Parkinson's Disease

What is Parkinson disease?

Parkinson disease (PD) is a chronic (long-lasting) disease of the brain that gets worse as time goes by. When you have PD, the brain cells that control your body's movement start to die. This causes changes in how you move, feel, and act. It also causes changes to certain body functions. Your symptoms can get so bad that they get in the way of how you live your life. Although there is no cure for PD, it is not a fatal (deadly) disease. With treatment, you body may become stronger and you may be able to move better. You may be able to take better care of yourself longer at home and at work.

What causes Parkinson disease?

No one really knows what causes PD. It may be caused by a problem with how your brain works. The brain chemical dopamine helps your brain control your movement, thoughts, and feelings. Some caregivers believe that the symptoms of PD happen when there is not enough dopamine in your brain. Another possible cause is a defect in your genes. Genes are proteins that help build and maintain your body. PD may also develop after your brain has been injured by trauma, infection, or drugs.

What may increase my risk of having Parkinson disease?

You may be more likely to get PD with any of the following:

• Being 60 years of age or older.
  
  
• Being exposed to pesticides or herbicides (pest control and gardening chemicals).
  
  
• Drinking well water.
  
  
• Having a family member with PD.
  
  
• Living in a rural area.

What are the signs and symptoms of Parkinson disease?

You will have problems with your body movement. These symptoms are often used to help diagnose PD. Your symptoms will usually get worse as you grow older. You may also develop more symptoms as you get older.

• Tremors: Tremors are shaking movements that you cannot control. Your hands and fingers may shake while you are at rest (not trying to move them). Your thumb, index, and middle fingers may rub together as if you are rolling a pill. You may also have tremors in your chin, jaw, lips, and legs. Tremors usually occur on one side of your body, but may occur on both sides. Tremors usually go away when you start moving on your own or while you are sleeping.
  
  
• Movement: It may take you longer to move your body. It may be harder to do your normal everyday tasks. You may have trouble doing tasks with small movements, such as buttoning, eating with forks, and opening jars. You may also have trouble turning over in bed or getting up from a chair. Your face may look stiff and you may not blink as much. As PD gets worse, you may have trouble starting to move. You may also suddenly stop moving.
  
  
• Rigidity: Your muscles and joints may become rigid (very stiff). Your joints are the parts of your body where two bones meet. You may become stiff in your neck, shoulders, hips, wrists, and ankles. Sometimes your movements will be stiff and jerky when your caregiver tries to move a part of your body.
  
  
• Posture and balance: Posture (body position) problems usually happen after you have had PD for a few years. You may hunch over while standing. You may lose your balance when you change your position. Problems with your balance may cause you to fall.
  
  
• Walking: You may walk in a stooped or hunched over position. You may shuffle your feet, or take smaller and quicker steps.
  
  
• Speaking and writing: You may have trouble speaking. You may also speak more softly than usual. Your handwriting may change and become so small that it is hard for anyone to read it.

What other problems may I have with Parkinson disease?

You may have symptoms that do not have anything to do with how you move. These include signs and symptoms that are related to your mental health, behavior, and body functions.

• Mood and mental changes: You may feel depressed (very sad) or anxious (worried and nervous). You may see or hear things that are not really there. You may have problems with your memory. It may be hard for you to pay attention or make decisions. You may easily be confused and unable to think clearly. It may be hard for you to complete tasks that are done in a certain order.
  
  
• Sleep: You may have a hard time falling asleep or you may sleep less than usual. You may wake up and be unable to go back to sleep again. You may become sleepy during the day. Your arms and legs may move during sleep, and your legs may shake beyond your control. You may act out your dreams, making you yell, swear, punch, kick, or move violently in your sleep. This can hurt you or your sleeping partner.
  
  
• Behavior: You may have a hard time controlling your actions. You may do things that are not good for you or other people. You may feel like you have to do certain things over and over again, like shuffling paper.
  
  
• Body functions: You may have trouble smelling things or you may not be able to smell at all. Your vision (eyesight) may be double or blurred. You may have trouble swallowing, which may cause drooling or choking. You may have trouble with bowel movements and you may urinate more often. Your blood pressure may drop suddenly when you change position, such as getting up from a chair. This can make you feel dizzy, lightheaded, or faint. You may have less pleasure during sexual intercourse (sex).
  
  
• Pain: You may have pain in your arms, legs, mouth, and other parts of your body. You may also have a tingling (pins and needles) feeling in your arms and legs.

How is Parkinson disease diagnosed?

• Your caregiver will ask about your signs and symptoms. He will ask your past health history and also the health of your family members. Your caregiver may test your muscles by moving your joints. He may check your balance and the way that you walk. Your caregiver will look for certain body movements that may mean that you have PD. These include slow movements, rigidity, tremors, and problems balancing.
  
  
• There is no laboratory test that can clearly show if you have PD. Imaging tests that may show changes in your brain. These tests may also check for medical conditions that may be causing your symptoms. Your caregiver may do a drug challenge test. In this test, your caregiver will give you medicine that is used to treat PD. If your signs and symptoms improve with this medicine, you most likely have PD.

