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Parkinson’s Disease Research, Education and Clinical Centers

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Frequently Asked Questions

Q. What is Parkinson’s disease (PD)?
Q. What are the symptoms of Parkinson’s disease?
Q. How is Parkinson’s disease diagnosed?
Q. How is Parkinson’s Disease treated?
Q. Is Parkinson’s disease fatal?

 

Q.  What is Parkinson’s Disease (PD)?

A.  Parkinson’s disease is a progressive neurological disorder or disorder of the brain.  It was first described by Dr. James Parkinson in 1817 in a paper titled “Essay on the Shaking Palsy.”   The average age of onset for Parkinson’s disease is 60 years old however, it can be seen in people much younger.  It affects men slightly more than women and Caucasians more than people of color.   As many as 1.5 million Americans are currently affected by PD.  The cause of PD is still not clearly understood.  There are many theories amongst scientists including genetic, environmental and viral factors.
 
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Q.  What are the symptoms of Parkinson’s disease?

A.  The most common symptoms of Parkinson’s disease include tremor at rest, rigidity (stiffness), bradykinesia (slowness of movement) and postural instability (lack of balance).    Generally, at least two of these four symptoms must be present for a diagnosis of PD to be made.  Parkinson’s disease is not limited to these four symptoms.  Individuals with PD may also experience  difficulty walking (shuffling or freezing), reduced facial expressions, small handwriting, soft and muffled speech, constipation, sleep disturbances, depression, anxiety, memory problems, difficulty swallowing, and reduced armswing.

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Q.  How is Parkinson’s disease diagnosed?

A.  Unlike many other disorders, medical tests and procedures cannot be used to diagnosis PD.  Diagnosis is almost always based on a clinician’s physical examination.  Again, diagnosis is typically made if an individual experiences two of the four chief symptoms (resting tremor, stiffness, slowness of movement and/or poor balance). 

Once PD is suspected, medication therapy may be started depending on the severity of the symptoms.  An individual’s response to antiparkinson medications is also a useful measure in confirming the diagnosis of Parkinson’s disease.  If symptoms improve after starting these medications, PD is typically the appropriate diagnosis.  If symptoms do not improve, other disorders, such as parkinson-plus syndromes, should be considered.  

Parkinson-plus syndromes include progressive supranuclear palsy, multiple system atrophy, and diffuse cortical Lewy body disease.  There are many disorders that can cause parkinson-like symptoms and therefore, a thorough history and exam is essential during the diagnostic process. 

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Q.  How is Parkinson’s Disease treated?

A.  At this time, there is no known cure for Parkinson’s disease.  Medications are the most useful form of treatment.   PD medications include:

-Carbidopa/Levodopa (Sinemet)
-Pramipexole (Mirapex)
-Pergolide (Permax)
-Ropinirole (Requip)
-Bromocriptine (Parlodel)
-Entacapone (Comtan)
-Amantadine (Symmetrel)
-Selegiline (Eldepryl)

These medications can be used in various combinations and typically provide good symptom management.  Unfortunately, as PD progresses, complications of these medications become more likely and often very troublesome.  Such complications can include dyskinesias (involuntary writhing movements of the body), hallucinations (seeing things that are not real), and motor fluctuations (wearing off of medications).  

Surgical procedures are also available and become a valuable option when the above medication complications are difficult to manage.  These options include:

-Pallidotomy
-Thalamotomy
-Deep Brain Stimulation

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Q.  Is Parkinson’s disease fatal?

A.  Despite common misconceptions, Parkinson’s disease itself does not shorten one’s life expectancy.  However, late stage symptoms such as immobility, poor balance, and difficulty swallowing, place patients at a higher risk for fatal complications.  These complications can include fractured hips, pneumonia, and choking. 

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