Parkisnons Disease

The main symptoms of Parkinson's disease are usually stiffness, shaking (tremor), and slowness of movement. Symptoms typically become gradually worse over time. Treatment often provides good relief of symptoms for several years.

What is Parkinson's disease (PD)?

PD is a chronic (persistent or long-term) disorder of part of the brain. It is named after the doctor who first described it. It mainly affects the way the brain co-ordinates the movements of the muscles in various parts of the body.

Who develops Parkinson's disease (PD)?

PD mainly develops in people over the age of 50. It becomes more common with increasing age. About 5 in 1,000 people in their 60s and about 40 in 1,000 people in their 80s have PD. It affects both men and women but is a little more common in men. Rarely, it develops in people under the age of 50.

PD is not usually inherited and it can affect anyone. However, inherited (genetic) factors may be important in the small number of people who develop PD before the age of 50.

What causes Parkinson's disease (PD)?

In PD, cells in the substantia nigra become damaged and die. The exact cause of this is not known. Over time, more and more cells become damaged and die. As cells are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain causes nerve messages to the muscles to become slowed and abnormal.

Parkinson's disease (PD) symptoms

The brain cells and nerves affected in PD normally help to produce smooth, co-ordinated movements of muscles. Therefore, three common PD symptoms that gradually develop are:

• Slowness of movement (bradykinesia). For example, it may become more of an effort to walk or to get up out of a chair. When this first develops you may mistake it as just 'getting on in years'. The diagnosis of PD may not become apparent unless other symptoms occur. In time, a typical walking pattern often develops. This is a 'shuffling' walk with some difficulty in starting, stopping and turning easily.
• Stiffness of muscles (rigidity) and muscles may feel more tense. Also, your arms do not tend to swing as much when you walk. 
• Shaking (tremor) is common, but does not always occur. It typically affects the fingers, thumbs, hands and arms but can affect other parts of the body. It is most noticeable when you are resting. It may become worse when you are anxious or emotional. It tends to become less when you use your hand to do something such as picking up an object.

The symptoms tend slowly to become worse. However, the speed in which symptoms become worse varies from person to person. It may take several years before they become bad enough to have much effect on your life. At first, one side of your body may be more affected than the other.

Some other symptoms may develop due to problems with the way affected brain cells and nerves control the muscles. These include:

• Fewer facial expressions such as smiling or frowning. Reduced blinking.
• Difficulty with fine movements such as tying shoe laces or buttoning shirts.
• Difficulty with writing (handwriting tends to become smaller).
• Difficulty with balance and posture and an increased tendency to fall.
• Speech may become slow and monotonous.
• Swallowing may become troublesome and saliva may pool in the mouth.
• Tiredness and aches and pains.

Various other symptoms develop in some cases, mainly as the condition becomes worse. These include:

• Constipation.
• Bladder symptoms and sometimes incontinence.
• Hallucinations - seeing, hearing or smelling things that are not real.
• Sweating.
• Sexual difficulties.
• Alterations in your sense of smell.
• Difficulties with sleeping.
• Weight loss.
• Pain.
• Depression.
• Anxiety.
• Problems with controlling impulses. For example, compulsive eating, shopping or gambling. (This could be linked to some types of medication - see 'Which medicines are used to treat Parkinson's disease?' section, below.)

How is Parkinson's disease (PD) diagnosed?

There is no test that can prove that you have PD. The diagnosis is based on your symptoms and signs discovered by your neurologist.

Treatment of PD is lifelong.