Prescription Medications To Treat Parkinsons
Most movement symptoms are due to a lack of dopamine. Therefore, drugs prescribed to treat PD are dopaminergic they either replenish dopamine or mimic its effects on the brain. The most common is called levodopa. The body converts this medication into dopamine to help control movement symptoms.
Make sure your doctor knows all medications you take including over-the-counter and supplements. This helps reduce the risk of drug interactions, a common issue for Parkinsons patients.
What Are The Symptoms
The best-known symptoms of Parkinson’s disease involve loss of muscle control. However, experts now know that muscle control-related issues aren’t the only possible symptoms of Parkinson’s disease.
Motor symptoms which means movement-related symptoms of Parkinsons disease include the following:
Additional motor symptoms can include:
- Blinking less often than usual. This is also a symptom of reduced control of facial muscles.
- Cramped or small handwriting. Known as micrographia, this happens because of muscle control problems.
- Drooling. Another symptom that happens because of loss of facial muscle control.
- Mask-like facial expression. Known as hypomimia, this means facial expressions change very little or not at all.
- Trouble swallowing . This happens with reduced throat muscle control. It increases the risk of problems like pneumonia or choking.
- Unusually soft speaking voice . This happens because of reduced muscle control in the throat and chest.
Several symptoms are possible that aren’t connected to movement and muscle control. In years past, experts believed non-motor symptoms were risk factors for this disease when seen before motor symptoms. However, theres a growing amount of evidence that these symptoms can appear in the earliest stages of the disease. That means these symptoms might be warning signs that start years or even decades before motor symptoms.
Non-motor symptoms include:
Stages of Parkinsons disease
Understanding Parkinsons Disease: Getting A Parkinsons Diagnosis
Once you start noticing some changes in your body that impact your daily life or are just simply bothersome, you should begin the process of figuring out if you have Parkinsons disease. It may seem like a daunting undertaking, but dont let fear stop you. Once you are diagnosed, you can start treating your symptoms and learning strategies that will help you feel better.
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If Its Not Parkinsons Disease What Else Could It Be
There are several other conditions that might produce symptoms that can be mistaken for Parkinsons disease. Here are some possibilities:
- Medication side effects: Certain drugs can produce or exacerbate symptoms.
- Essential, or familial, tremor: This is a relatively common and benign cause of recurrent tremor and is often confused with the tremor of idiopathic Parkinsons. A general neurologist or movement disorder specialist is the best physician to help differentiate between these two conditions.
- A Parkinsonian syndrome: The symptoms of several neurologic conditions are similar to those of idiopathic Parkinsons, but they are often managed differently and often do not respond to the typical medications.
Remember: Only a general neurologist or movement disorder specialist can tell you with reasonable certainty if you have idiopathic Parkinsons. If for some reason you are not comfortable with the results of your first physician visit, getting a second opinion from another general neurologist or movement disorder specialist is always an option. It is important that you feel comfortable with your physician to ensure the best possible outcome for you.
Once you or your loved one has a diagnosis of Parkinsons disease, it is time to discuss treatment options with your physician.
Diagnosis And Management Of Parkinsons Disease
There are no diagnostic tests for Parkinsons. X-rays, scans and blood tests may be used to rule out other conditions. For this reason, getting a diagnosis of Parkinsons may take some time.
No two people with Parkinsons disease will have exactly the same symptoms or treatment. Your doctor or neurologist can help you decide which treatments to use.
People can manage their Parkinsons disease symptoms through:
- seeing a Doctor who specialises in Parkinsons
- multidisciplinary therapy provided for example, by nurses, allied health professionals and counsellors
- deep brain stimulation surgery .
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Early Signs Of Parkinson’s
Early physical signs include the common motor symptoms: tremor, muscle rigidity and slowness. They may also include the following:
- Symptoms starting on one side of the body
- Change in facial expression
- Failure to swing one arm when walking
- Stooped posture
- Loss of sense of smell
- Depression or anxiety
Some of these symptoms are quite common and by no means exclusive to Parkinsons, so if you have some of them, it does not mean you have Parkinsons.
Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
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What Can I Expect If I Have This Condition
Parkinsons disease is a degenerative condition, meaning the effects on your brain get worse over time. However, this condition usually takes time to get worse. Most people have a normal life span with this condition.
You’ll need little to no help in the earlier stages and can keep living independently. As the effects worsen, youll need medication to limit how the symptoms affect you. Most medications, especially levodopa, are moderately or even very effective once your provider finds the minimum dose you need to treat your symptoms.
Most of the effects and symptoms are manageable with treatment, but the treatments become less effective and more complicated over time. Living independently will also become more and more difficult as the disease worsens.
How long does Parkinsons disease last?
Parkinsons disease isnt curable, which means its a permanent, life-long condition.
