Parkinson disease is a progressive neurological disorder. It gradually worsens over a period of years with loss of control of muscle movements.
Older people usually get Parkinson disease, but people younger than 40 can have early-onset disease. Both the actor Michael J. Fox and the boxer Mohammed Ali have Parkinson.
Brain cells that make the chemical dopamine start to die, which causes symptoms due to low dopamine levels. It’s unclear why this happens, but risk factors include blood vessel problems, infection, toxins such as pesticides and carbon monoxide, medicines, head injury or repeated trauma (from sports such as boxing), tumors, water on the brain (hydrocephalus), and thyroid and parathyroid gland problems. Parkinson disease seems to run in families.
Parkinson disease impairs muscle control, movement, and balance. An early symptom is a slight tremor of the hand or fingers. It’s often first noticed when handwriting changes or when people have trouble with fine motor movements (such as buttoning clothes). Tremor (called pill rolling) or shaking occurs in one or both hands, especially at rest. Other symptoms are muscle stiffness and freezing, gradual slowing and loss of movement, trouble with walking (especially starting up), swallowing problems, drooling, loss of facial expression, and trouble speaking.
The health care provider makes a diagnosis from a medical history and physical examination. There is no specific diagnostic test. Laboratory tests, magnetic resonance imaging (MRI), and computed tomography (CT) may be done to rule out other disorders. The health care provider will suggest seeing a neurologist (specialist in nervous system diseases).
No cure exists, but symptoms can be treated and complications can be prevented. Medicines, taken lifelong, are used to treat symptoms or slow disease progress. Surgery is rarely done and doesn’t always help, but may be suggested when symptoms get very bad and medicines don’t work. Stereotaxic surgery can carefully destroy brain cells causing movement problems. This stops or reduces tremors. Another operation involves transplanting cells from an embryo into the brain. The cells take over the work of the diseased cells. The third operation involves putting small electrodes in the brain to stimulate diseased parts.
People later need help with activities of daily living. An occupational therapist can assist with these.
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