April is Parkinson’s Disease Awareness Month. In support of raising awareness of this chronic condition, this post looks at Parkinson’s symptoms, diagnosis, and treatment. We also take a look at the early signs of Parkinson’s disease (PD) to aid in early diagnosis.
What Is Parkinson’s Disease?
Parkinson’s disease is a movement disorder that affects the nervous system, making it a neurodegenerative condition. It develops slowly, over the course of many years. While Parkinson’s is incurable, thankfully it is not fatal. However, it is a progressive disease, which means it gets worse over time.
While there is no cure for PD, there are treatments available to help manage symptoms. These include medications, surgical interventions (relatively rare), and holistic remedies to help improve function and quality of life.
How Many People Have Parkinson’s Disease?
Worldwide, there are more than 10 million Parkinson’s patients and the Parkinson’s Foundation predicts nearly 1 million Americans will have PD by 2020. Each year, the U.S. sees around 60,000 new diagnoses. Age and gender are the greatest risk factors. Around 96 percent of patients are over the age of 50 and men are around 1.5 times more likely to have PD.
Common Symptoms of Parkinson’s Disease
Parkinson’s is mostly known for its movement-related symptoms (which is why it’s known as a movement disorder). Everyone with Parkinson’s has the first symptom, bradykinesia. The term literally means slowness of movement. Researchers believe that this is due to changes in the motor areas of the brain (caused by PD). These changes interfere with the brain’s ability to “execute the commands to move.”
Experiencing bradykinesia alone does not result in a diagnosis of Parkinson’s disease. The patient must also exhibit at least one of the following movement symptoms:
- Postural instability
Of the three, tremor is the most common – and most commonly associated with the condition. It presents as a slight shaking in the hand or chin. Rigidity is when the patient experiences stiffness in the arms or legs that is not caused by arthritis. Finally, postural instability simply means that the patient has issues with balance or is prone to falling.
Other movement symptoms include:
- Stooped posture
- Involuntary, erratic movements in the face, limbs, or body
- Muscle cramping
- Taking short, rapid steps while walking
- A temporary inability to walk or initiate movement
- Speech difficulties, such as speaking in a soft or hoarse voice
- A serious, depressed, or angry expression even when not in a bad mood
- Changes to handwriting, particularly small, cramped, or messy handwriting
- Excess saliva or drooling
Movement symptoms are caused by reduced production of the neurotransmitter dopamine.
Although PD is most commonly associated with changes in motor movement, most patients develop non-movement symptoms as well. These include:
- Chronic or recurring pain
- Constipation, incontinence, or increased urgency/frequency with urination
- Delusions or hallucinations
- Dementia, language problems, memory, short attention span, planning, and other cognitive issues
- Difficulty reading up close
- Erectile dysfunction or other sexual issues
- Excessive sweating
- Feeling full even after eating only a small amount, which often leads to unintended weight loss
- Feeling lightheaded upon standing
- Insomnia, excessive daytime sleepiness, restless legs syndrome, vivid dreams, and other sleep disorders
- Losing sense of taste or smell
- Mood disorders such as anxiety, depression, and apathy
Some non-movement symptoms do not become apparent until a patient has had PD for many years.
Early Warning Signs of Parkinson’s Disease
Following are 10 early warning signs of Parkinson’s disease. If you have two or more of these symptoms, you may want to talk to your doctor.
Diagnosing Parkinson’s Disease
Before your doctor begins testing for Parkinson’s disease, you must have at least two of the common movement symptoms listed above. In addition, these must be present over time or be reoccurring. Many movement symptoms are common to other conditions or even the simple fact of getting older. For example, tremors are common after exercise, in response to stress, or as a side effect of certain medications.
If the patient’s primary doctor suspects PD, he or she typically makes a referral to a neurologist, preferably one who is a movement disorder specialist.
Treating Parkinson’s Disease
Treatment varies widely according to the patient’s symptoms. This is because there is no cure for Parkinson’s. All treatment is designed to manage symptoms and slow disease progression.
Prescription medications to treat Parkinson’s
Most movement symptoms are due to a lack of dopamine. Therefore, drugs prescribed to treat PD are dopaminergic; they either replenish dopamine or mimic its effects on the brain. The most common is called levodopa. The body converts this medication into dopamine to help control movement symptoms.
Make sure your doctor knows all medications you take – including over-the-counter and supplements. This helps reduce the risk of drug interactions, a common issue for Parkinson’s patients.
Surgical options for Parkinson’s disease
As of 2019, there are two surgeries prescribed to treat Parkinson’s. These are only ordered if medications previously helped control movement symptoms but are no longer effective.
The first is called deep brain stimulation. The surgeon inserts a wire, or lead, into the subthalamic nucleus, which is the part of the brain that controls movement. The wire extends to an external device called a neurostimulator. This sends electrical pulses through the lead to stimulate the subthalamic nucleus.
The second surgery is prescribed in cases where the patient suffers too many side effects from the levodopa or requires too strong a dose. A surgeon inserts a tube in the small intestine, through which the patient receives doses of carbidopa. This enhances the effect of levodopa, allowing the patient to receive a smaller dose.
Exercise and Parkinson’s disease
Research conducted by the Parkinson’s Foundation reveals that exercising at least 2.5 hours per week improves symptoms and slows disease progression. The group also found that the earlier patients began exercising, the more pronounced the benefits were.
To help with balance and mobility, the Foundation recommends aerobics, strength-training, and flexibility exercises. Popular options include:
- Qi gong
- Tai chi
- Weight lifting
The real secret to the best exercise program, though, is doing what you enjoy. For some ideas, please see our previous articles on strength-building exercise and how to begin an exercise program. And remember, never begin a new exercise regimen without talking to your doctor.
Alternative therapies to treat Parkinson’s disease
Although no herbs or supplements have been approved by the FDA to treat Parkinson’s, there are a variety of alternative therapies currently being researched.
- Calcium supplements are often prescribed because dairy makes it harder for the body to absorb levodopa.
- Coenzyme Q10 is an antioxidant thought to improve mitochondria health. Some researchers believe abnormal function of the mitochondria may play a role in Parkinson’s.
- Creatine may help increase levels of phosphocreatine, a substance that provides energy to the brain.
- Folate, aka vitamin B9, is vital to both brain health and the nervous system.
- Ginger is often recommended to reduce nausea caused by medications.
- The Mediterranean Diet may help manage symptoms and reduce blood pressure.
- Vitamin D supplements may be needed to help your body absorb calcium, particularly if you don’t get enough sunshine.
- Vitamin E may help fight damage to brain cells caused by free radicals, although studies concluded it does nothing to manage symptoms after diagnosis.
Finally, anecdotal evidence suggests that medical marijuana, now legal in 33 states plus Washington, D.C., may help patients with Parkinson’s disease. The Parkinson’s Foundation has a full page on the research being conducted to determine whether medical marijuana is a viable treatment option for PD patients.
Talk to Your Doctor
If you have at least two of the symptoms for Parkinson’s disease, please schedule an appointment. You can call our office at 760-305-1900 or use our Patient Portal.