What is Parkinsonism?
Parkinsonism is a progressive degenerative disorder. The most common symptoms are tremor, muscular stiffness, and slowness of movement. Although there are different types of parkinsonism, the most common condition today is the one first recognized in 1817, by James Parkinson, referred to as idiopathic Parkinson’s disease.
While experts agree symptoms are primarily due to a deficiency of the brain chemical, dopamine, they are uncertain as to why the nerve cells containing dopamine die. Parkinson's disease is not contagious.
The incidence of Parkinson’s disease increases with age and affects both men and women across all ethnic lines. An estimated 1.5 million people in the United State are afflicted with this disease and more are being diagnosed daily. As you age, you will either know of someone affected by Parkinson’s disease or be directly impacted by Parkinson’s yourself.
Diagnosis and Treatment of Parkinson’s Disease a Unique Challenge
Unlike many diseases, Parkinson’s disease symptoms, progression, and treatment response can vary widely from person to person. Thus, a knowledgeable professional needs to be consulted in order to optimize treatment for Parkinson’s disease.
Diagnosis
Diagnosis of Parkinson’s disease can not be made by a blood test or MRI. These are only used to rule out other causes for the symptoms being experienced. A neurologist or movement disorder specialist (specially trained neurologist) who can provide a thorough examination and assessment should be consulted when Parkinson’s disease is suspected. The OHSU PCO has specialized in diagnosing and treating Parkinson’s disease for over 20 years and are the resident experts in the Pacific Northwest.
»
Patient Care Clinic Visit
If you are recently diagnosed with Parkinson’s disease, please consider attending our Newly Diagnosed Education session, which is offered every other month at the PCO.
Symptoms and Appearance
Since the brain is affected, Parkinson’s disease can impact many different parts of the body. Less recognized, but equally troubling non-motor symptoms may occur in any combination for people with Parkinson’s disease. Secondary Non-Motor Symptoms
|
The most noticeable symptoms of Parkinson’s 
disease are the motor symptoms; these affect the body’s movement and muscle coordination and are also known as "primary" symptoms. "Secondary" symptoms (non-motor, non-movement related) also exist (see inset box). It is very important to remember that someone diagnosed with Parkinson’s disease will not get all of these symptoms, but should be aware that these issues can be related to Parkinson’s disease.
Primary Motor Symptoms
- Tremor*(shaking)
- Slowness of movement*
- Muscle stiffness* (rigidity)
- Expressionless face (masked face)
- Small handwriting
- Small, shuffling gait
- Reduced arm swing
- Soft voice
- Swallowing difficulties**
- Balance problems**
* two or more key to diagnosis
** usually occur later in the disease
Treatment Options for Parkinson’s Disease
Medications
There are many effective medications for treating the symptoms of Parkinson’s disease. But, since everyone is different, it requires some trial and error to find the appropriate medication(s) and dose for each individual depending on their stage of disease and their specific symptoms. Consultation with a neurologist is important. For more information about medications, check out The Parkinson’s Disease Handbook chapter on medications and/or the NPF website.
The American Academy of Neurology (AAN) has updated the suggested guidelines for treating Parkinson’s disease. These can be accessed by clicking the links below.
Diagnosis, Prognosis, and Treatments for Newly Diagnosed Parkinson Disease
Medical and Surgical Treatment for Motor Fluctuations and Dyskinesia in Parkinson Disease
Screening and Treatment for Depression, Dementia, and Psychosis in Parkinson Disease
Surgery
It is brain surgery! There are several different surgeries which can be preformed to improve the movement symptoms of Parkinson’s disease, including DBS (deep brain stimulation). An excellent introduction to these procedures is available through the NPF booklet, A Guide to Deep Brain Stimulation Therapy for the Treatment of Parkinson Disease, which can be found at the National Parkinson Foundation website.
Adjunct Therapies
A team approach to treatment is essential with Parkinson’s disease. Physical therapists, occupational therapists, and speech therapists, who specialize in neurological rehabilitation, can contribute a great deal to helping people with PD and their families in managing the disease and maximizing wellness.
» Learn more about our own Comprehensive Neurological Rehabilitation Team (CNRT)