Whats the outlook for Parkinsons disease?
Parkinson’s disease isn’t fatal, but the symptoms and effects are often contributing factors to death. The average life expectancy for Parkinson’s disease in 1967 was a little under 10 years. Since then, the average life expectancy has increased by about 55%, rising to more than 14.5 years. That, combined with the fact that Parkinson’s diagnosis is much more likely after age 60, means this condition doesn’t often affect your life expectancy by more than a few years .
What Happens At The Exam
If your doctor thinks you might have Parkinsonâs disease, theyll recommend that you see a specialist who works with nervous system issues, called a neurologist. One whoâs also trained in movement disorders, like Parkinsonâs, may be able to make the right diagnosis faster.
Your neurologist will probably want to see how well your arms and legs move and check your muscle tone and balance.
They may ask you to get out of a chair without using your arms for support, for example. They also may ask a few questions:
- What other medical conditions do you have now or have you had in the past?
- What medications do you take?
- Has your handwriting gotten smaller?
- Do you have trouble with buttons or getting dressed?
- Do your feet feel âstuckâ to the floor when you try to walk or turn?
- Do people say your voice is softer or your speech is slurred?
Parkinsonâs disease can look different from person to person. Many people have some symptoms and not others.
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What Causes The Condition
Although there are several recognized risk factors for Parkinsons disease, such as exposure to pesticides, for now, the only confirmed causes of Parkinsons disease are genetic. When Parkinsons disease isnt genetic, experts classify it as idiopathic . That means they dont know exactly why it happens.
Many conditions look like Parkinson’s disease but are instead parkinsonism from a specific cause like some psychiatric medications.
Familial Parkinsons disease
Parkinsons disease can have a familial cause, which means you can inherit it from one or both of your parents. However, this only makes up about 10% of all cases.
Experts have linked at least seven different genes to Parkinson’s disease. They’ve linked three of those to early-onset of the condition . Some genetic mutations also cause unique, distinguishing features.
Idiopathic Parkinsons disease
Experts believe idiopathic Parkinsons disease happens because of problems with how your body uses a protein called -synuclein . Proteins are chemical molecules that have a very specific shape. When some proteins dont have the correct shape a problem known as protein misfolding your body cant use them and can’t break them down.
With nowhere to go, the proteins build up in various places or in certain cells . The buildup of these Lewy bodies causes toxic effects and cell damage.
The possible causes are:
Its Time To Redefine Early Stage Parkinsons
The Parkinsons Foundation has shared 10 early signs of PD, including tremor, small handwriting, and loss of smell.
While younger people with early-onset PD may have some of the same signs and symptoms as older individuals, the onset may look different, so their issues may not be attributed to PD.
The American Parkinson Disease Association notes that, Because the majority of people who get Parkinsons disease are over the age of 60, the disease is often overlooked in younger people, leading many to go undiagnosed or misdiagnosed for extended periods of time.
My sister was finally referred to a neurologist at the Cleveland Clinic Center for Neurological Restoration in Ohio, as her symptoms slowly but consistently progressed. After multiple tests, including an MRI, cognitive testing, and a movement and balance analysis, she was diagnosed with PD.
One of Bevs early signs was weakness in her left hand, which she attributed to carpal tunnel syndrome. She regularly conducted echocardiograms and electrocardiograms, which required a lot of constant hand movement. She did not have stiffness or balance issues initially, but she did have a slight head tremor.
As Bevs PD progressed, she noticed that her writing was changing. She now has stage 3 PD and said, Sometimes I cant read my own writing. I feel like it looks like chicken scratch!
Bev also has cognitive issues, mostly related to her short-term memory.
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What Is Parkinson’s Disease Its A Movement Disorder
Parkinson’s disease is a progressive brain illness that affects the way you move. In more clinical terms, Parkinsons disease is a neurodegenerative disorder of the central nervous system.
Normally, there are cells in the brain that produce a chemical called dopamine. Dopamine sends signals to the parts of your brain that control movement. When approximately 60-80% of the dopamine-producing brain cells are damaged, symptoms of Parkinson’s disease appear, and you may have trouble moving the way you want.
Parkinson’s disease is a chronic illness and it slowly progresses over time. While there is no therapy or medicine that cures Parkinsons disease, there are good treatment options available that can help you live a full life.
Parkinson’s Disease And Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
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How Is Parkinsons Disease Tested And Diagnosed
At Banner Health, our neurologists have years of experience in testing and diagnosing Parkinsons disease. Our team of compassionate experts knows that each patient is different, so we work with you to quickly find the right diagnosis to begin building your treatment plan.
Parkinsons is not simple to diagnose. No test exists to diagnose Parkinsons disease. Doctors test and diagnose Parkinsons based on your medical history, symptoms and neurological and physical exams.
