Parkinson’s Treatments We Offer
There is no cure for Parkinson’s, but treatment at Cedars-Sinai can loosen the grip that symptoms have on your life. Parkinson’s is a progressive illness, meaning your needs change over time. We are here for you with a broad range of options and personalized recommendations.
Therapies that are best for you depend on your symptoms and how long Parkinson’s has been part of your life.
Parkinsons Foundation Center Of Excellence
Mount Sinai Beth Israel is designated as a Center of Excellence by the Parkinsons Foundation, specialized team of neurologists, movement disorder specialists, physical and occupational therapists, mental health professionals and others who are up-to-date on the latest Parkinson’s disease medications, therapies, and research to provide the best care.
What Kind Of Exercise Is Best
Ideally, combining a range of different fitness activities can bring the most benefit to patients, Amodeo says, since variety increases muscle learning and is more neurologically invigorating.
That said, any bit of exercise helps, she notes, adding that it also pays to build up slowly. An introductory session with a physical therapist is also recommended to help patients find the best beginning regimen for their ability level. The American Parkinson Disease Association National Resource Center for Rehabilitation runs a toll-free hotline that allows callers to speak with a licensed physical therapist who can offer advice about exercising and help connect callers to resources in their communities.
While the most important thing is finding a fitness activity you enjoy, and sticking with it, Amodeo says she’s seen benefits from a few particular types of exercises in particular such as boxing, which, she notes, combines aerobic exercise, weight training and balance all in one class, as well as yoga and tai chi, which deliver balance training and help with fluidity of movement. They’re also good for overall mindfulness and taking time for you, she notes. For those more limited in their mobility, she says a stationary bike or aquatic therapy are great options.
And finally, don’t overlook a dance class as a potentially fun and beneficial type of exercise. One study showed that Argentine tango classes in particular improved PD patients balance and functional mobility.
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Building On A Rich History
The Parkinson’s Disease and Movement Disorders Center is one of four entities comprising the Mass General Movement Disorders Unit. Our hospital has a long history of conducting research into Parkinson’s disease and caring for patients with this and other movement disorders. Robert Schwab, MD, laid the groundwork for the Movement Disorders Unit in the 1940s when he published his first research paper on Parkinson’s disease.
John Growdon, MD, serves as director of both the Parkinson’s Disease and Movement Disorders Center and the Movement Disorders Unit. His clinical interests include the cognitive and behavioral aspects of Parkinson’s disease and related disorders. Our staff includes over a dozen neurologists who specialize in the treatment of Parkinsons disease and movement disorders.
Mass General has earned the prestigious quality of Center of Excellence from the Parkinsons Foundation. In addition, our clinics physicians serve of advisory committees for the Parkinson Study Group and Michael J. Fox Foundation.
General Strategies For Getting The Most Out Of Your Care Team
It’s important to be an active partner in your care. Try to resist adopting the role of a passive patient who just follows the orders of the doctors. Ask questions. But ask them in a cordial way in order to learn. Ask questions so that you can maximize the benefits of any treatment you undergo. Try also to avoid the opposite danger of asking too many questions and of taking over the role of doctor yourself. You will have to learn to accept the care of others. Let them do their job. Learn from them. Partner with them. If you can establish this kind of partnership with your care team you and your family will find it easier to cope with all the challenges that PD will throw at you over the years.
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What Is A Tremor And What Makes It Different With Parkinsons
Tremor is an uncontrollable, rhythmic muscle contraction that triggers quivering in one or more parts of the body. It often occurs in hands, arms, or legs but can also affect the head, neck, or torso. This shaking may appear in sporadic spells or continue constantly.
The National Institute of Neurological Disorders and Stroke says that age is a risk factor middle-aged and older adults are more likely to experience tremors.
Getting To A Movement Disorder Specialist
If you live in a rural area or have difficulty traveling, it may be challenging to find or visit a movement disorder specialist. One option might be to travel to see a movement disorder specialist once or twice a year and follow up with a local general neurologist or primary care doctor more frequently. Any time spent with a specialist may be helpful.
Technology, too, may help. Some hospitals and services can connect you with a Parkinson’s specialist without you having to leave your home. Parkinson’s Disease Care New York, for example, offers people in the state of New York video calls through a computer, tablet or smartphone with a movement disorder specialist, a neurologist or a Parkinson’s-trained nurse at no cost. Ask your doctor or support group about telemedicine opportunities.
Be Part of the Answer
You have the power to impact your future and the future of millions living with Parkinson’s disease. Explore clinical research participation today.
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Tremors In Parkinsons Disease: What They Are Types Of Tremors And More
Getting the trembling associated with Parkinsons under control can be a challenge, but treatments can help.
