PARKINSON'S DISEASE

General Information

DEFINITION--A disease of the central nervous system that occurs in older adults and is characterized by gradual, progressive muscle rigidity, tremors and clumsiness.

BODY PARTS INVOLVED--Area of the brain that regulates movement; muscles.

SEX OR AGE MOST AFFECTED--Adults over 60.

SIGNS & SYMPTOMS

• Tremors, especially when not moving.
• General muscle stiffness and slowness.
• Awkward or shuffling walk; stooped posture; loss of facial expression; swallowing difficulty.
• Voice changes. The voice becomes weak and high pitched.
• Intellectual ability is unchanged until advanced stages, when it deteriorates slowly.

CAUSES

Usually unknown. It results from a deficiency of dopamine, a chemical that relays messages across the nerve pathways. It affects the area of the brain responsible for control of voluntary muscle movements and posture. > Some cases may be caused by: medications, such as phenothiazine tranquilizers; brain injury; tumors; post-influenza encephalitis; slow-virus infection; or carbon-monoxide poisoning (possibly).

RISK INCREASES WITH--Unknown.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• There are no confirming diagnostic tests for Parkinson's. Diagnosis is usually based on physical examination. Medical tests may be recommended to rule out other disorders.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Physical therapy, encouragement, reassurance and treatment of associated conditions (such as depression).
• Counseling to help relieve depression.
• Occupational and speech therapy may be recommended.

POSSIBLE COMPLICATIONS

• Dementia; pneumonia; severe constipation.
• Urine retention caused by medication.
• Falls and fractures; debilitation.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms can be relieved or controlled. Life expectancy is not significantly reduced. Research utilizing fetal tissue transplantation shows promise for future treatment. This therapy appears to resupply the brain with dopamine-producing cells.

How To Treat

GENERAL MEASURES--

• Gradual restrictions of the disease may frustrate you and cause social withdrawal. Seek professional help and ask your family for support in finding ways to remain active and useful.
• There are numerous techniques you can learn to help you cope with the physical limitations. These can be tailored to your specific needs as symptoms change.
• Compliance with your treatment program (diet, exercise, medications) is important to help you maintain an optimum level of function.
• Accidentproof your home to prevent falls and injuries.
• Wear a Medic-Alert (See Glossary) bracelet or neck tag that indicates your medical problem.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe: Anticholinergics; antihistamines; antitremor drugs, such as amantadine; or antiparkinson medications, including bromocriptine, levodopa and carbidopa. Selegiline is prescribed to maintain maximal effectiveness of levodopa and carbidopa. All these decrease tremors and reduce muscle rigidity, but they often have significant side effects.

ACTIVITY--Remain as active as possible and rest often. Physical abilities vary greatly between persons with this disease. The only restrictions are those imposed by muscle rigidity. Physical therapy and exercise help to increase or maintain your mobility.

DIET--

• No special diet, but soft foods may be necessary if swallowing becomes difficult. Add bulk or fiber to the diet and increase fluid intake to prevent constipation.
• If eating takes a long time, try eating smaller, more frequent meals.
• Special utensils and drinking cups are helpful if tremors cause too much unsteadiness.

Call Your Doctor If

New, unexplained symptoms develop, especially urination difficulty, confusion or blurred vision.