Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually, often starting with a barely noticeable tremor in just one hand. But while tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes a slowing or freezing of movement. Friends and family may notice that your face shows little or no expression and your arms don't swing when you walk. Speech often becomes soft and mumbling. Parkinson's symptoms tend to worsen as the disease progresses.
While there is no cure for Parkinson's disease, many different types of medicines can treat its symptoms. In some cases, your doctor may suggest surgery.
The symptoms of Parkinson's disease can vary from person to person. Early signs may be subtle and can go unnoticed. Symptoms typically begin on one side of the body and usually remain worse on that side even after symptoms begin to affect both sides. Parkinson's signs and symptoms may include:
· Tremor. The characteristic shaking associated with Parkinson's disease often begins in a hand. A back-and-forth rubbing of your thumb and forefinger, known as pill-rolling, is common, and may occur when your hand is at rest. However, not everyone experiences tremors.
· Slowed motion (bradykinesia). Over time, Parkinson's disease may reduce your ability to initiate voluntary movement. This may make even the simplest tasks difficult and time-consuming. When you walk, your steps may become short and shuffling. Or your feet may freeze to the floor, making it hard to take the first step.
· Rigid muscles. Muscle stiffness can occur in any part of your body. Sometimes the stiffness can be so severe that it limits the range of your movements and causes pain. People may first notice this sign when you no longer swing your arms when you're walking.
· Impaired posture and balance. Your posture may become stooped as a result of Parkinson's disease. Balance problems also may occur, although this is usually in the later stages of the disease.
· Loss of automatic movements. Blinking, smiling and swinging your arms when you walk are all unconscious acts that are a normal part of being human. In Parkinson's disease, these acts tend to be diminished and even lost. Some people may develop a fixed staring expression and unblinking eyes. Others may no longer gesture or seem animated when they speak.
· Speech changes. Many people with Parkinson's disease have problems with speech. You may speak more softly, rapidly or in a monotone, sometimes slurring or repeating words, or hesitating before speaking.
· Dementia. In the later stages of Parkinson's disease, some people develop problems with memory and mental clarity. Alzheimer's drugs appear to alleviate some of these symptoms to a mild degree.
When to see a doctor
See your doctor if you have any of the symptoms associated with Parkinson's disease — not only to diagnose the illness but also to rule out other causes for your symptoms.
See your doctor if you have any of the symptoms associated with Parkinson's disease — not only to diagnose the illness but also to rule out other causes for your symptoms.
Risk factors for Parkinson's disease include:
· Age. Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk continues to increase with age.
· Heredity. Having a close relative with Parkinson's increases the chances that you'll also develop the disease, although your risk is still no more than about 4 to 6 percent.
· Sex. Men are more likely to develop Parkinson's disease than women are.
· Exposure to toxins. Ongoing exposure to herbicides and pesticides puts you at slightly increased risk of Parkinson's
Complications
Parkinson's disease is often accompanied by these additional problems:
· Depression. Depression is common in people with Parkinson's disease. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson's disease.
· Sleep problems. People with Parkinson's disease often have trouble falling asleep and may wake up frequently throughout the night. They may also experience sudden sleep onset, called sleep attacks, during the day.
· Difficulty chewing and swallowing. The muscles you use to swallow may be affected in the later stages of the disease, making eating more difficult.
· Urinary problems. Parkinson's disease may cause either urinary incontinence or urine retention. Certain medications used to treat Parkinson's also can make it difficult to urinate.
· Constipation. Many people with Parkinson's disease develop constipation because the digestive tract works more slowly. Constipation may also be a side effect of medications used to treat the disease.
· Sexual dysfunction. Some people with Parkinson's disease may notice a decrease in sexual desire. This may stem from a combination of psychological and physical factors, or it may be the result of physical factors alone.
Medications for Parkinson's disease also may cause a number of complications, including involuntary twitching or jerking movements of the arms or legs, hallucinations, sleepiness, and a drop in blood pressure when standing up.
Tests and diagnosis
No definitive tests exist for Parkinson's disease, so it can be difficult to diagnose, especially in the early stages. And parkinsonism — the symptoms of Parkinson's disease — can be caused by many other types of problems. For example, other neurological disorders, toxins, head trauma and even some medications — such as chlorpromazine (Thorazine), prochlorperazine (Compazine) or metoclopramide (Reglan) — can cause parkinsonism.
A diagnosis of Parkinson's disease is based on your medical history and a neurological examination:
· Medical history. As part of your medical history, your doctor will want to know about any medications you take and whether you have a family history of Parkinson's.
· Neurological exam. This examination includes an evaluation of your walking and coordination, as well as some simple hand tasks.
A diagnosis of Parkinson's is most likely if you have:
· At least two of the three cardinal Parkinson's signs and symptoms — tremor, slowing of motion and muscle rigidity
· Onset of symptoms on only one side of the body
· Tremor more pronounced at rest, for example, when your hands are resting in your lap
· Significant improvement with levodopa, a Parkinson's drug
Alternative medicine
Forms of alternative medicine that may help people with Parkinson's include:
· Coenzyme Q10. People with Parkinson's disease tend to have low levels of coenzyme Q10, and some research has suggested it may be beneficial. However, subsequent research hasn't confirmed this benefit. You can buy coenzyme Q10 without a prescription in drugstores and natural food stores. Talk with your doctor before taking this supplement to ensure that it won't interfere with any medication you may be taking.
· Massage. Massage therapy can reduce muscle tension and promote relaxation, which may be especially helpful to people experiencing muscle rigidity associated with Parkinson's disease. These services, however, are rarely covered by health insurance.
· Tai chi. An ancient form of Chinese exercise, tai chi employs slow, flowing motions that help improve flexibility and balance. Several forms of tai chi are tailored for people of any age or physical condition.
· Yoga. Yoga is another type of exercise that increases flexibility and balance. Most poses can be modified, depending on your physical abilities.
Coping and support
Living with any chronic illness can be difficult, and it's normal to feel angry, depressed or discouraged at times. Parkinson's disease presents special problems because it can cause chemical changes in your brain that make you feel anxious or depressed. And Parkinson's disease can be profoundly frustrating, as walking, talking and even eating become more difficult and time-consuming.
Although friends and family can be your best allies, the understanding of people who know what you're going through can be especially helpful. Support groups aren't for everyone, but for many people, they can be a good resource for practical information about Parkinson's disease, as well as a place to find understanding from people that are going through the same things you are.
To learn about support groups in your community, talk to your doctor, a Parkinson's disease social worker or a local public health nurse. Or contact the National Parkinson Foundation or the American Parkinson Disease Association.
For more details contact us at drkurien@effectivelivingclinic.com 
