Frequently Asked Questions About Parkinson\’s Disease
As hard as we’re working to solve the mystery, we still don’t know.
Most cases don’t seem to run in families. Exposure to chemicals in the environment might play a role. For most people, the exact cause isn’t known.
Some patients connect the onset of their symptoms to a trauma such as an accident, surgery or extreme emotional distress. Most neurologists don’t think there’s a direct link, but they do believe that a traumatic event might cause symptoms to start a little earlier.
There’s no one test that can tell you if you have Parkinson’s. And sometimes a correct diagnosis takes time.
Usually, a neurologist will diagnose Parkinson’s disease based on your medical history, signs and symptoms, and a physical exam. MRI or CT brain scans can help rule out other disorders.
Your doctor might also prescribe carbidopa-levodopa, a Parkinson’s disease medication. If you improve significantly, this may confirm your diagnosis.
As of today, there’s no way to prevent or cure Parkinson’s, but many medications can make a big difference in how people feel and function. With medications, most people with Parkinson’s can live productive lives for many years.
- Levodopa. L-dopa is the cornerstone of Parkinson’s drug therapy, usually combined with carbidopa to diminish other side effects. Although people often have noticeable improvement with L-dopa, they typically need to increase their dose over time. Over long periods some people taking L-dopa may develop involuntary twisting and writhing (dyskinesia). That’s why doctors often start patients on other dopamine-increasing drugs and add L-dopa later. Surgery may be considered for severe dyskinesia. Patients should never stop taking L-dopa without consulting their doctor. Rapid withdrawal can have serious side effects.
- Dopamine agonists. These drugs include apomorphine, pramipexole, ropinirole, and rotigotine. They mimic dopamine in the brain and can be given alone or with L-dopa.
- MAO-B inhibitors. These drugs cause dopamine to accumulate in surviving nerve cells and reduce the symptoms of Parkinson’s. They include selegiline (also called deprenyl) and rasagiline.
- COMT inhibitors. These drugs prolong L-dopa’s effects by preventing the breakdown of dopamine. They include entacapone and tolcapone.
- Amantadine. An antiviral drug, amantadine, can help reduce symptoms and dyskinesia. It is often used alone in Parkinson’s early stages.
- Anticholinergics. These drugs include trihexyphenidyl, benztropine, and ethopropazine. They can be particularly effective for tremor.
Medications for Non-Motor Symptoms
Many medications can treat non-motor Parkinson’s symptoms, such as depression and anxiety.
Deep brain stimulation (DBS) is a common surgical treatment. An electrode is surgically implanted into part of the brain, where it stimulates the brain to help block Parkinson’s motor symptoms.
While DBS can make a big difference in motor function, it doesn’t usually help with speech problems, “freezing,” posture, balance, anxiety, depression, or dementia. Also, DBS does not stop Parkinson’s from progressing.
As with any brain surgery, there are potential complications, including stroke, but they are rare.
A wide variety of complementary and supportive therapies can help people with PD. Parkinson’s. For instance, physical, occupational, and speech therapies can help with walking and voice disorders, tremors and rigidity, and cognitive decline.
Other therapies include massage, tai chi, hypnosis, acupuncture, swallowing therapy, and the Alexander technique, which helps posture and muscle activity.
Exercises and movement classes also improve balance, helping people minimize gait problems. It can even strengthen certain muscles so that people can speak and swallow better.