How Is Pediatric Parkinsonism Diagnosed
The first step in diagnosing pediatric parkinsonism is a physical exam. A large part of the exam is to review past medication history. The doctor will also observe the patient for certain features, including:
- Balance problems that leads to falls
- Resting tremor
- Slow movements, also called bradykinesia
Two of the four features must be observed to be diagnosed with pediatric parkinsonism.
Doctors also might also order genetic testing or magnetic resonance imaging to diagnose parkinsonism.
Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 30 April 2019 Next review due: 30 April 2022
How Is Parkinson’s Disease Diagnosed
Someone with the symptoms of Parkinson’s disease may be sent to see a neurologist, a doctor who specializes in the brain, nerves, and muscles. The neurologist may do some tests, including a brain scan and blood tests. These tests will not make the diagnosis of Parkinson’s disease, but the doctor will want to make sure that there is no other problem causing the symptoms. To diagnose Parkinson’s disease, the doctor relies on a person’s medical history, symptoms, and a physical exam.
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Lessons I Learned From Being A Caregiver To My Mom
One of the first things I immediately learned about Parkinsons disease is that not only does it turn a patients life upside down, but that previously effortless tasks can become physical hazards. With my mother at home most of the time, it was very important that I became educated on the potential dangers within the household. Without a doubt, stairs have posed one of the biggest threats to my mom since she has gotten Parkinsons. Anywhere we go, whether its up the stairs to her bedroom, to the second floor of a parking garage, or even just one step up through the front door, I found that its best for me to accompany her to help keep her steady and to catch her in case she loses her balance.
Another hazard that posed a great threat to my mom was the bed she slept in. With getting a good nights rest being very beneficial for those with Parkinsons my family had to learn how to adjust the bed my mother slept in to ensure that she would be safe through the night. Since it can be a common symptom for my mom to jerk and move a lot in her sleep due to vivid dreaming and restless leg syndrome, we decided to invest in a bed rail to ensure she did not accidentally roll out of bed. We also bought pillows to support her neck which was especially crucial after her cervical realignment surgery.
What Is Pediatric Parkinsonism
With pediatric parkinsonism, a child has many of the symptoms of Parkinsons disease without actually having the same disorder. Symptoms include tremors, balance problems, slow movements and falls.
Parkinsonism leads to the breakdown of motor functions in the body, including coordination, walking and other movements. Young-onset Parkinsons disease is not the same as parkinsonism and is not usually diagnosed before the age of 20.
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Who Is Affected By Parkinsons Disease
Parkinsons disease affects both men and women. Statistically, however, men have a slightly higher chance of developing the disease. The risk of developing Parkinsons disease also increases with age, with the average age of onset being 65 years old. Five to ten per cent of people develop the condition before the age of 40 years old. When symptoms appear in people aged 21-40, this is known as young-onset Parkinsons disease. Juvenile Parkinsons disease is the term used when symptoms appear before the age of 18 years old, although this is extremely rare.
To-date, no one knows exactly why people get Parkinsons disease, but viral infection or environmental toxins may play a role. People with a parent, sibling or child with Parkinsons disease, are twice as likely to get it as people in the general population.
Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
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Talking To Children And Teenagers
If you’ve been diagnosed with Parkinson’s and have children or grandchildren, you may be thinking about how to talk to them about your condition. Maybe youre worried about how to start the conversation or how theyll react. You may also be concerned about how your Parkinsons will affect family life.
Yes, when youre ready.
Its natural to want to protect children from knowing about serious health issues in case it scares, upsets or worries them. But keeping it from them isnt the answer.
This is because:
- Children are very aware of whats happening around them. Even if you try to hide your condition, theyre likely to pick up that something is wrong from snippets of conversations or from changes in the mood or atmosphere at home.
- Not knowing whats wrong may mean that children come up with their own theories about whats happening and these may be worse than the reality.
- As Parkinsons progresses it will become more and more difficult to hide your symptoms and your children may find out from someone else. Its much better that they hear about it from you. If not, they may feel resentful or worried about why you didnt tell them.
- Trying to keep Parkinsons hidden from your children may be difficult and exhausting for you.
- You may feel relieved to tell your children. Speaking about your condition to your family may help to normalise your situation and make it less frightening for everyone.
Try to prepare yourself for the following emotions:
- worry
- sadness
- grief
Be Honest With Yourself And Your Doctor
It is important to discuss alcohol consumption with your doctor to make sure you are approaching it safely. Elements of PD, including motor symptoms such as bradykinesia and dyskinesia , will vary from person to person, so its important to make decisions based on your medical history.
