Parkinson's Disease: Causes, Symptoms & Treatment

Contents

In this article we will look at:

• What is Parkinson's disease?
• How does Parkinson's disease occur? 
• Stages of Parkinson's disease
• Who is prone to Parkinson's disease?
• What are the causes of Parkinson's disease?
• Symptoms of Parkinson's disease
• Diagnosis of Parkinson's disease
• What are the complications of Parkinson's disease?
• Treatment for Parkinson's disease
• Exercises for Parkinson's disease

You can click on any of the links above to navigate to the section of your interest. 

What is Parkinson's disease?

Parkinson's disease is a neurodegenerative disorder that affects the way you move. It occurs when there is a problem with the nerve cells in the brain that produce an important chemical called dopamine, which is responsible for motor function. As dopamine levels drop it leads to progressive deterioration of motor function in the person. Early signs of Parkinson’s disease include tremors in the hands, rigidity or stiffness in the body, difficulty while walking. The muscles of the person suffering from Parkinson’s disease gradually become weaker with time.  

How does Parkinson's disease occur? 

Parkinson’s disease affects different people in different ways. Not everyone will have the same symptoms at the same intensity, in the same order. Though there is a definite pattern of progression that has been observed in Parkinson’s disease. Broadly this disease has five stages. 

Stage One

During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Intermittent tremor and other movement-related symptoms may occur on one side of the body only. Slight changes in posture, walking and facial expressions may occur. In fact, the symptoms are so mild that the person may not seek medical attention or the doctor may not be able to make a diagnosis. The physician may ask the person to wait and see if the symptoms get any worse to be able to make a proper diagnosis. 

Stage Two

During this stage, the symptoms may start getting progressively worse with symptoms affecting both sides of the body. Tremor, rigidity and other movement-related symptoms affect both sides of the body. Problems with walking may become apparent however, the person is still able to live alone and perform daily tasks, albeit with a little difficulty. 
Some visible symptoms at this stage include:

• reduced degree of facial expressions or intermittent facial paralysis
• decreased rate of blinking
  
• speech abnormalities (slurred speech)
• neck or back pain due to a stiffness of muscles in the trunk leading to stooped posture
  
• inability to speak loudly
• general slowness in all activities of daily living
  

It is possible for a person to not be diagnosed with Parkinson’s disease even at this stag, if the only noticeable symptoms at this stage are slowness or lack of spontaneous movement. It is quite possible to confuse this stage with general symptoms of advancing age. 

Progressing from stage one of Parkinson's disease to stage two may take months or even years. 

Stage Three

This is the mid-stage of Parkinson’s disease and the most noticeable symptoms are:

• trouble maintaining balance
• frequently falling
  
• decreased reflexes (slowness in movements)
• takes longer for the person to eat, comb, or dress
  

Generally, there is no doubt in the diagnosis during stage three. Even though a person is still able to live alone and independently at this stage, they become very slow in performing their day-to-day activities. During this stage, the doctor may prescribe medication combined along with occupational therapy which may help to decrease symptoms.

Stage Four

At this stage, a person may be able to stand on his/her own but may require aids to be able to move around such as a walker. Living alone at this stage could be dangerous for the patient. 

Stage Five

This is the advanced and debilitating stage of Parkinson’s disease. At this stage, a person may require a wheelchair and be completely bed-ridden.  At stage five, a person has the tendency to fall a lot or freeze while moving. Around-the-clock care is needed for a person at this stage. 
At this stage, a person may hallucinate or suffer from delusions and paranoia.

Who is prone to Parkinson's disease?

Some people are more to Parkinson’s disease than others. They include:

• People who are of advanced age
• Males are more likely to get Parkinson’s disease than females
  
• People with a family history of Parkinson’s disease
• Postmenopausal women who have very low levels of oestrogen
  
• Women who have undergone hysterectomies
• People who suffer from vitamin B deficiency
  
• People who have suffered from head trauma
• People who are frequently exposed to environmental toxins such as a pesticide or herbicide
  

What are the causes of Parkinson's disease?

