Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors) and trouble walking and moving.
Nerve cells use a brain chemical called dopamine to help control muscle movement. With Parkinson disease, the brain cells that make dopamine slowly die. Without enough dopamine, the cells that control movement can't send proper messages to the muscles. This makes it hard to control the muscles. Slowly, over time, this damage gets worse. No one knows exactly why these brain cells waste away.
Parkinson disease most often develops after age 50. It is one of the most common nervous system problems in older adults.
The disease affects men more than women, although women also develop the disease. Parkinson disease sometimes runs in families.
The disease can occur in younger adults. In such cases, it is often due to the person's genes.
Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg is stiff and dragging. Jaw tremor has also been an early sign of Parkinson disease. Symptoms may affect one or both sides of the body.
Your health care provider may be able to diagnose Parkinson disease based on your symptoms and a physical exam. But the symptoms can be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse.
Your provider may do some tests to check for other conditions that can cause similar symptoms.
Treatment
There is no cure for Parkinson disease, but treatment can help control your symptoms.
MEDICINE
Your provider may prescribe medicines to help control your shaking and movement symptoms.
At certain times during the day, the medicine may wear off and symptoms can return. If this happens, your provider may need to change any of the following:
Type of medicine
Dose
Amount of time between doses
The way you take the medicine
You may also need to take medicines to help with:
Mood and thinking problems
Pain relief
Sleep problems
Drooling (botulinum toxin is often used)
Parkinson medicines can cause side effects that may be severe, including:
Confusion
Seeing or hearing things that are not there (hallucinations)
Nausea, vomiting, or diarrhea
Feeling lightheaded or fainting
Behaviors that are hard to control, such as gambling
Tell your provider right away if you have these side effects. Never change or stop taking any medicines without talking with your provider. Stopping some medicines for Parkinson disease may lead to a severe reaction. Work with your provider to find a treatment plan that works for you.
As the disease gets worse, symptoms such as stooped posture, frozen movements, and speech problems may not respond to the medicines.
SURGERY
Surgery may be an option for some people. Surgery does not cure Parkinson disease, but it may help ease symptoms. Types of surgery include:
Deep brain stimulation -- This involves placing electric stimulators in areas of the brain that control movement.
Surgery to destroy brain tissue that causes Parkinson symptoms.
Stem cell transplant and other procedures are being studied.
Use speech therapy to help you adjust to changes in your swallowing and speech.
Stay active as much as possible when you feel good. Do not overdo it when your energy is low.
Rest as needed during the day and avoid stress.
Use physical therapy and occupational therapy to help you stay independent and reduce the risk of falls.
Place handrails throughout your house to help prevent falls. Place them in bathrooms and along stairways.
Use assistive devices, when needed, to make movement easier. These devices may include special eating utensils, wheelchairs, bed lifts, shower chairs, and walkers.
Talk to a social worker or other counseling service to help you and your family cope with the disorder. These services can also help you get outside help, such as Meals on Wheels.
Support Groups
Parkinson disease support groups can help you cope with the changes caused by the disease. Sharing with others who have common experiences can help you feel less alone.
Outlook (Prognosis)
Medicines can help most people with Parkinson disease. How well medicines relieve symptoms and for how long they relieve symptoms can be different in each person.
The disorder gets worse until a person is totally disabled, although in some people, this can take decades. Parkinson disease may lead to a decline in brain function and early death. Medicines may prolong function and independence.
Possible Complications
Parkinson disease may cause problems such as:
Difficulty performing daily activities
Difficulty swallowing or eating
Disability (differs from person to person)
Injuries from falls
Pneumonia from breathing in saliva or from choking on food
Side effects of medicines
Effects from loss of strength and mobility (debilitation):
Breathing food, fluid, or mucus into the lungs (aspiration)
Blood clot in a deep vein (deep vein thrombosis)
Malnutrition
When to Contact a Medical Professional
Contact your provider if:
You have symptoms of Parkinson disease
Your symptoms get worse
New symptoms occur
If you take medicines for Parkinson disease, tell your provider about any side effects, which may include:
Changes in alertness, behavior, or mood
Delusional behavior
Dizziness
Hallucinations
Involuntary movements
Loss of mental functions
Nausea and vomiting
Severe confusion or disorientation
Also contact your provider if the condition gets worse and home care is no longer possible.
References
Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-1266. PMID: 29570866 pubmed.ncbi.nlm.nih.gov/29570866/.
Jankovic J. Parkinson disease and other movement disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 96.
Pringsheim T, Day GS, Smith DB, et al. The American Academy of Neurology Guideline Subcommittee. Dopaminergic therapy for motor symptoms in early Parkinson disease practice guideline summary. Neurology. 2021;97(20):942-957. www.neurology.org/doi/10.1212/WNL.0000000000012868.
Radder DLM, Sturkenboom IH, van Nimwegen M, et al. Physical therapy and occupational therapy in Parkinson's disease. Int J Neurosci. 2017;127(10):930-943. PMID: 28007002 pubmed.ncbi.nlm.nih.gov/28007002/.
Review Date:
1/23/2022
Reviewed By:
Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Internal review and update on 02/23/24 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.