Parkinson's Disease

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Parkinson's disease (PD) is a progressive disorder that affects the nervous system. It most frequently begins with a tremor. If you've developed a tremor, you should make an appointment to see your doctor. For most people, it will turn out to be an essential tremor (ET). But if you do have Parkinson's, there are treatments that can improve your symptoms and your quality of life. 

PD includes:

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

Diagnosis & Treatment at UVA Health

No tests exist that can definitively diagnose PD. Your doctor will instead do a clinical diagnosis. This means they'll assess your symptoms, do a physical and neurological exam, and collect your medical history. They'll also try to rule out toxins, stroke, or other issues that can present like Parkinson's. 

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

PD Medications

Your doctor can prescribe medications to help with:

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

Over time, the side effects of the medication may become troublesome. The medications may also lose their effectiveness. When this happens, your doctor may suggest surgery or other treatments. 

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

Surgery Without Cuts: Focused Ultrasound for Parkinson's

The FDA has approved a less invasive pallidotomy procedure using focused ultrasound. This procedure can treat issues with:

  • Mobility
  • Rigidity
  • Involuntary movements, known as dyskinesias

Unlike traditional surgery, this procedure doesn't require cutting and has shorter recovery times.

The procedure focuses sound waves on a small point in your brain. During the procedure, surgeons use MRI to pinpoint the area they're working on and guide the procedure. Changing that part of your brain can improve symptoms of Parkinson's disease.

Talk to your care team to see if focused ultrasound is a good option for your condition.

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.

Myoclonus Treatment

Our neurologists are well-versed in treating myoclonus, twitches or jerks sometimes caused by PD. 

Psychological Support

Consider joining a support group for PD. It helps to learn how others are living and coping with the challenges of PD.

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. 

Parkinson's 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

Parkinson's Symptoms

Symptoms of PD begin mildly and worsen over time.

PD may cause:

  • Problems with dexterity
  • Difficulty with activities of daily living
  • Fatigue
  • Muscle stiffness and rigidity, 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)

Though these are a lot of symptoms, early Parkinson's typically presents with the same early symptoms