Parkinson’s disease is a chronic, progressive, neurodegenerative disease that is most commonly associated with motor symptoms including tremors, slowness and trouble walking and moving. Signs and symptoms vary from person to person, and some may go unnoticed in the early stages.
“During the early stages of Parkinson’s disease, there are a lot of non-motor symptoms that are present,” explains neurologist Wendy Robinson Bond, M.D. “Things like depression, mood swings, constipation, cognitive decline, and loss of smell and taste are clues that could point to Parkinson’s disease. Additionally, about 50% of patients experience REM sleep disorder, which causes the patients to act out their dreams without realizing it – often kicking and hitting in the night, which affects a partner or spouse.”
Dr. Bond adds that patients and their caregivers and families may notice a tremor or rigidity on one side of the body, reduced arm swing or balance problems, and the patient’s handwriting may become smaller as the disease progresses.
Generally, patients see their primary care doctor initially and then obtain a referral to a neurologist for diagnosis and treatment.
“We review the patient’s medical history, perform a physical exam and order an MRI,” Dr. Bond says. “There isn’t a specific test to diagnose the disease, so we review all evidence and exclude other conditions, like stroke or head injuries.”
Treatment includes medications to help control the symptoms. “Parkinson’s disease is caused by a loss of neurons in the brain that produce dopamine, so the medications we prescribe increase or stimulate dopamine,” Dr. Bond explains. “Another type of treatment is deep brain stimulation (DBS), in which a surgeon implants electrodes into specific parts of the brain. The electrodes are connected to a pacemaker-like battery in the chest that sends electrical pulses to the area of the brain responsible for the tremors. DBS is an option for people who do not respond to the medications.”
In addition to medications or DBS, Dr. Bond says exercise is very important because it increases muscle strength, balance and flexibility; and it helps ward off depression and anxiety.
“With Parkinson’s disease, we really individualize the care because every patient is different,” Dr. Bond says. “But, we do know that a holistic approach – including neurology, physical therapy, psychiatry, support groups, exercise classes, etc. – help improve quality of life for the patient and his or her caregiver.”
