What Are The Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.
Parkinson disease dementia can cause problems with:
- Speaking and communicating with others
- Problem solving
- Paying attention
If you have Parkinson disease and dementia, in time, you likely won’t be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts don’t understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimer’s disease, another type of dementia.
Essential Tremor Vs Parkinson’s Tremors: A Guide To The Major Differences
When people think of Parkinson’sdisease, they may picture the shaking hands commonly associated with thecondition. Persistent shaking of hands and limbsalso known as tremorcan makeit difficult to write a grocery list, hold a cup of tea, button a shirt andapply makeup, among other routine tasks. When tremors interfere with dailylife, it can be very disruptive. While tremors are a hallmark of Parkinson’spatients, there are other diseases similar to Parkinson’s that can causetremors.
What Is Parkinsons Disease
Parkinsons disease is a progressive condition that causes trouble with movement. Its caused by the death of cells in a part of the brain called the substantia nigra. This part of your brain produces the neurotransmitter dopamine.
In some cases, specific genetic mutations are linked to the development of Parkinsons. But more often, it seems to appear randomly. Its thought that environmental factors such as exposure to pesticides, herbicides, or air pollution may contribute, but more evidence is needed to understand the potential link.
According to the National Institute on Aging, Parkinsons most commonly develops in people over the age of 60 and affects men about 50 percent more often than women.
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How Is Tremor Diagnosed
Tremor is diagnosed based on a physical and neurological examination and an individuals medical history. During the physical evaluation, a doctor will assess the tremor based on:
- whether the tremor occurs when the muscles are at rest or in action
- the location of the tremor on the body
- the appearance of the tremor .
The doctor will also check other neurological findings such as impaired balance, speech abnormalities, or increased muscle stiffness. Blood or urine tests can rule out metabolic causes such as thyroid malfunction and certain medications that can cause tremor. These tests may also help to identify contributing causes such as drug interactions, chronic alcoholism, or other conditions or diseases. Diagnostic imaging may help determine if the tremor is the result of damage in the brain.
Additional tests may be administered to determine functional limitations such as difficulty with handwriting or the ability to hold a fork or cup. Individuals may be asked to perform a series of tasks or exercises such as placing a finger on the tip of their nose or drawing a spiral.
The doctor may order an electromyogram to diagnose muscle or nerve problems. This test measures involuntary muscle activity and muscle response to nerve stimulation.
Getting Treatment: Essential Tremor Vs Parkinsons Disease
There is currently no cure for essential tremor or Parkinsons. However, that does not mean you have no control over your condition. As doctors learn more about these conditions, developments in treatment and disease management continue to help patients preserve their quality of life as much as possible.
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What Is The Difference Between Essential Tremor Andparkinson’s
The exact cause of essential tremor is unknown while Parkinson’sdisease is better understood.
In Parkinson’s disease, neurons located in the part of the brain thatcontrols movement become impaired or die. These neurons usually produce achemical called dopamine which enables regular body movements. When the neuronscan’t produce necessary levels of dopamine, tremors can occur, along withrigidity of limbs and decreased coordination.
Managing A Parkinsons Tremor
In the early stages of Parkinsons you may be able to suppress a tremor by squeezing or rolling a ball, pen or similar object in your hand. Anxiety or stress can make a tremor worse, so it’s important to find ways to relax. Some people find that certain medications can make their tremor worse. However, usually, a tremor can be kept under control effectively by Parkinson’s medication.
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What Is The Difference Between Tremors And Parkinson’s Disease
While the majority of Parkinson’s patients experience tremors,not everyone who has tremors has Parkinson’s. Tremors are also asymptom of other conditions, such as traumatic brain injury, stroke, certainmedicines, alcohol poisoning or anxiety.
Tremor is an unintentional, rhythmic musclecontraction that leads to shaking in one or more parts of thebody. Parkinson’s disease is a neurological disorder that causes tremors,stiffness in limbs and loss of coordination.
The most significant difference between tremor associated withParkinson’s disease and tremor associated with other conditions is thatParkinson’s tremor is typically a “resting tremor,” meaning it ispresent when an individual is at rest and goes away when the individual isactive. Tremors in most other conditions are classified as “actiontremor,” meaning shaking increases when a person is active and decreaseswhen the person is at rest.
