Ian Purcell MD PhD Monali Patel MD Otoneurology Call 858 223 2172
Educational Resources
Patient education

Parkinson's Disease

Parkinson's disease is a progressive movement disorder that causes tremor, slowness, stiffness, and balance problems, and it can also affect blood pressure control.

At a glance

Symptoms
Tremor at rest, slowness, stiffness, and balance problems
Common causes
Loss of dopamine-producing cells in the brain
How it's diagnosed
Neurologic examination, with imaging in selected cases
Treatment
Dopamine-replacing medication, exercise, and physical therapy

Overview

Parkinson's Disease (PD) is a progressive neurological disorder that affects movement, causing symptoms that worsen over time. It is characterized by the degeneration of nerve cells in the part of the brain called the substantia nigra, leading to a reduction in dopamine, a neurotransmitter vital for regulating body movements.

Symptoms

PD symptoms develop gradually and vary among individuals. Common symptoms include:

  • Tremor: Shaking often starts in a limb, usually the hand or fingers.
  • Bradykinesia (Slowness of Movement): Over time, Parkinson's may slow your movement, making simple tasks difficult and time-consuming.
  • Rigid Muscles: Muscle stiffness may occur in any part of your body, limiting the range of motion and causing pain.
  • Impaired Posture and Balance: Posture may become stooped, or you may have balance problems as a result of Parkinson's.
  • Loss of Automatic Movements: Decreased ability to perform unconscious movements, including blinking, smiling, or swinging your arms when you walk.

Other symptoms may include changes in speech, writing, and the development of non-motor symptoms such as changes in sleep patterns, mood disorders, and cognitive changes.

Causes and risk factors

The exact cause of Parkinson's Disease is unknown, but several factors seem to play a role:

  • Genetic Mutations: Rarely, PD may be attributed to specific genetic mutations.
  • Environmental Triggers: Exposure to certain toxins or environmental factors may increase the risk of PD, though the risk is relatively small.
  • Age: Parkinson's is most commonly diagnosed in people aged 60 and older.
  • Heredity: Having a close relative with Parkinson's increases your chances, but the risk is still low unless you have many relatives affected by the disease.
  • Sex: Men are more likely to develop Parkinson's Disease than women.

Diagnosis

There's no specific test for Parkinson's Disease. Diagnosis is based on medical history, a review of signs and symptoms, and neurological and physical examinations. Your doctor may also order tests to rule out other conditions that could be causing symptoms.

Treatment

While there's no cure for PD, treatment options are available to help control symptoms, usually including:

  • Medications: Aimed at managing problems with walking, movement, and tremor by increasing or substituting for dopamine.
  • Surgical Procedures: Deep brain stimulation (DBS) and others may be recommended for some individuals.
  • Lifestyle Modifications: Including aerobic exercise, physical therapy, and speech therapy.

Living with Parkinson's Disease

Managing Parkinson's Disease is a multifaceted approach involving medical treatment, lifestyle adjustments, and support. It's crucial to have a comprehensive care team, including neurologists, physical therapists, and support groups, to navigate the challenges of PD.

Testing that can help

Testing is chosen from your history and examination. These are the tests most often used here.

Computerized Dynamic Posturography (CDP)Balance platform testing that measures how vision, vestibular input, and body sensation contribute to postural control.
Specialty care: Parkinson's DiseaseParkinson's Disease is a progressive nervous system disorder that affects movement.Orthostatic HypotensionOrthostatic hypotension is a drop in blood pressure on standing that can cause lightheadedness, blurred vision, or fainting.Normal Pressure HydrocephalusNormal pressure hydrocephalus is a buildup of fluid in the brain that classically causes walking difficulty, memory problems, and bladder urgency, and it can improve with treatment.Neuromuscular DisordersNeuromuscular disorders affect the nerves outside the brain and spinal cord, the junction between nerve and muscle, or the muscles themselves, causing weakness, numbness, and imbalance.

When to seek urgent care

Call 911 or go to the nearest emergency department if dizziness or imbalance starts suddenly together with any of the following, since these can be signs of a stroke or another emergency:

  • Weakness or numbness of the face, arm, or leg, especially on one side
  • Trouble speaking or understanding speech
  • Double vision or sudden loss of vision
  • A sudden, severe headache
  • Inability to walk or stand
  • Chest pain, fainting, or a seizure

Further reading

This article is for general education and does not replace a medical evaluation. Testing and treatment are chosen for each patient after a full history and examination.