- Memory Loss, Dementia
- Anxiety, Depression
- Slow Blinking
- No Facial Expression
- Difficulty Swallowing
- Shaking, Tremors
- Loss of small or fine hand movements
- Problem with Balance or Walking
- Stooped Posture
- Aches and Pains
At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms. Usually, affected individuals are given levodopa combined with carbidopa. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can use levodopa to make dopamine and replenish the brain's dwindling supply.
Although levodopa helps most parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all. Anticholinergics may help control tremor and rigidity.
Other drugs, such as pramipexole and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine. An antiviral drug, amantadine, also appears to reduce symptoms. In 2006, the U.S. Food and Drug Administration (FDA) approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD.
Deep Brain Stimulation
In some cases, surgery may be appropriate if the disease doesn't respond to drugs. A therapy called deep brain stimulation (DBS) has been approved by the FDA. In DBS, electrodes are implanted in the brain and connected to a small electrical device called a pulse generator that can be externally programmed.
DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.
Fundamental to the success of DBS was the pioneering work of Mahlon DeLong, MD, of Emory University School of Medicine. He recently received the Distinguished Medical Science Award from the Friends of the National Library of Medicine (FNLM) for his work on DBS.
What Is the Prognosis?
PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some individuals, while for others tremor is only a minor complaint and other symptoms are more troublesome. It is currently not possible to predict which symptoms will affect an individual, and the intensity of the symptoms also varies from person to person.
Find Out More
- National Institute of Neurological Disorders and Stroke (NINDS): www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm
- MedlinePlus: medlineplus.gov/parkinsonsdisease.html
- Parkinson's Disease: Hope Through Research – NINDS: www.ninds.nih.gov/disorders/parkinsons_disease/detail_parkinsons_disease.htm
- Parkinson's Disease Research: www.ninds.nih.gov/research/parkinsonsweb/index.htm
- National Institute of Environmental Health Sciences: www.niehs.nih.gov/health/topics/conditions/parkinson
- Parkinson's Disease Foundation: