson's) is the most common form of parkinsonism, a group of motor system disorders. It is a slowly progressing, degenerative disease that is usually associated with the following symptoms, all of which result from the loss of dopamine-producing brain cells:

* tremor or trembling of the arms, jaw, legs, and face
* stiffness or rigidity of the limbs and trunk
* bradykinesia (slowness of movement)
* postural instability, or impaired balance and coordination

Dopamine is a substance produced in the body which has many effects, including smooth and coordinated muscle movement.

Facts about Parkinson's disease:

It is incorrectly believed that Parkinson's disease disappeared after the introduction of levodopa (L-dopa) in the 1960s. In fact, about 60,000 Americans are newly diagnosed with Parkinson's disease each year, with more than 1.5 million Americans affected at any one time. Further, more people suffer from Parkinson's disease than multiple sclerosis, muscular dystrophy, and amyotrophic lateral sclerosis combined.


What causes Parkinson's disease (PD)?

The specific cause of PD is unknown, however, medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Parkinson's disease is chronic (persists over a long period of time), and progressive (symptoms grow worse over time).

Although the disease may appear in younger patients (even teenagers), it usually affects people in late middle age. It is not contagious, nor is it likely passed on from generation to generation.

The biggest risk factor for developing PD is advancing age. In addition, men have a slightly higher risk of developing it than women.

Family history is another important risk factor. Individuals with a parent or sibling who are affected have approximately two times the chance of developing PD. This increased risk is most likely because of a combination of environmental and genetic factors.

Environmental causes are being researched and the strong consistent findings are that rural living, exposure to well water, and exposure to agricultural pesticides and herbicides are related to PD. It is important to remember, however, that these factors do not guarantee the development of PD, nor does their absence prevent it. Less than one percent of PD is familial (occurring among members of a family).

Currently researchers believe that in most individuals the cause of PD is a combination of genetics and environmental exposure.

What are the four primary symptoms of Parkinson's?

The following are the most common symptoms of Parkinson's disease. However, each individual may experience symptoms differently. Symptoms may include:

* muscle rigidity - stiffness when the arm, leg, or neck is moved back and forth.
* resting tremor - tremor (involuntary movement from contracting muscles) that is most prominent at rest.
* bradykinesia - slowness in initiating movement.
* postural instability - poor posture and balance that may cause falls; gait or balance problems.

How is Parkinson's disease diagnosed?

Making an accurate diagnosis in the early stages of Parkinson's disease can be difficult, and may require observation of the patient for some time until it is apparent that the tremor is consistently present and is joined by one or more of the other classic symptoms.

Currently, there are no specific tests or markers for PD, although there are several methods for making the diagnosis. Diagnosis depends on the presence of two of the three major signs: tremor at rest, rigidity, and bradykinesia, as well as the absence of a secondary cause of the signs.

Other methods to assist with the diagnosis of PD include:

* neurological examination (including evaluation of symptoms and their severity)
* trial test of drugs - when symptoms are significant, a trial test of drugs (primarily levodopa [L-dopa]) may be used to further diagnose the presence of PD. If a patient fails to benefit from levodopa, a diagnosis of Parkinson's disease may be questionable.
* computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
* magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment for Parkinson's disease:
Specific treatment for a Parkinson's disease will be determined by your physician based on:

* your age, overall health, and medical history
* extent of the condition
* type of condition
* your tolerance for specific medications, procedures, or therapies
* expectations for the course of the condition
* your opinion or preference

With today's medicine, we have yet to find a cure for Parkinson's disease. However, based upon the severity of the symptoms and medical profile, the physician will establish an appropriate treatment protocol. Treatment for Parkinson's disease may include the following:

* medications
* surgery