Nicole Rerk/Shutterstock
Tremors are a defining characteristic of Parkinsons disease, affecting about 8 out of 10 people with this movement disorder. Many people think the involuntary shaking motion is the main problem for patients. While it is certainly an irritating symptom that individuals want to get under control, other characteristics of the disease can be more debilitating.
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Working With Your Care Team
Once you have chosen members of your care team how can you best interact with them? You and your team want the same thing: They want to give you the best possible care they can and you want to receive the best care available. Why then do so many persons with PD not get the best possible care available? One reason is that communication between patient and care team breaks down.
How can you keep the communication lines between you and your healthcare team open? Here are a few tips.
For every visit to a health professional try to have the following information written down so that you can hand it over to the secretary instead of having to repeat it ad infinitum:
- Your name
- Insurance information and member number
- Date of birth social security number
- Current medications, including over the counter medications and any nutritional supplements you use, the dose you take, and the purpose of the medication
- Known allergies or adverse reactions to medications or common medical equipment
- Current health problems and dates of onset
Don’t forget that medication errors are all too common. You should learn a few ideas to reduce the chance of a medication error.
Our Medical Professionals Work Together To Provide The Care You Need
Our expert team of neurologists and neurosurgeons work closely with our physical therapists,speech therapists, occupational therapists,nutritionists, social workers and nurses to provide our patients suffering from conditions like ataxia, dystonia, essential tremor or spasticity with the care they need to begin reclaiming their independence.
- Pain management
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How Fitness Controls Symptoms And Which Activities Doctors Recommend You Try
by Cheryl Platzman Weinstock, AARP, April 23, 2021| 0
En español | You know that exercise is good for your heart and that it strengthens your bones. But it’s also one of the more important cornerstones of managing Parkinson’s disease , the second most prevalent progressive degenerative disease of the nervous system that affects movement.
Intensive research in the past several years has found that for Parkinson’s patients, exercise can increase coordination and balance, reduce falls and improve mood. Codrin Lungu, program director in the Division of Clinical Research at the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health , says that preliminary evidence also shows that exercise slows the progression of the disease.
To understand how that might be so, research is building on earlier studies showing that exercise in older adults increases brain volume and improves neurological connections in areas that would otherwise undergo age-related decline. Research also has shown that intensive exercise appears to increase dopamine receptors that coordinate signals from the brain to muscles. Scientists believe a lack of dopamine causes PD.
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Diagnosis Of Parkinsons Disease
The movement disorder specialists at Mount Sinai are expert in diagnosing and treating Parkinsons disease. There is no one test that diagnoses Parkinsons disease. Instead, we conduct a comprehensive history of symptoms and a detailed neurologic examination. After we confirm the diagnosis, we develop a comprehensive treatment plan, personalized to your needs.
Our neurosychologists and neuropsychiatrists evaluate patients who are being considered for certain medications or treatments , provide support and counseling, and oversee treatments and strategies for dealing with mood, memory, or other challenges.
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Is Telemedicine An Option
COVID-19 has facilitated the implementation of telemedicine. The fact that insurance will cover these types of visits further enhances this option. This has been a godsend for me and has saved me hours of driving. My movement disorder specialists office is over 80 miles from my home. In addition, my doctors have a much better track record at being on time for my telemedicine appointment compared with in-office visits.
If Its Not Parkinsons Disease What Could It Be
Here are some possibilities:
Side effects of medication: Certain drugs used for mental illnesses like psychosis or major depression can bring on symptoms like the ones caused by Parkinsonâs disease. Anti-nausea drugs can, too, but they typically happen on both sides of your body at the same time. They usually go away a few weeks after you stop taking the medication.
Essential tremor: This is a common movement disorder that causes shaking, most often in your hands or arms. Itâs more noticeable when youâre using them, like when you eat or write. Tremors caused by Parkinsonâs disease usually happen when youâre not moving.
Progressive supranuclear palsy: People with this rare disease can have problems with balance, which may cause them to fall a lot. They donât tend to have tremors, but they do have blurry vision and issues with eye movement. These symptoms usually get worse faster than with Parkinson’s disease.
Normal pressure hydrocephalus : This happens when a certain kind of fluid builds up in your brain and causes pressure. People with NPH usually have trouble walking, a loss of bladder control, and dementia.
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Dementia With Lewy Bodies
- Dementia with Lewy bodies is a progressive, neurodegenerative disorder in which abnormal deposits of a protein called alpha-synuclein build up in multiple areas of the brain.
- Dementia with Lewy bodies is second to Alzheimers as the most common cause of degenerative dementia that first causes progressive problems with memory and fluctuations in thinking, as well as hallucinations. These symptoms are joined later in the course of the disease by parkinsonism with slowness, stiffness and other symptoms similar to PD.
