Parkinson’s disease care in Denver, Colorado
Swedish Medical Center offers customized treatment plans for individuals with a variety of movement disorders, including Parkinson’s disease. Although Parkinson’s disease does not yet have a cure, Swedish Medical Center is committed to using the latest medical advances to create treatment protocols that are designed with each individual’s needs and goals in mind.
What is Parkinson’s disease?
Parkinson’s disease is a neurodegenerative disorder that is categorized in a group of conditions called movement disorders. The disease involves the degeneration of nerves in the substantia nigra, the area of the brain that controls movement. The dead or impaired nerve cells ultimately lose the ability to produce dopamine, which is a critical chemical for proper movement.
Parkinson’s disease symptoms start to develop when approximately 80% of the dopamine-producing cells are severally impaired or dead in the substantia nigra. When this occurs, a person may experience tremors at rest, stiffness in limbs, slowness of movements and/or balance problems.
What causes Parkinson’s disease?
The specific causes for the degeneration of nerves that lead to Parkinson’s disease symptoms are largely unknown. Some scientists and researchers suggest that genetics, the environment or both could play a role.
Risk factors for developing the disease
Although the specific causes are up for debate, there are some risk factors that increase a person’s likelihood of developing Parkinson’s disease. It is essential to understand that a person can develop the disease without any of the associated risk factors; however, the following factors have been shown to increase risk:
- Age: Diagnosis is usually seen in people 50 years old and older, but onset can be anywhere from 35 to 85 years old.
- Gender: Men are 1.5 times more likely to develop the disease.
- Race: Caucasians are shown to have a slightly higher rate of developing Parkinson’s disease compared to the rate of those who are of Asian or African descent.
- Genetics: For people diagnosed before 50 years old, most have abnormal genes that tend to run in their families. For those diagnosed after 60 years old, the role of genetics is unclear.
Parkinson’s disease symptoms
The most common symptoms of Parkinson’s disease include tremors at rest, stiffness and slowness of movements that typically start very slowly and increase in severity over time. The specific symptoms and development timeline vary from person to person.
Not every person with Parkinson’s disease will develop every symptom, and some symptoms may start before the presence of the movement-related issues.
Some of the most common symptoms of Parkinson’s disease are:
Tremors or shakes
The tremors or shakes typically occur at rest and are usually absent when sleeping or when purposely moving. Onset is often slow, starting in a single finger and may progress to the entire arm, feet, etc. “Pill rolling” may also occur, which is characterized by rubbing the index and thumb together.
Balance and coordination issues
Balance issues and problems with coordination typically involve unsteadiness when walking, increased risk of falling and difficulties completing everyday activities, such as eating and writing.
Muscle stiffness or rigidness
Muscle stiffness and rigidness often involves involuntary tightening, which makes it difficult to initiate the desired movement. Automatic movements such as swinging arms while walking, swallowing and facial expressions may become increasingly difficult.
Slowed movements (bradykinesia)
Slowed movements, also known as bradykinesia, often involves shuffling when walking and shorter steps.
Additionally, other common symptoms of the disease may include:
- Difficulty with speech
- Stooped posture
- Cramping (mainly in the legs)
- Sleep issues (sometimes from restless leg syndrome)
- Changes in personality
- Memory issues
- Increased sweating
- Bladder control issues
- Reduced or loss of sense of smell
- Sexual dysfunction
- Body temperature changes
- Freezing (typically advanced stages)
- Increase in urination frequency (nocturia)
- Fluctuating blood pressure (especially when standing)
- Oily-looking skin (seborrhea)
How is Parkinson’s disease diagnosed?
Although there are no laboratory tests for the disease, there are several things doctors look for when making a diagnosis. In addition to performing a physical exam and obtaining detailed information on your medical history, the movement specialist will also look for the presence of two to three of the main symptoms associated with Parkinson’s disease.
However, everyone is different and may therefore not be showing all (or most) of the common symptoms. A neurological exam may be ordered to observe tremors as well as evaluate everything from muscle tone and gait to stability, precision and quickness of movement.
If a diagnosis is still unclear, to help rule out other possible causes, other tests may be conducted, including CT scans, DAT scans, MRI scans and/or PET scans.
Additionally, a movement disorders specialist may prescribe a trial medication, such as levodopa, to see if the medication helps with improving symptoms and confirming a diagnosis.
Treatment for Parkinson’s disease
Since there is not a cure for Parkinson’s disease, the primary treatment options involve symptom management, typically in the form of medications that increase dopamine. However, most treatment plans include one or a combination of the following:
Medications that help relieve Parkinson’s disease symptoms involve either increasing the amount of dopamine or activating the dopamine receptors. Carbidopa and levodopa are typically the most effective in treating movement-related symptoms.
If the disease is affecting a person’s ability to speak, including being able to speak loud enough to be heard, then speech therapy may become part of the treatment plan.
The specific lifestyle changes will vary depending upon the individual’s needs, goals, symptoms and current lifestyle. Some of the following changes may be recommended: more rest, diet changes, more exercise, stress management, depression management or home safety modifications.
Some people have seen symptom reduction from surgery; typically, surgery involves deep brain stimulation, also known as DBS or neurostimulation.
Alieving Parkinson’s disease symptoms with deep brain stimulation
Deep brain stimulation involves the placement of electrodes in different areas of the brain and then sending an electrical impulse to those electrodes, which can result in symptom reduction. Deep brain stimulation is less invasive than other surgical options, may be reversible if necessary and is adjustable to help meet the specific needs of the patient. However, every surgical procedure involves risks and should therefore be discussed with your neurologist.
Individualized Parkinson’s disease treatment plans
The key to successfully treating Parkinson’s disease lies partly in finding a neurologist that specializes in movement-related diseases and can create customized treatment plans for each patient. The neurologists at our hospital in the Denver, Colorado area combine the latest technology and research with movement disorder expertise to craft a custom plan that meets each individual’s specific needs and goals—all with the mission of helping to improve quality of life for those who live with Parkinson’s disease.