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Frequently Asked Questions About Parkinson's Disease

  • What Is Parkinson's Disease?
  • Answer:

    Parkinson's disease is a progressive neurological disorder that results from degeneration of neurons (nerve cells) in a region of the brain that controls movement. This degeneration creates a shortage of the brain-signaling chemical (neurotransmitter) known as dopamine, causing the impaired movements that characterize the disease.

  • What Are the Symptoms of Parkinson's Disease?
  • Answer:

    Often, the first symptom of Parkinson's disease is tremor (trembling or shaking) of a limb, especially when the body is at rest. The tremor often begins on one side of the body, frequently in one hand. Other common symptoms include slow movement (bradykinesia), an inability to move (akinesia), rigid limbs, a shuffling gait, and a stooped posture. People with Parkinson's disease often show reduced facial expressions and speak in a soft voice. Occasionally, the disease also causes depression, personality changes, dementia, sleep disturbances, speech impairments, or sexual difficulties. The severity of Parkinson's symptoms tends to worsen over time.

  • How Many People Are Affected?
  • Answer:

    In the United States, at least 500,000 people are believed to suffer from Parkinson's disease, and about 50,000 new cases are reported annually. These figures are expected to increase as the average age of the population increases. The disorder appears to be slightly more common in men than women. The average age of onset is about 60. Both prevalence and incidence increase with advancing age; the rates are very low in people under 40 and rise among people in their 70s and 80s. Parkinson's disease is found all over the world. The rates vary from country to country, but it is not clear whether this reflects true ethnic and/or geographic differences or discrepancies in data collection.

  • What Causes Parkinson's Disease?
  • Answer:

    Although there are many theories about the cause of Parkinson's disease, none has ever been proved. Recent studies of twins and families with Parkinson's have suggested that some people have an inherited susceptibility to the disease that may be influenced by environmental factors. The strong familial inheritance of the chromosome 4 gene is the first evidence that a gene alteration alone may lead to Parkinson's disease in some people. About 15% to 25% of people with Parkinson's report having a relative with the disease.

  • How Is Parkinson's Disease Diagnosed?
  • Answer:

    Parkinson's disease is usually diagnosed by a neurologist who can evaluate symptoms and their severity. There is no test that can clearly identify the disease. Sometimes people with suspected Parkinson's disease are given anti-Parkinson's drugs to see if they respond. Other tests, such as brain scans, can help doctors decide if a patient has true Parkinson's disease or some other disorder that resembles it.

  • What Treatments Are Available for Parkinson's Disease?
  • Answer:

    There is no cure for Parkinson's disease. Many patients are only mildly affected and need no treatment for several years after the initial diagnosis. When symptoms grow severe, doctors usually prescribe levodopa (L-dopa), which helps replace the brain's dopamine. Sometimes doctors prescribe other drugs that affect dopamine levels in the brain.

     Usually, patients are given levodopa combined with carbidopa.  Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain.  Nerve cells can use levodopa to make dopamine and replenish the brain's dwindling supply.  Although levodopa helps at least three-quarters of Parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all. Anticholinergics may help control tremor and rigidity. 

    Other drugs, such as pramipexole and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine. An antiviral drug, amantadine, also appears to reduce symptoms. In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced Parkinson's disease or as a single-drug treatment for early Parkinson's disease. 

    In some cases, surgery may be appropriate if the disease doesn't respond to drugs. In patients who are very severely affected, a kind of brain surgery known as pallidotomy has reportedly been effective in reducing symptoms. A therapy called deep brain stimulation (DBS) has now been approved by the FDA. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.

WebMD Medical Reference

Reviewed by Jon Glass on August 13, 2012

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