Parkinson’s disease – a progressive nervous system disorder – is an incredibly diverse disease that looks different for everyone diagnosed with it. Here, we shed some light on the wide range of symptoms it can cause, as well as what treatment plans might involve for those diagnosed with the disease.
Parkinson’s disease is a neurodegenerative disorder that affects a specific area of the brain called the substantia nigra. This structure, located in the midbrain, plays an important role in the brain’s function, particularly regarding eye movement, motor planning, reward-seeking, learning, and addiction. Parkinson’s compromises this area of the brain by killing off dopaminergic neurons, which are the nervous system’s primary source of dopamine, a neurotransmitter that plays a key role in the brain functions mentioned above.
Symptoms
When someone has Parkinson’s disease, the symptoms of it usually develop gradually, and the progression of these symptoms can vary greatly among individuals. Some of the primary symptoms of the disease include:
- Tremor
- Stiffness / limb rigidity
- Slowness of movement (bradykinesia)
- Difficulty with gait and balance
However, there are a number of other symptoms that might arise, including:
- Cramping muscles
- Involuntary movements (dyskinesia)
- Walking with short, rapid steps
- Soft speech or a hoarse voice
- Shuffling gait
- Small, untidy handwriting (micrographia)
- Constipation
- Drooling
- Fatigue
- Cognitive impairment
- Loss of smell
- Sleep disorders
- Incontinence
- Lightheadedness
- Mood disorders
- Decreased facial movement
- Loss of taste
- Excessive sweating
Parkinson’s affects people in different ways and with varying severity. However, there are stages of the disease that are guided by typical progression patterns. In stage one of the disease, the person experiences mild symptoms that usually don’t interfere significantly with daily life, such as changes in posture, walking, or tremor or movement symptoms that occur on one side of the body. In stage two of the disease, movement symptoms typically begin to affect both sides of the body. Stage three is considered to be the middle stage of the disease’s progression, and loss of balance and slow movements become common. At stage four, symptoms are often severe and limit the person’s ability to live and function successfully on their own. Stage five – the most advanced stage – often restricts the person to a wheelchair or bed, with around-the-clock care required. At this point, hallucinations and delusions may affect the individual with the disease.
Causes
“There is no single, definitive cause of Parkinson’s disease,” says Dr. Tareck Kadrie, a neurologist on staff at CHI Memorial. “It is likely a combination of genetic, environmental, and unknown factors.” Research estimates that genetics causes somewhere between 10 and 20% of Parkinson’s cases, and certain genetic mutations have been linked to Parkinson’s.
Environmental and lifestyle risk factors are varied. Head trauma, especially repeated head trauma, as well as exposure to certain chemicals, pesticides, or heavy metals can potentially increase the risk of developing Parkinson’s. “It is more likely to develop in males than in females,” adds Dr. Kadrie. “Advancing age also makes one more susceptible to the disease. The average age of onset is approximately 60 years of age.”
Diagnosis
Just as there is no one definitive cause of Parkinson’s disease, there is also no one definitive method of diagnosing it. Commonly, your physician will first make note of key symptoms, such as tremors or trouble with movement, and patients will often be referred to a neurologist following this. The neurologist will then review your symptoms, medical history, and any physical or neurological exam results.
Some of the tests that might be administered include a dopamine transporter scan (DaTscan), though many patients do not require this for a diagnosis to be made. Other imaging tests such as an MRI, PET scan, or brain ultrasound might be administered, primarily to rule out other conditions. Some doctors confirm the diagnosis by prescribing Parkinson’s medication to see if the patient’s symptoms improve as a result.
Treatment
While there is currently no cure for Parkinson’s disease, there are a variety of treatments available for it. Medications are available that can help manage primary symptoms such as tremors or difficulty with movement, and other medications might also be prescribed to treat secondary symptoms such as depression. Depending on the advancement of the disease, surgical treatments might also be considered. Clinical trials might also be an option.
Therapies, as well as lifestyle changes, are also often recommended as treatment methods. “Formal physical therapy, occupational therapy, and speech therapy are often helpful in managing disease,” says Dr. Kadrie. “It is also important to address cognitive impairment, sleep disorders, and mood disorders, which are often seen. Chewing and swallowing impairment can be seen later in the disease and will need to be managed.”
If someone diagnosed with Parkinson’s isn’t already exercising regularly, an exercise program might be recommended, as physical activity can help maintain balance, muscle strength, and flexibility. However, it’s important to consult with your doctor before beginning, as certain types of exercise can elevate the risk of falling for someone with movement or balance issues. If you’re struggling mentally with a Parkinson’s diagnosis, support groups may be available in your area and can offer resources as well as an environment to help you cope. If you’re experiencing symptoms that aren’t being addressed, be sure to let your doctor know, as it’s not unusual for comprehensive treatment plans to shift and change over time.
Tareck Kadrie, MD
Neurologist, CHI Memorial Medical Staff
