Parkinson's Disease

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Parkinson's disease (PD) is a progressive movement disorder. PD is characterized by:

  • Slowing down of movements (bradykinesia)
  • Tremor at rest
  • Muscle rigidity
  • Loss of reflexes that maintain posture and equilibrium

Causes of PD

The loss of certain nerve cells in the brain causes a decrease in the amount of a brain chemical called dopamine. Low dopamine levels cause PD symptoms.

The brain cells may be lost because of genetic defects, the environment or some combination of the two. Some people with PD have an early-onset form, which is genetic. 

Risk Factors

PD is more common in men and in people aged 50 years and older. Other factors that increase your chance of PD include:

  • Family members with PD
  • Exposure to toxins, such as insecticides, carbon monoxide or manganese
  • Certain medications, such as antipsychotics, antiseizures, antiemetics or cardiovascular medications
  • Certain health conditions, such as:
    • High cholesterol
    • Traumatic brain injury
    • AIDS
    • Encephalitis
    • Stroke
    • Brain tumors
    • Hydrocephalus
    • Melanoma


Symptoms of PD begin mildly and worsen over time.

PD may cause:

  • Problems with dexterity
  • Difficulty with activities of daily living
  • Fatigue
  • Stiffness and rigidity of muscles, usually beginning on one side of the body
  • Tremors that are present at rest, improve with movement or are absent during sleep
  • Slowness of purposeful movements
  • Neuropsychiatric symptoms, such as:
    • Depression
    • Anxiety
    • Dementia
    • Hallucinations
  • Difficulty and shuffling when walking
  • Poor balance
  • Tendency to fall
  • Loss of smell
  • Sleep problems
  • Flat, monotonous voice
  • Stuttering
  • Trouble speaking (often speaking with a low volume)
  • Increasingly mask-like face, with little variation in expression
  • Drooling and excessive salivation
  • Shaky, spidery or small handwriting
  • Seborrhea (a skin condition)
  • Trouble chewing and swallowing
  • Urinary frequency and urgency
  • Bowel movement symptoms (straining, constipation)

Diagnosis & Treatment at UVA

No tests exist that can definitively diagnose PD. Your doctor will try to rule out other causes of your symptoms with blood and urine tests.

Currently, no treatments can cure PD or slow its progression. Some interventions and medications may help to improve symptoms.

PD Medications

Over time, the side effects of the medication may become troublesome. The medications may also lose their effectiveness.

Your doctor can prescribe medications to help with:

  • Depression or hallucinations
  • Sleep problems
  • Constipation, drooling and lightheadedness when standing 

Surgical Procedures 

Different brain operations are available, and many more are being researched, including:

  • Deep brain stimulation (DBS) involves a device that stimulates certain parts of the brain to decrease tremor and rigidity
  • Thalamotomy and pallidotomy procedures destroy certain areas of the brain to improve tremor when medication does not work (not as common as deep brain stimulation)
  • Researchers are trying to increase the amount of dopamine made in the brain through nerve-cell transplants

Physical Therapy

Therapy can improve muscle tone, strength and balance with exercise and stretches. Some evidence suggests that aerobic and strengthening exercises may be beneficial.

Psychological Support

Consider joining a support group for PD. It will help to learn how others are learning to live with the challenges of PD.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.