Taking into account environmental factors such as how central alcohol is to your social life can affect the decisions you make. Be honest with your doctor about your habits and preferences remember, your doctor wants to work with you to make your symptoms as manageable as possible, not to judge or shame you.
As you decide how alcohol may fit into your life post-diagnosis lifestyle, there are many factors to consider, such as the type of alcoholic beverage, your other risk factors, and your neurologists recommendations specific to your medical history. Most importantly, monitor how you feel when you drink alcohol and be willing to have open and honest conversations about drinking with your doctor and other important people in your life.
I am not even a big drinker, but miss the odd one, wrote a MyParkinsonsTeam member. So, I had an alcohol-free beer, which tasted OK, to be honest.
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Parkinsons Books For Kids
The following books were written to facilitate discussion with children about Parkinsons disease. The books offer age-appropriate information about PD and perspectives to help children and teens better understand important issues in the PD world. This is not a comprehensive list of available titles, but its a great place to start. All of the books below are available on Amazon.com and other online retailers.
- Ill Hold Your Hand, So You Wont Fall: A Childs Guide to Parkinsons Disease by Rasheda Ali, with a foreward by Muhammad Ali
- Carina and Her Care Partner Gramma by Kirk Hall
- Carson and His Shaky Paws Grampa by Kirk Hall
- My GrandPas Shaky Hands by Dr. Soania Mathur
- Parkinsons in the Park: For Children of Parents with Parkinsons by Jessica Christie
- Shaky Hands: A Kids Guide to Parkinsons Disease by Dr. Soania Mathur
- The Tale of a Parkie Princess: A Chronic Illness Described in a Fairy Tale by Annie Konopka
Causes Of Parkinsons Disease
At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:
- environmental triggers, pesticides, toxins, chemicals
- genetic factors
- combinations of environment and genetic factors
- head trauma.
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What Is Parkinsons Disease
Parkinsons disease is a progressive neurological disorder. The first signs are problems with movement.
Smooth and coordinated bodily muscle movements are made possible by dopamine, a substance in the brain. Dopamine is produced in a part of the brain called the substantia nigra.
In Parkinsons, the cells of the substantia nigra start to die. When this happens, dopamine levels are reduced. When they have dropped 60 to 80 percent, symptoms of Parkinsons start to appear.
Some of the early symptoms of Parkinsons can begin several years before motor problems develop. These earliest signs include:
- problems with attention and memory
- difficulty with visual-spatial relationships
Early signs of Parkinsons disease may go unrecognized. Your body may try to alert you to the movement disorder many years before movement difficulties begin with these warning signs.
The exact cause of Parkinsons is unknown. It may have both genetic and environmental components. Some scientists believe that viruses can trigger Parkinsons as well.
Low levels of dopamine and norepinephrine, a substance that regulates dopamine, have been linked with Parkinsons.
Abnormal proteins called Lewy bodies have also been found in the brains of people with Parkinsons. Scientists do not know what role, if any, Lewy bodies play in the development of Parkinsons.
While theres no known cause, research has identified groups of people who are more likely to develop the condition, which include:
What Causes Parkinson’s Disease
In the very deep parts of the brain, there is a collection of nerve cells that help control movement, known as the basal ganglia . In a person with Parkinson’s disease, these nerve cells are damaged and do not work as well as they should.
These nerve cells make and use a brain chemical called dopamine to send messages to other parts of the brain to coordinate body movements. When someone has Parkinson’s disease, dopamine levels are low. So, the body doesn’t get the right messages it needs to move normally.
Experts agree that low dopamine levels in the brain cause the symptoms of Parkinson’s disease, but no one really knows why the nerve cells that produce dopamine get damaged and die.
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Parkinsons Disease In Women
Until recently, little has been written regarding the effect that gender has on the development and management of Parkinsons disease.
Current research has focused mainly on the impact that sex hormones have on the development of Parkinsons disease. Less has been written on the impact that Parkinsons disease has on menstruation, pregnancy and menopause. This article will review the most recent information on both the affect that Parkinsons disease has on women and the impact that gender has on Parkinsons disease.
