Parkinson’s Disease

Parkinson’s is a disease of unknown cause that damages nerve pathways in the brain, causing tremor and stiffness of movement, & often dementia.  It affects about 1 in 300 people over 40, but most are significantly older (maybe 1 in 50 people >80).  Symptoms gradually progress, about 75% of patients die or have major disability by 10 years, although a small minority hardly ever get worse.  A variety of medications can cause Parkinson’s symptoms, especially psychiatric drugs, but those go away when the meds are stopped.

The main movement-related symptoms of Parkinson’s are:

  • Tremor, that’s worst while resting and goes away while doing something.  For example, hands tremble while calmly in the lap, but not when being used.  Tremor can occur in the legs, lips and tongue, usually not the head.
  • Slow-Start (“bradykinesia”), meaning a hard time beginning a movement.  A person may feel frozen, has to propel themselves forward in a shuffle.  In the arms, it may be hard to button clothes, double-click a mouse, take coins from a pocket.
  • Stiffness or Rigidity, called “cogwheeling.”  As the examiner gently moves an arm at the elbow, there’s constant tiny bursts of resistance like a ratchet, without full relaxation.

Other symptoms may include small handwriting, drooling, loss of facial expression, decreased eye blinking, stooped posture, trouble turning over in bed.  There may also be fatigue, mood problems, loss of smell, runny nose, and balance difficulties.

Dementia (memory loss) occurs eventually in almost half of patients.ย  The thinking process slows, memory loss occurs, patients are unable to multi-task or make decisions.ย  Personality changes are common, paranoia may develop.ย  There may be hallucinations, mostly seeing things but also smelling or hearing things.

It may be hard to tell the difference between Parkinson’s and Lewy Body Dementia (see Dementia).  If dementia occurs less than 1 yr after getting Parkinson’s, or certainly if before, it’s probably Lewy-body.

Treatment includes a number of medications to help with movement abnormalities, and brain surgeries as well.  But there are no treatments to cure the disease, or stop its progression.  Information may be obtained from the Parkinson’s Disease Foundation, 800-457-6676, http://www.pdf.org, and info@pdf.org.  Patients & families should beware of trolling the net, because there’ll be lots of scary stories, and every patient’s symptoms and progression are different.

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