The causes of Parkinson’s disease include:

• Genetics and family history
• Frequent exposure to pesticides such as insecticides, herbicides, and fungicides
  
• Lewy bodies that are abnormal clumps of proteins found in the brain stem of people with Parkinson’s disease which affect brain functions
• Loss of dopamine production in the brain when cells that produce dopamine are damaged
  
• Advanced age

What are the symptoms of Parkinson's disease? How is Parkinson's disease diagnosed?

People with Parkinson’s disease suffer from motor symptoms as well as non-motor symptoms. 

Motor symptoms include intermittent tremors, slow and rigid movements. Non-motor symptoms include loss of smell, pain and even dementia.

In the initial stages of Parkinson’s disease a person may experience symptoms such as:

• Slight rigidity in the arms and legs (unable to swing arms easily and heaviness or stiffness in the legs)
• unable to change facial expressions according to emotions spontaneously
  
• Slight back pain due to which the posture of the person may be slightly stooped
• Sudden stiffness in the body at times
  
• Tremor on one arm on one side of the body
• The symptoms may be experienced only on one side of the body
  
• Handwriting may get messier and smaller

In the intermediate stage of Parkinson’s disease a person may experience symptoms such as:

• Slower movements and therefore takes longer to do the daily work such as combing, dressing etc
• Loss of balance
  
• Sudden falls due to frequent loss of balance
• Slurring of speech
  
• Inability to speak loudly and clearly
• Erratic footwork, as the person is unable to start walking immediately after getting up as if the feet are stuck to the ground, or change direction quickly while walking
  
• Taking smaller steps than normal while walking
• Trouble swallowing food
  
• May require aids while walking such as a walker

In the advanced stage of Parkinson’s disease the symptoms include:

• Severe movement issues due to a rigidity of limbs
• Being in a wheelchair and completely bedridden
  
• Need round-the-clock care to perform daily tasks
• Hallucinations
  
• Delusions  
• Obsessive Compulsive Behaviour

Diagnosis

There are no specific diagnostic tests to diagnose Parkinson's disease. Your doctor who may be a general practitioner may refer you to a neurologist who can advise you to take certain tests such as blood tests, to rule out other conditions that may be causing your symptoms and MRI, ultrasound of the brain, SPECT and PET scans to help rule out other disorders. 

A neurologist can diagnose Parkinson’s disease based on a physical examination, asking about your and your family’s medical history and a neurological examination to rule out other possibilities. 

What are the complications of Parkinson's disease?

The complications of Parkinson’s disease include:

• Depression
• Anxiety
• Dependence on others
• Sexual dysfunction
  
• Urinary incontinence
• Hallucinations
  
• Delusions
• Obsessive Compulsive Behaviour
  

What is the treatment for Parkinson's disease?

Medical Treatment for Parkinson's disease

Parkinson's disease cannot be cured, though taking the medicines timely as prescribed by the doctor can control your symptoms, often dramatically. The doctor may suggest lifestyle changes, and exercises and physical therapy that focuses on balance and stretching.

Based on the severity of the patient’s condition the doctor may also suggest surgery. 

Exercise

Exercising is highly essential to manage Parkinson’s disease. A study shows that some people at an earlier stage of Parkinson’s disease who start exercising showed a slow decline in quality of life compared to those who start at a later stage of the disease. 

To start an exercise regime first find out from your doctor which exercises will suit you best depending on other medical conditions you may suffer from apart from Parkinson’s disease. 

Some forms of exercises that can be of immense help to patients suffering from Parkinson’s disease include:

• Flexibility (stretching) exercises
• Aerobic activity
  
• Resistance training or strengthening exercises
• Tai Chi
  
• Yoga
• Pilates
  
• Dancing

Patients need to make sure their trainer is nearby while exercising.