Patient's Guide for Parkinson's Disease
Understanding Parkinson's Disease
Parkinson's disease is the one of the most common movement disorders, affecting 1 million Americans and about 1% of people over age 60. Although there’s no cure, early treatment can slow progression of the disease and care options are continually improving. Cedars-Sinai Parkinson’s Disease Center, offers a full spectrum of treatment options, medication therapy and management. Use this guide to understand the condition and prepare questions for your doctor visits.
What is Parkinson's Disease?
Parkinson's disease is a progressive illness that occurs when brain cells don't produce enough of a brain chemical called dopamine. This results in symptoms such as tremor (trembling) at rest, stiffness of limbs, slow movements and problems with balance and coordination.
Symptoms begin gradually, often on one side of the body, and later affect both sides. As symptoms get worse, it becomes harder to walk, talk, or do simple tasks. People with the disease may also experience poor smell, constipation, depression, sleep problems, or trouble chewing, swallowing, or speaking.
The cause of Parkinson’s disease is unknown, but there are 4 main risk factors:
- Being middle-aged or older. The average age of onset is 60, and only 4% of people with Parkinson’s are diagnosed before age 50.
- Being male. For unknown reasons, men are 1.5 times more likely to develop Parkinson’s disease than women.
- Family history. Having one or more close relatives with the disease increases your risk.
- Environment. Significant exposure to pesticides or heavy metals, or a history of head injuries increases your risk.
Symptoms may vary from person to person. They may appear slowly and in no particular order. Early symptoms may be subtle and progress over years before they interfere with daily activities.
Most common symptoms include:
- Bradykinesia. Slowness in starting movement.
- Resting tremor. Involuntary movements that occur on their own.
- Rigid muscles. Stiffness when you move your arm, leg or neck back and forth.
- Postural instability. Poor posture and balance issues that can cause falls.
How Parkinson’s Disease Is Treated
Even though there isn’t currently a cure for Parkinson’s disease, there are treatment options available to help manage symptoms. Because Parkinson’s disease is a progressive illness, your treatment needs may change over time.
Here’s what you can expect during different stages of the condition.
In its early stage, Parkinson’s disease often responds well to medications that increase dopamine levels or ease symptoms dramatically. This is the reason they are often the main treatment option. Your doctor may also recommend lifestyle changes, such as regular exercise and diet modifications.
Parkinson’s medications often lose effectiveness as the disease progresses or can produce unwanted side effects. The Movement Disorders team will monitor and adjust medications and dosages as needed. However, when medications are no longer deemed effective, other treatments at this stage may include:
- Botulinum toxin injections (known by trade names Botox®, Dysport®, Myobloc® and Xeomin®), which can reduce involuntary muscle contractions.
- Deep brain stimulation, a minimally invasive surgical procedure to implant an electrical stimulation device. This device sends electrical pulses to stimulate the parts of the brain that control movement.
In later stages of the disease, patients may develop emotional, cognitive or physical symptoms such as anxiety, depression, agitation, dementia or hallucinations and experience disabling constipation, urinary and sexual problems, insomnia and pain. Your care team will try a combination of the most effective therapies to assist with late-stage physical, mental and emotional problems and ease your symptoms in order to help you manage your day to day health the best way possible.
Assembling a team that will provide physical and emotional support and adapt to your needs over time is one of the best ways to remain healthy. Parkinson’s disease is complex and requires a multi-focused approach to care. Your team may include, but is not limited to:
- Neurologist (movement disorder specialist)
- Primary care provider
- Rehabilitation specialists including a physical, occupational, and speech & language pathologist
- Social worker
When you're treated for Parkinson’s disease at Cedars-Sinai, your care team will develop a personalized approach to fit your needs. That usually includes:
- Individual counseling
- Individual treatment strategies, including any relevant clinical trials
- Information on treatment advances
- Long-term follow-up care
Keeping a positive outlook and adopting healthy habits has been known to help Parkinson’s patients ease symptoms and the stress of living with the disease. Always check with your doctor and care team before starting a new regimen.
- Exercise. A proper exercise program can include cardiorespiratory exercise (fitness training), resistance exercises (strength training), flexibility exercises (stretching), and gait and balance training.
- Nutritional diet. A healthy diet can increase energy, help your medications work better, and promote overall well-being.
- Sleep. Getting seven or more hours of sleep daily can reduce symptoms and improve overall function.
- Yoga. Along with tai chi and relaxation therapy, simple yoga stretches can help ease symptoms.
- Massage. Patients often report that massage helps manage pain and/or stress.