Definition

Parkinson disease (PD) is a brain disorder that causes tremors and problems moving.

Part of the Brain Affected by PD—Yellow Section
Substansia Nigra
Copyright © Nucleus Medical Media, Inc.

Causes

Dopamine is a chemical in the brain. It helps people move and control their emotions. PD is caused by a loss of brain cells that make dopamine. It is not known why this happens.

A small number of people with PD have an early-onset form. This type is caused by a faulty gene. It is passed down from parents.

Risk Factors

PD is more common in older adults. Other things that may raise the risk are:

  • Family members with PD
  • Exposure to toxins, such as well water and pesticides

Symptoms

Symptoms start slowly and get worse over time. Common ones may be:

  • Tremors that are worse at rest
  • Moving slowly
  • Muscle stiffness
  • Problems doing tasks with the hands
  • Problems moving, such as taking smaller steps and shuffling
  • Problems doing activities of daily living, such as dressing
  • Fatigue
  • Pain
  • Sleep problems
  • Mood swings
  • Problems thinking
  • Perceiving things that are not there
  • Believing things that are not based in reality
  • Lightheadedness
  • Constipation
  • Problems with urine and bowel control

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to make the diagnosis. There are no tests for PD.

Images may be taken to rule out other causes and confirm the diagnosis. These may be:

Treatment

There is no cure. Treatment is aimed at managing symptoms.

Medicine

Medicines that may be used to ease symptoms are:

  • Levodopa-carbidopa to treat tremors and problems moving
  • Dopamine agonists
  • Monoamine oxidase type B inhibitors
  • Anticholinergics
  • COMT inhibitors
  • Antivirals

Medicine may also be given to ease symptoms of depression.

Surgery

Surgical choices are:

  • Deep brain stimulation (DBS)—implants a device to stimulate certain parts of the brain to ease problems with movement
  • Thalamotomy—destroys certain parts of the brain to improve severe tremors

Physical Therapy

Therapy can improve muscle tone, strength, balance, and movement.

Cognitive Behavioral Therapy

Cognitive behavioral therapy may ease symptoms and improve quality of life. It has a person examine their feelings and thought patterns, learn to interpret them, and apply coping methods to situations.

Prevention

There are no current guidelines to prevent PD.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2019 -
  • Update Date: 10/21/2019 -