Parkinson's disease (PD) is a progressive movement disorder. PD is characterized by:
PD is caused by a loss of certain nerve cells in the brain. The loss of these cells causes a decrease in the amount of a brain chemical called dopamine. Low dopamine levels cause PD symptoms.
The brain cells may be lost because of genetic defects, the environment, or some combination of the two. A small amount of people with PD have an early-onset form. This type is caused by an inherited gene defect.
PD is more common in men and in people aged 50 years and older. Other factors that increase your chance of PD include:
PD is a progressive disease. Symptoms begin mildly and worsen over time.
PD may cause:
The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no tests to definitively diagnose PD. The doctor will ask many questions. This will help to rule out other causes of your symptoms.
Tests to rule out other conditions may include:
Imaging tests evaluate internal bodily structures. This can be done with:
Currently, there are no treatments to cure PD. There are also no proven treatments to slow or stop its progression. Some medications may help to improve symptoms. Over time, the side effects of the medication may become troublesome. The medications may also lose their effectiveness.
Medications that may be used to treat PD include:
Depression or hallucinations may also occur with PD and its treatment. Medications may be prescribed to attempt to treat these conditions. The drugs may include:
Hip fractures are common in those with PD. Bisphosphonates are medications that may help reduce this risk.
Constipation, drooling, and lightheadedness when standing are common and may improve with medications or other treatments.
Different brain operations are available, and many more are being researched including:
Therapy can improve muscle tone, strength, and balance. It includes exercises and stretches. There is also evidence that alternative therapies, such as tai chi, yoga, or dance, may be beneficial.
Consider joining a support group with other people with PD. It will help to learn how others are learning to live with the challenges of PD.
Cognitive training works on aspects of the brain that control certain functions so they can be performed better in daily life. Activities are meant to promote and increase brain fitness through learning or exercises. It works best in conjunction with other healthy lifestyle habits. Some people with Parkinson's disease have seen improvements in reasoning, problem solving, processing speed, and working memory.
National Parkinson Foundation
Parkinson's Disease Foundation
Parkinson Society Canada
Alvarez MV, Evidente VG. Understanding drug induced parkinsonism: Separating pearls from oysters. Neurology. 2008;70(8):e32-e34.
Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural instability in patients with Parkinson’s disease. N Engl J Med. 2012;366(6):511-519.
Liu R, Gao X, Lu Y, Chen H. Meta-analysis of the relationship between Parkinson disease and melanoma. Neurology. 2011;76(23):2002-2009.
Managing your PD. Parkinson’s Disease Foundation website. Available at: http://www.pdf.org/en/managing_pd. Accessed August 28, 2015.
Nielsen NM, Rostgaard K, Hjalgrim H, Aaby P, Askgaard D. Poliomyelitis and Parkinson disease. JAMA. 2002;287(13):1650-1651.
NINDS Parkinson's disease information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm. Updated July 27, 2015. Accessed August 28, 2015.
Obeso JA, Rodriguez-Oroz MC, Goetz CG, et al. Missing pieces in the Parkinson’s disease puzzle. Nat Med. 2010;16(6):653-661.
Parkinson disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease. Updated September 11, 2016. accessed September 22, 2016.
Parkinson's disease. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Parkinsons%20Disease.aspx. Accessed August 28, 2015.
Perlmutter JS, Eidelberg D. To scan or not to scan: DaT is the question. Neurology. 2012;78(10):688-689.
Ristić AJ, Vojvodić N, Janković S, Sindelić A, Sokić D. The frequency of reversible parkinsonism and cognitive decline associated with valproate treatment: a study of 364 patients with different types of epilepsy. Epilepsia. 2006:47(12):2183-2185.
Samii A, Nutt JG, Ransom BR. Parkinson's disease. Lancet. 2004;363(9423):1783-1793.
Schenkman N, Hall DA, Barón AE, Schwartz RS, Mettler P, Kohrt WM. Exercise for people in early- or mid-stage Parkinson disease: A 16-month randomized controlled trial. Phys Ther. 2012;92(11):1395-1410.
Siderowf A, Stern M. Update on Parkinson's disease. Ann Intern Med. 2003;138(8):651-658.
Wider C, Wszolek CK. Movement disorders: Insights into mechanisms and hopes for treatments. Lancet Neurology. 2009;8(1):8-10.
1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Spinks A, Wasiak J, Bernath V, Villaneuva E. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2009;(4):CD002851.
4/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Marras C, Hincapié CA, Kristman VL, et al. Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis. Arch Phys Med Rehabil. 2014;95(3S):S238-S244.
9/3/2014 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed August 28, 2015.
11/10/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Shanahan J, Morries ME, Bhriain ON, Saunders J, Clifford AM. Dance for people with Parkinson disease: what is the evidence telling us? Arch Phys Med Rehabil. 2015;96(1):141-153.
2/24/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Leung IH, Walton CC, Hallock H, et al. Cognitive training in Parkinson disease: a systematic review and meta-analysis. Neurology. 2015;85(21):1843-1851.
10/17/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115172/Parkinson-disease: Ni M Signorile JF, et al. Comparitive effect of power training and high-speed yoga on motor function in older patients with Parkinson disease. Arch Phys Med Rehabil. 2016 Mar;97(3):345-354.
Last reviewed September 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.