What Tests Might I Have
People who have Parkinsonâs disease donât make enough of a brain chemical called dopamine, which helps you move. If those first tests donât show a reason for your symptoms, your doctor may ask you to try a medication called carbidopa-levodopa, which your brain can turn into dopamine. If your symptoms get much better after you start the drug, your doctor probably will tell you that you have Parkinsonâs disease.
If the medication doesnât work for you and thereâs no other explanation for your issues, your doctor might suggest an imaging test called a DaTscan. This uses a small amount of a radioactive drug and a special scanner, called a single photon emission computed tomography scanner, to see how much dopamine is in your brain. This test can’t tell you for sure that you have Parkinson’s disease, but it can give your doctor more information to work with.
It can take a long time for some people to get a diagnosis. You may need to see your neurologist regularly so they can keep an eye on your symptoms and eventually figure out whatâs behind them.
What Are Lewy Bodies
The affected neurons of people with Parkinsons disease have been found to contain clumped proteins called Lewy bodies, but researchers arent yet sure why Lewy bodies form or what role they play in the disease.
Lewy bodies are clumps of a protein called alpha-synuclein . Neurons cant break down these protein clumps, which may lead to the death of these cells.
Some other theories about what causes the death of brain cells in people with Parkinsons disease include free radical damage, inflammation, or toxins.
Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
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How Does Parkinsons Progress
Parkinsons is a chronic and slowly progressive disorder. This means that symptoms normally appear slowly and develop gradually over time. The stage at which symptoms appear, speed at which they progress and the severity of those symptoms will vary from person to person. The most important point is that Parkinsons affects everyone differently.
There are a wide range of symptoms, but it is highly unlikely that you will experience every possible symptom. Some of the early symptoms of Parkinsons include handwriting changes, reduced sense of smell, tiredness and constipation. As Parkinsons progresses symptoms will change over time, and new symptoms will emerge. It can take many years for symptoms to progress to a point where they cause problems.
Ultimately symptoms will begin to impact on your day to day life. Many symptoms are related to physical movement, so you may find that walking becomes difficult. You may also experience non-movement symptoms such as mood changes, disrupted sleep or difficulty communicating. As these symptoms worsen it may become difficult to manage all of your daily activities.
Currently, there is no known way to slow the progression of Parkinsons. However, medications and other treatments can help to effectively manage your symptoms. To ensure the effectiveness of medications, they will need to be reviewed regularly by your specialist or doctor.
What To Expect At The Appointment
To make a Parkinsons diagnosis, your doctor will look for the three main motor symptoms: bradykinesia , tremor and rigidity. Remember, not everyone with Parkinsons disease has a tremor. They will also ask questions and examine you to see if there are possible other explanations for your symptoms besides Parkinsons.
The doctor will ask you questions and look for Parkinsons signs like:
- If you have a resting tremor, meaning your tremor appears when your limb like an arm or leg is still
- If your tremor and/or other movement issues occur on one side of your body only
- If your handwriting has become very small
- If you have issues with balance
- If the way you walk has changed for example, you are taking small steps or having trouble turning
- If you have stiffness, aka rigidity, in your arms or legs for example, you dont swing your arm when you walk
- If you have difficulty with fine motor movements like combing your hair or brushing your teeth
- If your voice has become softer or more difficult for others to hear
To assess your non-motor symptoms, your doctor may ask you questions about:
- If youve lost your sense of smell
- If you experience constipation
- If you talk or act out dreams while you sleep
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
What Is Parkinson’s Disease
Parkinsons disease occurs when brain cells that make dopamine, a chemical that coordinates movement, stop working or die. Because PD can cause tremor, slowness, stiffness, and walking and balance problems, it is called a movement disorder. But constipation, depression, memory problems and other non-movement symptoms also can be part of Parkinsons. PD is a lifelong and progressive disease, which means that symptoms slowly worsen over time.
The experience of living with Parkinson’s over the course of a lifetime is unique to each person. As symptoms and progression vary from person to person, neither you nor your doctor can predict which symptoms you will get, when you will get them or how severe they will be. Even though broad paths of similarity are observed among individuals with PD as the disease progresses, there is no guarantee you will experience what you see in others.
Parkinsons affects nearly 1 million people in the United States and more than 6 million people worldwide.
For an in-depth guide to navigating Parkinsons disease and living well as the disease progresses, check out our Parkinsons 360 toolkit.
What Is Parkinson’s Disease?
Dr. Rachel Dolhun, a movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, breaks down the basics of Parkinson’s.
Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
Disease Or Functional Problem
For a person with ET, its not much comfort to call tremors a functional problem. When tremors are severe and incapacitating, it feels like a disease condition. However, in medical terms, a disease is an organic or pathological state with cellular changes that can usually be identified or diagnosed by physical tests. Such tests include blood and tissue analysis that may reveal distinct cellular changes or biomarkers, and various types of imaging for abnormalities . Also, many diseases lead to death if left untreated, or if there is no known cure. Thus, ET does not qualify as a diseasebut this is of little comfort if tremors become so severe that life is no longer normal.
However, ET is sometimes incorrectly diagnosed as Parkinsons disease . One of the main symptoms of PD is tremors, usually starting in the fingers or hands, but which can also affect other parts of the body as the disease progresses. In addition, PD brings stiffness and rigidity, slowness of voluntary movements, facial and postural drooping, balance and gait problems, skin abnormalities, cognitive and emotional difficulties, and eventually near-total disability. Thus, a diagnosis of PD is devastating.