What medicines are used to treat Parkinson disease?

Your caregiver may give you medicine to help treat your symptoms.

• Anti-Parkinson: This medicine is used to control your movement symptoms, such as muscle stiffness, twitches, and restlessness. Anti-Parkinson medicine acts like the dopamine in your brain. There will be times when you may have little or no movement symptoms, called the 'on' period. There will be other times when your movement symptoms get worse, called the 'off' period. The longer you take anti-Parkinson medicines, the longer your 'off' period may be. Your caregiver may give you more than one kind of anti-Parkinson medicine.
  
  
• Anti-depressants: This medicine is given to decrease or stop the symptoms of depression. It can also be used to treat other behavior problems. Some anti-depressants may help you sleep better.
  
  
• Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.
  
  
• Anti-psychotics: This medicine is usually given to decrease the symptoms of psychosis or severe (very bad) agitation. If you have psychosis, you may see or hear things that are not really there.
  
  
• Botulinum toxin (botox): Botox may be given as a shot into your muscles to make them less stiff.
  
  
• Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

What therapies are used to treat Parkinson disease?

• Counseling: You may want to see a mental health counselor. Your caregiver will listen to the things that upset or frustrate you. Your caregiver will teach you about PD. He may also teach you new ways to act and react to things that bother you. Your family may attend meetings to learn new ways to take better care of both you and themselves.
  
  
• Exercise and physical therapy: A physical therapist may help you with special exercises. He may teach you some exercises that help make your muscles stronger. Physical therapy will not make your symptoms go away, but may help you control your body's movements. Exercise may also help you keep your balance and fall less often.
  
  
• Occupational therapy: An occupational therapist teaches you special skills for activities such as bathing, dressing, and eating. Your occupational therapist may help you choose special equipment to help you at home and work. He can also suggest ways to keep your home and work place safe.
  
  
• Speech therapy: A speech therapist may work with you to help you talk or swallow. He will help you speak more louder and more clearly so that other people can better understand you.

Can brain surgery help treat my Parkinson disease?

Your caregiver may suggest that you have brain surgery called deep brain stimulation. During this surgery, an electrical device is placed inside your brain. This device helps your brain work to better control your movement symptoms, such as tremors and rigidity. Once the device is in your brain, you may turn the device on or off whenever you want.

What problems might I have with Parkinson disease?

• Medicine that you take for PD may cause nausea (an upset stomach), swelling, and weight gain. You may feel more sad, anxious, and sleepy. You may see or hear things that are not really there. You may also start doing things that are not good for you, like gamble or shop too much. As time goes by, the medicine you take may be less effective. You may feel confused after brain surgery. Your brain may become damaged, infected, or bleed too much.
  
  
• If your PD is left untreated, your symptoms may get worse more quickly. You may get more symptoms and the quality of your life may become worse. Your condition may make it hard for you to do your normal daily activities. You may feel bad about yourself and it may be harder to get along with others. You may fall and get broken bones. You may have a higher risk for pneumonia, heart disease, heart attacks, or stroke. You may die from these diseases. Talk to your caregiver if you have any questions or concerns about your condition, treatment, or care.

Where can I find support and more information about Parkinson disease?

PD is a life-changing disease for you and your family. Learning more about PD may help you cope better with this disease. Talking to other people with PD may also help you feel less alone. Contact the following for support and more information:

• American Parkinson Disease Association
  135 Parkinson Ave.
  Staten Island , NY 10305
  Phone: 1- 718 - 981-8001
  Web Address: http://www.apdaparkinson.org
  

• National Parkinson Foundation
  1501 N.W. 9th Avenue / Bob Hope Road
  Miami, Florida , 33136-1494
  1501 N.W. 9th Avenue / Bob Hope Road
  Miami, Florida , 33136-1494
  Phone: 1- 305 - 243-6666
  Phone: 1- 800 - 327-4545
  Web Address: http://www.parkinson.org
  

• The Michael J. Fox Foundation for Parkinson's Research
  Grand Central Station, P.O. Box 4777
  New York , NY 10163
  Phone: 1- 800 - 708-7644
  Web Address: http://www.michaeljfox.org
  

When should I call my caregiver?

Call your caregiver if:

• You are not sleeping well or you sleep more than usual.
  
  
• You cannot eat or are eating more than usual.
  
  
• You have a fever (high body temperature).
  
  
• You feel that your condition is getting worse.
  
  
• You have new symptoms since you last saw your caregiver.
  
  
• You have problems that may be caused by the medicine you are taking.
  
  
• Your sad feelings or thoughts change the way you function during the day.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You feel like hurting or killing yourself or others.
  
  
• You feel light-headed or dizzy.
  
  
• You have fainted.
  
  
• You suddenly have changes in your vision.
  
  
• You have chest pain.
  
  
• You have trouble breathing.
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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