Many times a primary care provider is the first to suspect a Parkinsons diagnosis. If youre experiencing symptoms such as tremors, shaking, slow movement, stiffness and/or trouble with balance, talk to your doctor or seek the opinion of a neurologist. Banner Health neurologists are movement disorder specialists, who have experience and specific training to assess and treat Parkinsons.
Passive Manipulation Of Limbs
To test for the presence of rigidity, we need to passively manipulate the limbs of the patient. However, If the disease is in its early stage or the symptoms are well controlled with medications, we may not be able to see rigidity. We will need to use some activation maneuvers, that basically consist in performing repetitive movements with the limb contralateral to the one that is being tested.
Also, there are two types of rigidity:
– Lead-pipe rigidity: where the tone is uniformly and smoothly increased throughout the entire range of movement
– Cogwheel rigidity: where a tremor is superimposed on the hypertonia, making the movement irregular due to intermittent increase and reduction of tone
Upper Extremity Testing
For the upper extremity the most sensitive joint where to check for rigidity is the wrist. To uncover rigidity, passively rotate the wrist and feel for a resistance to the movement. It is very important that the arm of the patient is fully relaxed when rotating the wrist. To do this, place your proximal hand under the patients forearm, while your distal hand grabs and rotates the wrist of the patient. When rigidity is present, the range of motion will be preserved but you will feel a resistance in performing the movement.
Wrist rotation with activation maneuver.
It is also possible to test for rigidity in the elbow by passively flexing and extending the forearm.
Elbow flexion-extension with activation maneuver.
Lower Extremity Testing
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Scientifically Backed Ways To Prevent Parkinsons Disease
Dopamine plays a major role in a variety of mental and physical functions, including:
- Voluntary movement
- General behavior
Parkinsons now afflicts roughly 1.5 million people in the United States alone, with primary symptoms being body tremors, slow movement, rigid limbs, reduced memory, a shuffling gait and speech impairment. So we have to ask:
1.) What causes it?
2.) How do we prevent it?
Currently there isnt a known cure, and its not fully understood what causes the dip in dopamine however, we know that aging is the single most important risk factor for PD, with inflammation and stress contributing to cell damage. And we now know enough about the disease to understand the preventative measures that counter the aging and death of the neurons under attack.
Because there is no known cure, its critical that we prevent the disease before symptoms arise. Granted, thanks to recent advancements in modern surgical procedures, there are some safe surgeries that can mitigate some of the more severe symptoms associated with PD. The most common one now is deep brain stimulation, in which they implant an electrode into the brain that can stop some of the more severe symptoms of Parkinsons.
But this article will try to keep it from getting to that point. The less drugs and surgery we can have in our lives, the better.
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About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.
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How Soon After Treatment Will I Feel Better And How Long Will It Take To Recover
The time it takes to recover and see the effects of Parkinson’s disease treatments depends strongly on the type of treatments, the severity of the condition and other factors. Your healthcare provider is the best person to offer more information about what you can expect from treatment. The information they give you can consider any unique factors that might affect what you experience.
How Do I Take Care Of Myself
If you have Parkinsons disease, the best thing you can do is follow the guidance of your healthcare provider on how to take care of yourself.
- Take your medication as prescribed. Taking your medications can make a huge difference in the symptoms of Parkinson’s disease. You should take your medications as prescribed and talk to your provider if you notice side effects or start to feel like your medications aren’t as effective.
- See your provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your conditions and finding the right medications and dosages.
- Dont ignore or avoid symptoms. Parkinsons disease can cause a wide range of symptoms, many of which are treatable by treating the condition or the symptoms themselves. Treatment can make a major difference in keeping symptoms from having worse effects.
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What Treatment Options Are Available To Those Dealing With Advanced Disease
1 – Drugs
First, one should try to find effective drug treatment, including combining several drugs, dividing the doses into an increasing number of times a day and increasing the amount of medication in each dose.
2 – Surgery
There are three approved treatments to treat advanced-stage Parkinsons which are provided by Israeli health funds.
One treatment option is surgery to implant electrodes for brain stimulation to the areas of movement control in the brain, which is called deep brain stimulation. This procedure is performed in an increasing number of centers in the country. After the surgical procedure, the patient arrives at an institute that treats Parkinson’s and undergoes a procedure to calibrate the electrodes, until optimal therapeutic efficacy is reached. It will be monitored regularly over the years and doctors will decide to make changes depending on the progress of the disease and the side effects.
3 – Levodopa gel
4 – Apomorphine
Third is a subcutaneous pump, which continuously infuses apomorphine , thus helping to improve the symptoms of advanced disease, in parallel with continued drug treatment.
All treatments are effective, safe and have been used with thousands of patients.