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What Makes Pd Hard To Predict
Parkinsonâs comes with two main buckets of possible symptoms. One affects your ability to move and leads to motor issues like tremors and rigid muscles. The other bucket has non-motor symptoms, like pain, loss of smell, and dementia.
You may not get all the symptoms. And you canât predict how bad theyâll be, or how fast theyâll get worse. One person may have slight tremors but severe dementia. Another might have major tremors but no issues with thinking or memory. And someone else may have severe symptoms all around.
On top of that, the drugs that treat Parkinsonâs work better for some people than others. All that adds up to a disease thatâs very hard to predict.
What Is The Treatment For Parkinson’s Disease
There is currently no treatment to cure Parkinson’s disease. Several therapies are available to delay the onset of motor symptoms and to ameliorate motor symptoms. All of these therapies are designed to increase the amount of dopamine in the brain either by replacing dopamine, mimicking dopamine, or prolonging the effect of dopamine by inhibiting its breakdown. Studies have shown that early therapy in the non-motor stage can delay the onset of motor symptoms, thereby extending quality of life.
The most effective therapy for Parkinson’s disease is levodopa , which is converted to dopamine in the brain. However, because long-term treatment with levodopa can lead to unpleasant side effects , its use is often delayed until motor impairment is more severe. Levodopa is frequently prescribed together with carbidopa , which prevents levodopa from being broken down before it reaches the brain. Co-treatment with carbidopa allows for a lower levodopa dose, thereby reducing side effects.
In earlier stages of Parkinson’s disease, substances that mimic the action of dopamine , and substances that reduce the breakdown of dopamine inhibitors) can be very efficacious in relieving motor symptoms. Unpleasant side effects of these preparations are quite common, including swelling caused by fluid accumulation in body tissues, drowsiness, constipation, dizziness, hallucinations, and nausea.
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What Are The Risk Factors For Parkinsons Disease
Risk factors for Parkinsons disease include:
People with a first-degree relative with Parkinsons are at an increased risk for the disease possibly as much as 9 percent greater.
Fifteen to 25 percent of people with Parkinsons have a known relative with the disease, but a condition called familial Parkinsons, which has a known genetic link, is relatively rare.
The average age of onset is 60 years, and the incidence rises with advancing age. About 10 percent of people have early-onset or young-onset disease, which begins before age 50.
Parkinsons affects about 50 percent more men than women, for unknown reasons.
Exposure to some pesticides has been shown to raise the risk of developing Parkinsons.
Problematic chemicals include organochlorine pesticides like DDT, dieldrin, and chlordane. Rotenone and permethrin have also been implicated.
Fungicide and Herbicide Exposure
Exposure to the fungicide maneb or the herbicides 2,4-dichlorophenoxyacetic acid , paraquat, or Agent Orange may raise the risk of Parkinsons.
The U.S. Veterans Health Administration considers Parkinsons to be a possible service-related illness if the person was exposed to significant amounts of Agent Orange.
Head injuries may contribute to the development of Parkinsons in some people.
Coffee and Smoking
People who drink coffee or smoke tobacco have been found to have a lower risk of Parkinsons disease, for reasons that remain unclear.
Learn More About Parkinsons Disease: Overview
Lewy Body Dementia Vs Parkinsons Disease Dementia
Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.
Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.
The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.
This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.
The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.
Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.
Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.
Parkinsons disease itself isnt fatal, but complications can be.
Research has shown a median survival rate of about
Talking To Your Spouse/partner
As noted earlier, many people receive their Parkinsons diagnosis with their partner sitting next to them however, for those whose partner isnt there, its important to tell them in a timely manner so that you can plan to move forward together. Even if you want to protect them from the truth, or youre worried about how things might change, being open with them is critical.
If youre having trouble getting the words out, think about how you would feel if they hid a diagnosis like this from you. Take the time you need to come to terms with your diagnosis, but dont wait too long. You and your spouse can grow to understand Parkinsons by asking questions and seeking information together. Your partner or significant other may also have pertinent questions that you havent thought of or offer a different perspective that can help you see your diagnosis in a new way.
Your partner can also become a resource and an advocate for you. Once you have told them, they can help facilitate further disclosures of your diagnosis. For example, it may be particularly challenging to tell your children, but telling them together can make it easier. They may also help you practice for future conversations and work out what you do and dont want to share with specific people.
What If You Have Parkinson’s
After Parkinson’s is diagnosed, your doctor will help you develop an individualized plan to address the symptoms that have the biggest impact on your everyday life and help slow down the progression of the disease. The first step is getting a referral to a neurologist for expert care especially one who is trained in movement disorders.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
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Cognitive And Psychiatric Symptoms
- depression and anxiety
- mild cognitive impairment slight memory problems and problems with activities that require planning and organisation
- dementia a group of symptoms, including more severe memory problems, personality changes, seeing things that are not there and believing things that are not true
How To Share Your Parkinsons Diagnosis With Family Friends And Co
Youve been diagnosed with Parkinsons. Now what? Do you tell people? If so, how, who, and when?
Whether youve been recently diagnosed, youve known for a while but dont know how to tell people, or youve told people but arent satisfied with how it went, we hope this information will be useful. While not all of these situations will apply to you, we offer several strategies that can help you approach these potentially difficult conversations with more ease.