Parkinson's Disease and How It Can Affect You

Parkinson's Disease is an uncommon but well-known and progressive disease of the nervous system. About 60,000 Americans are diagnosed with Parkinson's Disease every year. Although the cause of this illness is not well understood, it is important to recognize the symptoms of Parkinson's Disease, because treatment can greatly reduce clinical signs and improve quality of life.

Parkinson's Disease is caused by degeneration and loss of neurons (nerve cells) in the portion of the brain called the substantia nigra. These neurons are responsible for connecting portions of the brain together that control movement and for producing dopamine. Dopamine is a neurotransmitter that allows the brain to signal the muscles and nerves of the body to control and coordinate movement. The result is that movements are jerky and uncoordinated. This is especially true for movements that require delicate fine motor control, like moving the hands and fingers to write. No symptoms are seen until the neurons that produce dopamine are 80% gone.

Symptoms of Parkinson's Disease are rarely seen in people under 60 years of age and usually start as tiny changes in the body's ability to move. Usually, symptoms start on one side of the body, and often, this side will always display worse symptoms than are seen on the body's other side. Often, signs start with a tremor in one hand, especially when the hand is at rest. An involuntary "pill-rolling" motion may be seen, where the forefinger and thumb continuously rub against one another. Also, Parkinson's Disease causes bradykinesia, or slowing of body movements. Walking may become more difficult, with slower and shorter steps, and motions like standing or sitting down may take longer and require more concentration. Speech may be quiet, slow, or slurred, and muscle rigidity, especially in the legs and back, can cause difficulty moving or pain.

While all the factors that lead to the development of Parkinson's Disease are not well understood, it is believed that heredity does play an important role. Several specific genes have been isolated that are associated with the development of Parkinson's Disease before the age of 60. In addition, nearly 20% of people diagnosed with the disease have a close relative who is also affected. Caucasians are more likely to be affected than blacks or Asians, and men are twice as likely as women to develop Parkinson's Disease. Not only are genetic causes implicated, but environmental factors also seem to affect a person's risk of developing Parkinson's Disease. Exposure to high levels of carbon monoxide, insect repellents like permethrins, and Agent Orange during military service all increase the likelihood of developing the disease.

While there is no cure for Parkinson's Disease and the disorder is progressive over time, it is not fatal and most people can lead normal or near-normal lives with appropriate medical treatment. It is important for people showing signs of Parkinson's Disease to seek diagnosis and treatment from a physician, because the symptoms can be very similar to those caused by other serious disorders such as benign essential tumors, strokes, and Huntington's Disease. Parkinson's Disease is diagnosed by excluding other neurologic diseases for which there are specific tests, and by documenting the typical symptoms of Parkinson's Disease in the patient (tremors, bradykinesia, and muscle rigidity).

Generally, patients are given dopamine to replace that which is not being produced by the degenerating neurons in the brain, and if their symptoms quickly improve, then Parkinson's Disease is very likely. In addition, imaging such as MRI and CT scans may be done to rule out stroke or other physical changes in the nervous system. Over time, medications may become less effective or may result in periods of time when movement is normal alternating with periods of time when the patient is immobile or has very jerky movements. This can usually be addressed with changing the kind or dose of medication prescribed.

Parkinson's Disease is a serious disorder, but one that can be managed with medication to produce a good quality of life. If you are experiencing symptoms of Parkinson's Disease, see your physician right away to discuss your options.