What is Parkinson’s Disease

What is Parkinson’s disease?
Parkinson’s disease is a chronic neurological disorder caused by the loss of nerve cells in a specific region of the brain, the substantia nigra. The loss of these cells reduces production of an important chemical, dopamine. Dopamine deficiency leads to one or more problems with movement. Neither the cause nor cure for Parkinson’s disease are currently known. However, medications and surgical procedures can help relieve the symptoms of most patients.

Parkinson’s disease occurs worldwide and is slightly more prevalent in men than women. It occurs in 1.5% of the population over 55 years of age and typically is diagnosed between the ages of 50 and 60. However, Parkinson’s disease can develop at a much younger age, and between 5% and 10% of the people with Parkinson’s are diagnosed before the age of 40. Risk factors include increasing age, family history, and a rural environment. It is likely that a combination of many factors, both genetic and environmental, play a role in the development of PD. Familial forms of PD are known but are uncommon and atypical.

What are the symptoms of Parkinson’s disease?
The symptoms of Parkinson’s disease vary between individuals and can vary from day to day in the same individual. For many people the symptoms can be quite mild and may progress little over a long period of time. The disease is progressive, however, and disability as a result of its progression will increase over time. People do not die of Parkinson’s disease.

There are four major symptoms of Parkinson’s disease: a tremor at rest, slowness of movement (bradykinesia), rigidity, and loss of balance. Diagnosis is based on ruling out other conditions and physical examination. There currently is no test. Two of the four symptoms are needed to initiate the diagnosis. Other symptoms may occur as well, including a shuffling walk, difficulty initiating movement, “freezing,” lack of facial expression, problems with speech and swallowing, constipation, urinary problems, sleep disturbance, confusion, depression, and dementia. Again, like the cardinal symptoms, the secondary symptoms vary from person to person, and each person responds to treatment differently. Other conditions can initially look like Parkinson’s disease but do not respond to standard treatment or other symptoms emerge. Obtaining an accurate diagnosis is essential.

The hallmark for treatment of Parkinson’s disease is medication. There are a variety of medications that can be used to control the symptoms and each person needs to be evaluated and treated individually. The balancing of medication is critical and changes over time. Medications can also cause side effects, so the treatment regimen needs to be monitored closely by the patient, family and physician. Surgery is an option for some when the medication loses its effectiveness.

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