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Parkinson disease (or, simply, Parkinson) is the most common form of parkinsonism, a group of motor system disorders. It is a slowly progressing, degenerative disease caused by the loss of dopamine-producing brain cells. Dopamine is a substance produced in the body that has many effects, including smooth and coordinated muscle movement. It is usually associated with the following symptoms:
Parkinson's is also called primary parkinsonism or idiopathic Parkinson disease. (Idiopathic is the term for a disorder for which no cause has yet been identified.)
The specific cause of Parkinson is unknown; however, medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Parkinson is chronic, and symptoms grow worse over time.
Although the disease may appear in younger people (even teenagers), it usually affects people in late middle age. It is not contagious.
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 Parkinson. It is important to remember, however, that these factors do not guarantee the development of the disease, nor does their absence prevent it. Currently researchers believe that in most people the cause of Parkinson’s is a combination of genetics and environmental exposure.
In the other forms of parkinsonism, either the cause is known or suspected, or the disorder occurs as a secondary effect of another primary neurological disorder that may have symptoms of Parkinson's disease. These forms, described as Parkinson syndrome, atypical Parkinson, or, simply, parkinsonism, may be caused by the following:
The biggest risk factor for developing Parkinson is advancing age. The average age for the onset of Parkinson is 60 years. In addition, men are affected than women. However, the reason for this is unclear.
Family history is another important risk factor. A person with a parent or sibling affected have approximately two times the chance of developing Parkinson. This increased risk is most likely because of a combination of environmental and genetic factors. Having one or more close relatives with Parkinson increases the risk of developing the disease; however, unless there is a known genetic mutation for Parkinson present, the increased risk is only 2% to 5%.
The following are the most common symptoms of Parkinson. However, each person may experience symptoms differently. Symptoms may include:
Symptoms of Parkinson vary from person to person. The symptoms may appear slowly and in no particular order. Early symptoms may be subtle and may progress over many years before reaching a point where they interfere with normal daily activities.
Other symptoms are divided into motor (movement-related) and non-motor symptoms.
As the disease progresses, walking may become affected, causing the person to stop in mid-stride or "freeze" in place, and maybe even fall over. People also may begin walking with a series of quick, small steps as if hurrying forward to keep balance, a practice known as festination.
The symptoms of Parkinson may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.
Making an accurate diagnosis in the early stages of Parkinson can be difficult, as the beginning signs and symptoms may look like other conditions or the effects of normal aging. For this reason, observation may be required for some time until the symptoms are consistently present.
Currently, there are no blood or lab tests that are useful in the diagnosis of Parkinson. Diagnosis of Parkinson is based primarily on a medical history and thorough neurological exam. Brain scans and/or lab tests may be done to help rule out other diseases or conditions, but brain scan generally will turn out to be normal with Parkinson.
Methods to diagnose Parkinson include:
Specific treatment for a Parkinson will be determined by your health care provider based on:
So far, there is no cure for Parkinson. However, based on the severity of the symptoms and medical profile, the health care provider will establish an appropriate treatment protocol. Treatment for Parkinson may include the following:
Once the diagnosis has been made, the next decision is whether medication is an option, which depends on the following:
No two people react the same way to a given drug; therefore, it takes time and patience to find an appropriate medication and dosage to alleviate symptoms.
Based on the severity of the condition and the medical profile, surgery may be recommended for Parkinson disease.
There are several types of surgery that may be done that can help people with Parkinson disease. Most of the treatments are aimed at helping the tremor or rigidity that comes with the disease. In some people, surgery may decrease the amount of medication that is needed to control the symptoms of Parkinson.
There are three types of surgeries that may be performed for Parkinson disease, including the following:
It is important to remember that surgery may help with symptoms of Parkinson, but does not cure the disease or stop its progression.
Although Parkinson is a chronic, progressive disease, treatment can help minimize symptoms. It is also important to eat a healthy diet and maintain mobility with the use of assistive devices, if needed. Regular exercise, physical therapy, occupational therapy, and speech therapy can promote independence. Talk with your health care provider about depression, anxiety, or other mental health issues that may arise.
Tips to help you get the most from a visit to your health care provider:
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