While Parkinsons disease is usually thought of as a disease of the elderly, approximately 3-5% of women diagnosed with this disorder are under the age of 50. A large number of these women are still experiencing regular menstrual cycles. Studies that have reviewed the effect of hormone fluctuations and menstruation on Parkinsons disease have noted an impact of the menstrual cycle on disease control. During menstruation women described increasing Parkinsonian symptoms, decreasing medication responsiveness and increased off times. They also complain of increased fatigue, cramps and heavier menstrual flow. This can lead to occasional humiliating self-care issues due to worsening dexterity.
Incidence Of Parkinsons Disease
Its estimated that approximately four people per 1,000 in Australia have Parkinsons disease, with the incidence increasing to one in 100 over the age of 60. In Australia, there are approximately 80,000 people living with Parkinsons disease, with one in five of these people being diagnosed before the age of 50. In Victoria, more than 2,225 people are newly diagnosed with Parkinsons every year.
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How Is Parkinsons Treated
Doctors, nurses, physical and occupational therapists, social workers, speech therapists, and other professionals work with people with Parkinsons to help them enjoy happy, active lives.
There are many kinds of medications that can help people with Parkinsons. These medications make it easier to walk, stand up and sit down and do other things that are part of a normal day. Sometimes the medications that help with Parkinsons can make people dizzy, tired or have an upset stomach. But most of these problems can be improved by finding the right combination of medications.
In addition to medications, we are learning more through research and the experiences of other people with PD about how exercise can help people manage their symptoms and might even slow the progression of the disease! Your parent will want to talk to their doctor before starting anything new, but you can feel good about continuing to engage in active sports/activities with your parent.
When Getting Dressed
- Allow yourself plenty of time to get ready. Avoid rushing.
- Select clothes that are easy to put on and take off.
- Try using items with Velcro instead of buttons.
- Try wearing pants and skirts with elastic waist bands. These may be easier than buttons and zippers.
Yoga uses targeted muscle movement to build muscle, increase mobility, and improve flexibility. People with Parkinsons may notice yoga even helps manage tremors in some affected limbs. Try these 10 yoga poses to help ease symptoms of Parkinsons.
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What Can I Do
Have family chats once a month or even once a week. Use this time to share with your parents how Parkinsons makes you feel. They can also explain some of what they are going through. This will help you understand each other better, and you can try to find ways to help each other and reduce stress.
Talk to someonewhoever you feel a connection with. This could be a friend, relative, teacher or counselor. You may have concerns or worries you dont feel comfortable telling your parents about. Expressing these feelings might help you feel better, and the person might have good advice.
Get involved. Sometimes we feel better when we can DO something to improve a situation. Go to a local Moving Day®, organize your own fundraiser to support PD research through Parkinsons Champions or raise awareness of PD at your school, church or other community center. The Parkinsons Foundation can help with ideas on how to get involved.
Connect with other people your age. You are not the only one with a parent with Parkinsons disease. If your parents are in a Parkinsons support group, they might know other people with PD with children who would like to talk or hang out. Even your parents doctor may know of other children to connect with. Connect online with others in the same situation. Some groups already existtry searching for the groups Young Adult Children of Parkinsons Patients or Parkinsons, Children Living With THEM, or create your own!
Who Gets Early Onset Parkinsons Disease
About 10%-20% of those diagnosed with Parkinsons disease are under age 50, and about half of those are diagnosed before age 40. Approximately 60,000 new cases of Parkinsons are diagnosed each year in the United States, meaning somewhere around 6,000 12,000 are young onset patients.
Is it genetic or hereditary?
The cause of Parkinsons disease is not yet known. However, Parkinsons disease has appeared across several generations of some families, which could indicate that certain forms of the disease are hereditary or genetic. Many researchers think that Parkinsons disease may be caused by genetic factors combined with other external factors. The field of genetics is playing an ever greater role in Parkinsons disease research, and scientists are continually working towards determining the cause or causes of PD.
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What Are The Symptoms Of Parkinson’s Disease
The symptoms of Parkinson’s disease include tremors or trembling difficulty maintaining balance and coordination trouble standing or walking stiffness and general slowness.
Over time, a person with Parkinson’s may have trouble smiling, talking, or swallowing. Their faces may appear flat and without expression, but people with Parkinson’s continue to have feelings even though their faces don’t always show it. Sometimes people with the disease can have trouble with thinking and remembering too.
Because of problems with balance, some people with Parkinson’s fall down a lot, which can result in broken bones. Some people with Parkinson’s may also feel sad or depressed and lose interest in the things they used to do.
The symptoms of Parkinson’s disease appear gradually and get worse over time. But because Parkinson’s disease usually develops slowly, most people who have it can live a long and relatively healthy life.