While Parkinson’s is typically the most widely-known disease associatedwith tremor, a condition called essential tremor is more common, affectingapproximately 5% of people aged 65 and older.
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Essential Tremor Is Not Parkinsons Disease
Essential tremor and Parkinsons disease are different conditions. Essential tremor is characterised by shaking when movement starts, which can continue or worsen during movement. The symptoms of Parkinsons disease include:
- involuntary tremor when you are not moving
- muscle stiffness
- slowness of movement
Parkinsons disease is caused by a lack of supply of the brain chemical dopamine, which is necessary for smooth and controlled muscular movement.
Parkinsons Sleep Problems: Diagnosis And Treatment
Parkinsons disease is chronic and progressive, meaning it tends to get worse over time. However, there are treatment options that can help manage symptoms and allow patients to get more restful sleep.
The simplest way to start sleeping better with Parkinsons disease is by adopting healthy sleep habits. Sleep hygiene tips for Parkinsons disease sufferers include:
- Sticking to regular bedtimes
- Following a consistent bedtime routine with soothing activities such as listening to music or reading a calming book
- Getting regular exercise, preferably early in the day
- Getting adequate exposure to light, whether outdoors or through light therapy
- Avoiding long naps and naps late in the day
- Creating a cool, dark, and comfortable sleeping environment
- Restricting bedtime activities to sex and sleep only
- Turning off screens an hour before bedtime
- Reducing liquid intake before bedtime
- Avoiding caffeine, alcohol, and tobacco
- Eating a healthy diet and avoiding large meals at night
Light therapy, exercise, and deep brain stimulation have been successfully used to improve overall sleep quality and to treat specific conditions, such as REM sleep behavior disorder, in patients with Parkinsons disease. Cognitive behavioral therapy for insomnia has proven effective at reducing insomnia in healthy adults, although further research is needed on the effects of CBT in patients with Parkinsons disease.
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How Is Tremor Treated
Although there is no cure for most forms of tremor, treatment options are available to help manage symptoms. In some cases, a persons symptoms may be mild enough that they do not require treatment.
Finding an appropriate treatment depends on an accurate diagnosis of the cause. Tremor caused by underlying health problems can sometimes be improved or eliminated entirely with treatment. For example, tremor due to thyroid hyperactivity will improve or even resolve with treatment of thyroid malfunction. Also, if tremor is caused by medication, discontinuing the tremor-causing drug may reduce or eliminate this tremor.
If there is no underlying cause for tremor that can be modified, available treatment options include:
A new treatment for essential tremor uses magnetic resonance images to deliver focused ultrasound to create a lesion in tiny areas of the brains thalamus thought to be responsible for causing the tremors. The treatment is approved only for those individuals with essential tremor who do not respond well to anticonvulsant or beta-blocking drugs.
When people do not respond to drug therapies or have a severe tremor that significantly impacts their daily life, a doctor may recommend surgical interventions such as deep brain stimulation or very rarely, thalamotomy. While DBS is usually well tolerated, the most common side effects of tremor surgery include dysarthria and balance problems.
How Is A Diagnosis Made
There is no medical test that can confirm a diagnosis of ET. Your physician will review your medical history and family history, and will conduct a physical exam. He or she will explore whether another condition is causing your tremors by conducting a neurological exam and ordering laboratory tests. Your doctor also may give you a “performance test,” in which you are asked to drink from a glass, hold your arms outstretched, write your name, or draw a spiral.
Essential tremor is sometimes misdiagnosed as Parkinson’s disease. But whereas people with Parkinson’s often have balance problems, slowness of movement, and freezing of gait, people with ET only rarely have problems in their legs.
Confusion With Essential Tremor
The tremor of Parkinsons disease is often confused with the tremor of a condition called Essential Tremor, or Benign Familial Tremor . Katherine Hepburn had Essential Tremor, and was originally misdiagnosed with Parkinsons. Ronald Reagan also had Essential Tremor. Both had a head tremor and a vocal tremor. In Essential Tremor, the hands are most commonly involved, followed by the head and then the voice. Essential Tremor can also cause the jaw to tremor, and it may be difficult to figure out if a jaw tremor is from Essential Tremor or Parkinsons. Unfortunately, some people may have both disorders. Some authorities believe that there is, in fact, an increased association between the two conditions, so that more people with Parkinsons disease have Essential Tremor than would be expected by chance alone, but this has not been established.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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How Is Tremor Classified
Tremor can be classified into two main categories:
Resting tremor occurs when the muscle is relaxed, such as when the hands are resting on the lap. With this disorder, a persons hands, arms, or legs may shake even when they are at rest. Often, the tremor only affects the hand or fingers. This type of tremor is often seen in people with Parkinsons disease and is called a pillrolling tremor because the circular finger and hand movements resemble rolling of small objects or pills in the hand.