- While the same abnormal protein is found in the brains of those with PD, when individuals with PD develop memory and thinking problems it tends to occur later in the course of the disease.
- There are no specific treatments for DLB. Treatment focuses on symptoms.
Treatments For Parkinson’s Disease
Although PD has no cure, the symptoms of the disease are treatable.
Because each patient experiences symptoms differently, physicians base each patients treatments on his or her specific symptoms. The Movement Disorders team works closely with other UT Southwestern specialists such as those in psychiatry and speech, physical, and occupational therapy to provide patients with individualized care to manage symptoms and maximize mobility, balance, and coordination.
Treatments for Parkinsons disease include:
The benefits and disadvantages of medications can be different for each individual. Medications that might be prescribed include:
- Catechol-O-methyltransferase inhibitors lengthen the half-life of levodopa in the bloodstream.
- Dopamine agonists work by directly stimulating the post-synaptic dopamine receptors.
- Levodopa has been the mainstay of treatment for PD since the 1970s. This drug is taken orally, transported to the brain, and, inside the dopaminergic brain cells, converted into natural dopamine.
- Monoamine oxidase type-B inhibitors inhibit the breakdown of dopamine in the brain, thus lengthening the clinical response to levodopa.
Patients often see significant improvement after beginning PD medication. Over time, however, the benefits of drugs become less consistent for many people.
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Finding The Right Doctor For You
Even the most qualified doctor might not be right for you. You will probably see this doctor at least every few months once you start working together. You will see each other more often if you have problems. You need to feel comfortable with the doctor.
Dont be afraid to interview your doctor before you make your choice. Here are points to consider:
- Do you feel your doctor listens to you and lets you take an active role in your care?
- Is your doctor available when needed?
- How easy is it to contact your doctor?
- How long does it take for the doctor to call back?
- Does the doctor have a good support system to cover you when he or she is not available?
Risk Factors For Parkinson’s Disease
While a primary cause for PD is not yet known, certain risk factors can increase a persons likelihood of developing the disease:
- Age: PD is rare in young people. People who develop the disease are usually around 60 or older, and the risk increases with age.
- Exposure to environmental toxins: Exposure to certain herbicides and pesticides can increase risk.
- Gender: Men are more likely to develop PD than women. On average, three men will develop the disease for every two women.
- Heredity: Having a close relative with PD increases the chances of developing the disease. However, that risk is still small unless family members develop the disease at a young age.
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How Can You Improve Aggressiveness And Hallucinations In Parkinsons
Hallucinations may spark anger or aggression in a person with Parkinsons disease. Some ways to help include:
- Reassure them, tell them they are safe.
- Speak slowly and calmly.
- Ask questions about the persons feelings.
- Listen to the person, dont interrupt.
- Avoid sudden movements.
- Give the person space and a way out, so they dont feel cornered or threatened.
- Make an emergency plan ahead of time for what you and others in the house will do if the person experiencing hallucinations becomes a danger to themselves, you, or anyone else.
- When it is safe, help the person speak with their healthcare provider about making a plan to address the hallucinations.
Choose A Neurologist Who Specializes In Movement Disorders
Your first task is to find a neurologist who specializes in movement disorders . You need someone who can tell you what to anticipate and who can put you in touch with the best resources and treatment options available. This neurologist will know when to start medications and when to adjust the dosages of those medications to achieve maximum benefit and so forth. So how do you find such a specialist?
First, ask your primary care doctor for a referral to a Parkinson’s specialist. Your primary care doctor will certainly be able to point you in the right direction.
You can also find a local support group for Parkinson’s patients and ask those individuals for recommendations on specialists. You can get information on local support groups as well as local specialists from the local or regional chapters of a national Parkinson’s disease organization. If you can’t find a support group in your community, check out the online support communities for people with Parkinson’s disease who live in your area. You may even be able to get an idea of a neurologist who would meld well with your own personality by asking questions and hearing others talk about their experiences.
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Types Of Hallucinations In People With Parkinsons Disease
Hallucinations involve the five senses: sight, smell, touch, hearing, and taste.
People with hallucinations have sensory experiences that feel real to them, but are not actually happening and are not apparent to anyone else.
Types of hallucinations include:
- Auditory: Hearing things
- Gustatory: Tasting things
For people who experience Parkinsons-related hallucinations, the hallucinations are usually visual. They are typically non-threatening, but less commonly they can be of a threatening nature.
Often people with Parkinsons disease psychosis see small people or animals, or loved ones who have already died. They are not interacting with them, just being observed.
Auditory hallucinations are more common in people with schizophrenia, but can happen with Parkinsons disease. With Parkinsons disease, auditory hallucinations are usually accompanied by visual hallucinations.
More specific types of hallucinations experienced by people with Parkinsons disease include: