What is Parkinson's disease?
Parkinson's disease is a disorder of the central nervous system. The central nervous system includes the brain and spinal cord. Parkinson's disease is one of the conditions known as a movement disorder.
Certain cells in the brain make a chemical substance called dopamine (DOE-puh-mean). Dopamine carries messages that tell the body how and when to move. Parkinson's disease occurs when these brain cells die or are damaged. There is no longer enough dopamine to carry these messages, and movement becomes more difficult.
Parkinson's disease is both a chronic and progressive disease. Chronic means that it lasts for a long time. Progressive means the symptoms get worse over time. The symptoms of Parkinson's disease and the speed at which the disease progresses differ for each person.
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What causes Parkinson's disease?
Parkinson's disease occurs when brain cells containing dopamine in a specific part of the brain die or are damaged. Experts do not know for sure what causes the damage in these brain cells. They believe that Parkinson's disease may be related to one or more of the following:
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Chemicals called free radicals that build up in the brain and damage the cells that make dopamine |
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Toxins (poisons) in the environment, such as pesticides |
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Genetic factors -- 15% to 20% of people with Parkinson's disease have a close relative with similar symptoms, such as shaking, slowness, and stiffness |
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Faster-than-usual loss of the brain cells that make dopamine |
Some experts believe that future studies will show that a combination of these factors may be the cause of Parkinson's disease. Others believe there are still unknown factors that may be important.
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Who is more likely to get Parkinson's disease?
Nearly 100 thousand Canadians may have this disease. Parkinson's disease affects both men and women almost equally. People of every race, economic class, and ethnicity can get Parkinson's disease.
However, age is a clear risk factor. Most people who get Parkinson's disease are over the age of 50. But Parkinson's disease can strike at any age. The average start of the disease is age 60; however, doctors are now finding Parkinson's disease in a growing number of people under the age of 40. This is called early onset Parkinson's disease.
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What are the signs and symptoms of Parkinson's disease?
Because the early symptoms of Parkinson's disease are often very slight and begin slowly, they can be hard to notice. Family members or friends are often the first to spot the early symptoms, such as a constant blank look on the face, shaky hands, decreased arm swinging, a stooped posture, or shorter steps when walking. Parkinson's disease patients may notice that they are weaker or more tired. The disease may eventually involve 2 or more of the 4 main symptoms of Parkinson's disease:
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Tremors -- rhythmic movements or shaking, especially in the hands and particularly when they are at rest |
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Rigid limbs and trunk -- muscle tenseness, stiffness, aching, or weakness |
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Slowness of movement -- difficulty beginning a task, such as washing or dressing |
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Poor balance and coordination -- problems with walking, such as shuffling, which may cause falls |
As time goes on, Parkinson's disease sometimes leads to other symptoms, such as depression or anxiety, problems with chewing and swallowing, and speech changes. Some people may have problems with urination or constipation. Others may have trouble sleeping or problems with skin that is too oily or too dry.
It is always important to remember that the symptoms of Parkinson's disease can vary greatly from person to person. For example, one person may have tremors, while another may be very stiff and slow without any tremor.
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How is Parkinson's disease diagnosed?
The diagnosis of Parkinson's disease is usually based on typical signs and symptoms. It is often hard for a healthcare provider to diagnose Parkinson's disease during the early stages when the symptoms are very slight. The healthcare provider will need to observe the patient carefully and take a detailed health history. Family members can also offer important observations. Tests like an MRI (Magnetic Resonance Imaging) may be used to make sure that nothing else is causing the symptoms. It may be helpful to find a healthcare provider who specializes in Parkinson's disease.
People with Parkinson's disease often seek treatment for tremors because they are visible and easily observed. Whether or not a patient has tremors, the healthcare provider will look for the other common symptoms of Parkinson's disease, such as stiffness, poor balance, difficulty walking, and slowness of movement. When several of these symptoms occur, the healthcare provider can often see a pattern that leads to a diagnosis of Parkinson's disease. There is still no medical test or scan approved by Health Canada that can diagnose Parkinson's disease.
