Below:
 • What is Parkinson's disease?
 • What are the symptoms of Parkinson's disease?
 • What causes Parkinson's disease?
 • Who gets Parkinson's disease?
 • What can be done to treat Parkinson's disease?
 • What can I do to stay healthy?
 • What about surgery as an option?
 • Additional Information

Note: This article has been localised for an Irish audience.

We all lose brain cells as we age-and most of them aren't really missed. But when the wrong cells stop doing their job, a person can become seriously ill.

Certain nerve cells, for example, have the vital job of producing dopamine, a compound that relays messages between parts of the brain that tells muscles how to move smoothly. People develop Parkinson's disease when these cells-which help control muscle movements-stop working.

One theory is that genes are to blame; another is that nerve cells are harmed by chemicals in the environment, and gradually stop sending messages to each other. When the supply of dopamine dwindles, the messages to the muscles get garbled. As the communication breakdown continues, you slowly lose control over your body, particularly over the muscles that control walking and balance.

Some viruses, such as a certain strain of influenza A, may also be responsible for bringing on Parkinson's. An unusual number of people born in the early part of the century, particularly after the 1918 influenza epidemic in the United States, developed Parkinson's later in life, pointing to a possible link between viral infections and nerve damage.

Many patients eventually have trouble walking, driving, and performing simple daily tasks. Parkinson's disease is a chronic, progressive condition, and, if left untreated, the symptoms will grow steadily worse.

But if you have Parkinson's, don't give up hope: researchers are making progress in developing new treatments. Treatment for the disease has improved dramatically in recent years, and many patients continue to lead rewarding lives. With the right medications and a healthy lifestyle, you may well be productive and active.

In the earliest stages, the signs of Parkinson's disease are subtle and easy to overlook. You may feel unusually tired, anxious, irritable, and depressed, and you may have trouble sleeping. Your fingers may shake a bit when at rest, or you may drag a foot when walking. You may have trouble doing things with your hands, such as buttoning your shirt and holding forks or spoons. Some people freeze, are unable to move, slur their words and have trouble swallowing. Friends and family may notice less expression in your face, and you may seem a bit stiff or slow.

As months and years go by-and as more brain cells are damaged or die-the symptoms will grow worse. Most patients develop uncontrollable shaking, or tremors, in their hands. Often, the tremors make it impossible to hold a book or a cup of coffee. Tremors may also affect your jaws, face, arms, and legs. You may find that your torso and limbs are stiff, and that your movements are slowing down. You may also have problems with balance and be unsteady on your feet. Some people also have trouble with memory or speech, but there's no clear sign that Parkinson's clouds reasoning ability.

No laboratory test can detect Parkinson's disease, and many other conditions can cause similar symptoms. For this reason, your doctor may have to observe you carefully before diagnosing you with Parkinson's disease.

If you do have a tremor, don't leap to the conclusion that you have Parkinson's disease. There are a number of common conditions that could also make your hand tremble. Check with a doctor before assuming your shaking is a sign of other serious Parkinson's symptoms to come.

There's no doubt that damaged or dying nerve cells in a part of the brain known as the substantia nigra cause Parkinson's disease, but nobody knows why this occurs. Certain genes seem to make these cells easier to harm, but what actually pulls the trigger? Some experts blame pesticides and other poisons, some point to viruses or oxidation damage in the brain, and some speculate that in some people the brain simply ages faster than usual. Many researchers believe that it takes a combination of these factors-plus genetics-to actually cause the disease.

Parkinson's disease seems to pick its victims almost at random. It's slightly more common in people with a family history of the disease, and it strikes a few more men than women. But patients don't fit a single profile. They come in all races, lifestyles, and body types. And even though the disease usually happens to people over age 50, people in their 40s, 30s, or even 20s aren't immune. Many patients-including actor Michael J. Fox-contract the disease under age 40. Most Parkinson's patients, however, are older, the boxer Muhammed Ali for example.

According to the Parkinson's Association of Ireland, one in every 100 people over the age of 65 years will develop Parkinson's disease. The disease isn't contagious and isn't passed directly from one family member or generation to the next.

There is no cure for Parkinson's, but your doctor can prescribe drugs to drastically reduce your symptoms. In the earliest stages of the disease, you may not need medications at all. As symptoms get a bit worse, your doctor will eventually prescribe medication to help you carry on with your life.

At some point, almost everyone with Parkinson's will take levodopa (also known as L-dopa)-a drug seemingly capable of miracles. The brain converts levodopa into dopamine, thus replenishing the supply of this crucial compound as well as restoring, at least temporarily, long-lost physical abilities. You may remember levodopa from the movie "Awakenings," which was based on a true story. With one shot of the drug, the character played by Robert DeNiro awoke from a long coma brought on by a Parkinson's-like disease.

For Parkinson's patients, the response to levodopa can be almost as dramatic. In some cases, the disease seems to disappear, at least temporarily. The drug can give a patient years of normal, productive living when they would have otherwise been disabled. Levodopa is especially useful for relieving slowness and stiffness, but it has a limited effect on tremors.

Levodpa also has its drawbacks. For one thing, it only helps about 75 percent of all patients. (Some of these patients may be misdiagnosed.) It can also cause nausea, vomiting, low blood pressure, involuntary movements, and restlessness. Patients who take the drug for several years can begin to suffer serious symptoms whenever the effects of the medicine begin to wear off.

More importantly, levodopa can't revive dead brain cells or slow the progression of the disease. As the disease grows worse, a patient needs ever-increasing doses to keep symptoms in check. Eventually, a person may need to take the drug every 90 minutes. (Doctors can reduce this problem somewhat by combining the drug with carbiopa, a compound that slows the breakdown of levodopa).

Recognising that levodopa has drawbacks, researchers have continued to develop new drugs for treating Parkinson's. One effective medication, selegiline, protects brain cells from damage. If used in the early stages of the disease, selegiline can delay the need for levodopa. And when prescribed in combination with levodopa, selegiline may slow the onset of disability. According to the National Medicines Information Centre, levodopa, administered in conjunction with a dopa decarboxylase inhibitor remains the mainstay of therapy for Parkinson's disease.

Many patients find that regular exercise or physical therapy helps them move freely and keep their balance. Ask your doctor about exercise programmes, or find some time to walk around the neighbourhood or work in the garden. The Parkinson's Association of Ireland has issued a booklet detailing exercises, but consult with your GP first.

Just like everybody else, people with Parkinson's disease should try to eat a healthy, well-balanced diet. However, there are no special foods or supplements that seem to prevent Parkinson's or ease the symptoms. If you're taking levodopa, keep in mind that a high-protein diet could interfere with the drug's power.

When medications stop working, some patients seek relief from tremors and rigidity through surgery. One procedure involves destroying the overactive nerve cells by burning a small spot of the brain that causes shaking. Another procedure involves implanting a wire in the brain that delivers a mild electrical signal, which blocks the brain signals that cause tremors. These surgeries do involve some risk, but some patients have reported a significant drop in shaking that lasts several years.

As you continue your fight against Parkinson's, you'll feel much better if you reach out for support. Call the Parkinson's Association of Ireland (01 8722234), Tuesday to Friday 9.30 am to 2.30 pm.

Citations M. Takahashi, T. Yamada. "Viral etiology for Parkinson's disease-a possible role of influenza A virus infection." Japanese Journal of Infectious Disease, June 1999. "Results in Levadopa Drug Study," Parkinson's Disease Foundation Study, 1999. This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published March 22, 2001
Copyright © 2000 Consumer Health Interactive

or find more on: Back to top of page

See all readers' comments Comments Name (optional) E-mail (optional)