Parkinson's disease Health Article

Signs and tests

The health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. The signs (tremor, change in muscle tone, problems walking, unsteady posture) become more clear as the illness progresses.

An examination may show:

• Difficulty starting or finishing voluntary movements
• Jerky, stiff movements
• Muscle atrophy
• Parkinson's tremors
• Variation in heart rate

Reflexes should be normal.

Tests may be needed to rule out other disorders that cause similar symptoms.

Treatment

There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.

Medications control symptoms, mostly by increasing the levels of dopamine in the brain. As symptoms change, the following may need to be altered:

• Type of medication
• Dose
• Amount of time between doses
• How the medications are taken

Work closely with your doctors and therapists to adjust the treatment program. Never change or stop taking any medications without talking with your doctor.

Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.

Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.

Medications used to treat symptoms of Parkinson's disease are:

• Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
• Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
• Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
• Amantadine or anticholinergic medications -- to reduce early or mild tremors
• Entacapone -- to prevent the breakdown of levodopa

Lifestyle changes that may be helpful for Parkinson's disease:

• Good general nutrition and health
• Exercising, but adjusting the activity level to meet changing energy levels
• Regular rest periods and avoiding stress
• Physical therapy, speech therapy, and occupational therapy
• Railings or banisters placed in commonly used areas of the house
• Special eating utensils
• Social workers or other counseling services to help you cope with the disorder and get assistance (such as Meals-on-Wheels)

Less commonly, surgery may be an option for patients with very severe Parkinson's disease who no longer respond to many medications. These surgeries do not cure Parkinson's, but may help some patients:

• In deep brain stimulation (DBS), the surgeon implants electrical stimulators in specific areas of the brain to help with movement.
• Another type of surgery destroys brain tissues that cause Parkinson's symptoms.