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Parkinson Disease

What is Parkinson Disease (PD)?

  • Progressive disorder that affects the brain by causing reduced dopamine (chemical involved in movement and coordination of movement)

  • As a patient with PD ages, there is less and less dopamine stored leading to inability to move with fluid movement.  

  • ​2nd most common neurodegenerative disease (after Alzheimer’s disease)

  • Approximately 60,000 Americans are diagnosed with Parkinson's disease each year (many more not diagnosed)

  • Incidence of Parkinson’s increases with age, but an estimated 4% of people with PD are diagnosed before the age of 50.

  • Men are 1.5 x’s more likely to have Parkinson's than women.

How do I know if I have PD?

  • The diagnosis is made based on the history and the exam but should only be performed by a physician.  Each person is different and medical expertise is important.

  • On history, patients describe:

    • Poor smell​ (hyposmia)

    • Acting out dreams (REM sleep behavior disorder)

    • Smaller handwriting (micrographia)

    • Leaning forward only to keep going

    • Softening voice (hypophonia)

    • Dragging one leg or not swinging one arm when walking

  • On the exam, your movement disorder specialist (MDS) will find:​

    • rigidity (stiffness usually on one side of the body followed by the other side years later)​

    • bradykinesia (slowness of movement starting off large and progressively getting smaller)

    • masked face (decreased blinking and expression in the face)

    • resting tremor (** not all PD has a tremor!)

What can be done about it and what is the treatment?

  • While there is not yet a cure for Parkinson Disease, there are many studies and much research being done to find ways to slow it down, stop it's progression, and reverse the damage already done.

  • Since dopamine is low, much of the treatment revolves around replacing it or preventing it's breakdown

  • There are many classes of medications that treat PD so discussing with your physician what is best for you is the most important consideration.  Your physician must be knowledgeable in the latest treatments for PD and the art in taking the medication.  

  • Timing of your medication is of uttmost importance!  The goal is to keep your dopamine levels steady (or gas tank full)

  • This is accomplished through strategies such as number and quantity of the medication and the timing of when the meds are taken.  

  • For those patients who have many offs (inability to move in a fluid fashion) or excessive ons (dyskinesia or excessive movement), there are considerations such as deep brain stimulation (DBS) or newer medications that promote better absorption of dopamine.

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