Action tremor occurs with the voluntary movement of a muscle. Most types of tremor are considered action tremor. There are several sub-classifications of action tremor, many of which overlap.
- Postural tremor occurs when a person maintains a position against gravity, such as holding the arms outstretched.
- Kinetic tremor is associated with any voluntary movement, such as moving the wrists up and down or closing and opening the eyes.
- Intention tremor is produced with purposeful movement toward a target, such as lifting a finger to touch the nose. Typically the tremor will become worse as an individual gets closer to their target.
- Task-specific tremor only appears when performing highly-skilled, goal-oriented tasks such as handwriting or speaking.
- Isometric tremor occurs during a voluntary muscle contraction that is not accompanied by any movement such as holding a heavy book or a dumbbell in the same position.
Tremors Yes Parkinson’s Disease No
Essential tremor is often mistaken for Parkinson’s disease, but the two conditions differ in several ways. Essential tremor is an action tremor, meaning that the involuntary shaking increases when you move and try to use your hands. In Parkinson’s disease, tremors occur mainly at rest, and activity reduces the symptoms. Some people with essential tremor develop head nodding or shaking few people with Parkinson’s do. Balance problems and rigidity of the arms and legs are common features of Parkinson’s disease but not of essential tremor. One of the hallmarks of essential tremor, useful in diagnosing the disorder, is that alcohol can temporarily ease symptoms in Parkinson’s, alcohol has little effect on the tremor.
Parkinson’s disease is marked by a progressive loss of brain cells that produce dopamine, a chemical messenger that enables normal body movements. Essential tremor also appears to involve a disruption in the activity of motor pathways, but it’s uncertain whether there is any loss of brain cells. Postmortem examinations of brain tissue taken from people with essential tremor reveal various abnormalities in the cerebellum and brainstem, including the loss of Purkinje cells, which produce an important neurotransmitter, called GABA. But the samples don’t all show the same changes, so the import of these findings is uncertain.
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Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
Who Is Affected By Tremor
About 70% of people with Parkinsons experience a tremor at some point in the disease. Tremor appears to be slightly less common in younger people with PD, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.
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Characteristics Of Pd Tremors
The tremors of PD characteristically occur at rest, stop with voluntary action, and recur again after you hold your new position for a few minutes. PD tremors can affect the hands, arms, face, jaw, legs, and/or feet, and are often slightly more prominent on one side than the other.
The tremor almost always begins in the hand before affecting other parts of the body, and it usually looks like you are rolling a pill between your thumb and index finger. Thats why its called a pill-rolling tremor.
A pill-rolling tremor is the most common type of PD tremor, but shaking tremorswhich may involve the hands or other areas of the bodycan also occur.
Which Body Parts Do Parkinsons Tremors Affect
There are five main places youâll have Parkinsonâs tremors:
1. Hands. Parkinsonâs disease tremors often start in the fingers or hands with whatâs called a pill-rolling motion. Imagine holding a pill between your thumb and index finger and rolling it back and forth.
2. Foot. A Parkinsonâs foot tremor is more likely to happen while youâre sitting or lying down with your feet at rest. If the tremor moves into your thigh muscles. It could look like your whole leg is shaking.
Foot tremors disappear when you stand or walk because those are active movements. A foot or leg tremor while youâre standing may be another condition.
3. Jaw. This is common in people with Parkinsonâs. It may look like youâre shivering. It can become bothersome if the tremor makes your teeth chatter. If you wear dentures, it could make them shift or fall out.
Chewing eases the tremor, so gum might help.
4. Tongue. Itâs rare, but a tongue tremor can cause your entire head to shake.
5. Internal. Some people with Parkinsonâs say they can feel a shaking sensation in their chest or abdomen. But canât be seen from the outside.