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What are the treatment choices?
Although there is no cure for Parkinson's disease, medication can provide relief from many of the symptoms. To decide on the best treatment, the healthcare provider will need to know how much the symptoms are affecting the person's life. It may also take some trial and error to find the best medication and the right dose. People with Parkinson's disease may have to take several medications to control their symptoms.
Most medications used to treat Parkinson's disease either mimic the effect of dopamine, increase dopamine levels, or extend the action of dopamine in the brain.
Healthcare providers strive to get the best results for their patients while trying to limit the side effects of the medications. It is important to note that the medications used to treat the symptoms of Parkinson's disease cannot stop the disease from progressing over time. But they may help relieve the symptoms and help a person with Parkinson's disease to carry on daily activities
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What other treatment choices are available?
In patients who do not respond well to medication, brain surgery is sometimes used during the later stages of Parkinson's disease.
One new surgical procedure that doctors are using to treat the symptoms of Parkinson's disease is deep brain stimulation. Researchers are also studying the effects of transplanting nerve cells into the brain to produce dopamine.
In the past, experts thought that vitamin E might help delay or prevent Parkinson's disease. Studies have not been able to prove that vitamin E has any protective benefit for Parkinson's disease.
Exercise can be helpful. Although it will not stop the disease from progressing, it can improve muscle strength, balance, bowel function, and bone strength. That, in turn, can help a person with Parkinson's disease feel better, stay in shape, and keep up with as many daily activities as possible.
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Does Parkinson's disease have to be treated?
The purpose of treating Parkinson's disease is to reduce the effect of symptoms on a person's daily life. Current treatment neither cures Parkinson's disease nor stops it from advancing. Each person responds differently to treatment. The patient, family, and healthcare provider should work together to find the treatment plan that works best.
Without treatment, a person with Parkinson's disease will most likely find that the symptoms make it very hard to perform daily activities. Parkinson's disease symptoms, such as shaking and stiffness, may also cause discomfort. The risk of injury from falls may increase, and swallowing may become more difficult.
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What can someone caring for a person with Parkinson's disease do to help?
Those who care for someone with Parkinson's disease often face increased challenges as the disease advances. As symptoms worsen, some people with Parkinson's disease will have more and more trouble caring for themselves. Examples of the things they may need help with can include:
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Bathing |
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Dressing |
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Eating |
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Taking medication |
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Walking |
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Cleaning |
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Shopping |
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Paying bills |
Offer to help as needed. Keep in mind not only the person's symptoms but also how much he or she wants to be helped. Remember to be respectful of the person's independence and dignity.
People with Parkinson's disease are sometimes depressed, anxious, or insecure. They may even withdraw socially. You may encourage your loved one to attend support group meetings. He or she will have a chance to talk with other people facing some of the same challenges. You and your loved one may also learn tips from them about coping with Parkinson's disease. You and others may find these groups helpful even if your loved one is unable or reluctant to attend.
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What questions might I ask the healthcare provider about treating Parkinson's disease?
If you or a loved one has been diagnosed with Parkinson's disease, you might find it helpful to write down any questions you have before your next appointment with your healthcare provider. This can help your visit be more efficient and fulfilling. Here are a few suggestions to get you started:
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What treatments are available for me at my stage of Parkinson's disease? |
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Which one do you think is best for me? Why? |
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How well do you think a particular treatment will work? |
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What are the possible side effects of each treatment? |
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How can I manage the side effects that I might have? |
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What symptoms, side effects, or problems should I report right away? |
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How will treatment affect my daily activities? |
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How soon can I expect the treatment to start working? |
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How often do I need a check-up for my Parkinson's disease? |
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How will Parkinson's disease affect my personal life in terms of work, retirement, relationships, and need for help? |
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Where can I find a support group? |
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