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Parkinson's Disease Symptoms and Treatments

By the National Institutes of Health

Use your browsers back button to navigate this parkinson's disease menu.

What is Parkinson's Disease?
Parkinson's Disease treatments?
What is the prognosis?
What research is being done?
Parkinson Disease Organizations
Related NINDS Publications and Information
Publicaciones en Español
Additional resources from MEDLINEplus

What is Parkinson's Disease?

Parkinson's disease belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of Parkinson's disease are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Parkinson's disease usually affects people over the age of 50.  Early symptoms of Parkinson's disease are subtle and occur gradually.  In some people the disease progresses more quickly than in others.  As the disease progresses, the shaking, or tremor, which affects the majority of Parkinson's disease patients may begin to interfere with daily activities.  Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.  There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic Parkinson's disease.  Therefore the diagnosis is based on medical history and a neurological examination.  The disease can be difficult to diagnose accurately.   Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.

Is there any treatment?

At present, there is no cure for Parkinson's disease, but a variety of medications provide dramatic relief from the symptoms.  Usually, patients 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 at least three-quarters of 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 bromocriptine, pergolide, 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 May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced Parkinson's disease or as a single-drug treatment for early Parkinson's disease. 

In some cases, surgery may be appropriate if the disease doesn't respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into 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.

What is the prognosis?

Parkinson's disease 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 patients, while for others tremor is only a minor complaint and other symptoms are more troublesome.  No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms also varies from person to person.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts Parkinson's disease research in laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country.  Current research programs funded by the NINDS are using animal models to study how the disease progresses and to develop new drug therapies. Scientists looking for the cause of Parkinson's disease continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role.  Other scientists are working to develop new protective drugs that can delay, prevent, or reverse the disease.

More information about Parkinson's Disease research is available at http://www.ninds.nih.gov

Select this link to view a list of studies currently seeking patients.

Organizations

American Parkinson Disease Association
135 Parkinson Avenue
Staten Island, NY   10305-1425
aParkinson's diseasea@aParkinson's diseaseaparkinson.org
http://www.aParkinson's diseaseaparkinson.org
Tel: 718-981-8001 800-223-2732 Calif: 800-908-2732
Fax: 718-981-4399

Parkinson Alliance
P.O. Box 308
Kingston, NJ   08528-0308
admin@parkinsonalliance.org
http://www.parkinsonalliance.org
Tel: 609-688-0870 800-579-8440
Fax: 609-688-0875

Parkinson's Action Network (PAN)
1025 Vermont Ave., NW
Suite 1120
Washington, DC   20005
info@parkinsonsaction.org
http://www.parkinsonsaction.org
Tel: 800-850-4726 202-638-4101
Fax: 202-638-7257

Parkinson's Institute
1170 Morse Avenue
Sunnyvale, CA   94089-1605
http://www.thepi.org
Tel: 408-734-2800 800-786-2958
Fax: 408-734-8522

WE MOVE (Worldwide Education & Awareness for Movement Disorders)
204 West 84th Street
New York, NY   10024
wemove@wemove.org
http://www.wemove.org
Tel: 212-875-8312 866-546-3136
Fax: 212-875-8389

National Parkinson Foundation
1501 N.W. 9th Avenue
Bob Hope Road
Miami, FL   33136-1494
contact@parkinson.org
http://www.parkinson.org
Tel: 305-243-6666 800-327-4545
Fax: 305-243-5595

Michael J. Fox Foundation for Parkinson's Research
Grand Central Station
P.O. Box 4777
New York, NY   10163
http://www.michaeljfox.org
Tel: 212-509-0995

Parkinson's Disease Foundation (Parkinson's diseaseF)
1359 Broadway
Suite 1509
New York, NY   10018
info@Parkinson's diseasef.org
http://www.Parkinson's diseasef.org
Tel: 212-923-4700 800-457-6676
Fax: 212-923-4778

Parkinson's Resource Organization
74-090 El Paseo
Suite 102
Palm Desert, CA   92260-4135
info@parkinsonsresource.org
http://www.parkinsonsresource.org
Tel: 760-773-5628 310-476-7030 877-775-4111
Fax: 760-773-9803

Bachmann-Strauss Dystonia & Parkinson Foundation
Mt. Sinai Medical Center One Gustave L. Levy Place
P.O. Box 1490
New York, NY   10029
Bachmann.Strauss@mssm.edu
http://www.dystonia-parkinsons.org
Tel: 212-241-5614
Fax: 212-987-0662

Related NINDS Publications and Information

Publicaciones en Español

Last updated December 20, 2006

Parkinson Disease Symptoms

By the Parkinson's Disease Foundation

It is important to realize that not every person with Parkinson's develops all signs or symptoms of the disease. For example, some people experience tremor as the primary symptom, while others may not have tremor but do have balance problems. Also, for some people the disease progresses quickly, and in others it does not. The following are descriptions of the most common primary symptoms of Parkinson's disease.

Tremor

In the early stages of the disease, about 70 percent of people experience a slight tremor in the hand or foot on one side of the body, or less commonly in the jaw or face. It appears as a "beating" or oscillating movement. Because the Parkinson's tremor usually appears when a person's muscles are relaxed, it is called "resting tremor." This means that the affected body part trembles when it is not doing work, and it usually subsides when a person begins an action. The tremor often spreads to the other side of the body as the disease progresses, but remains most apparent on the original side of occurrence.

Rigidity

Rigidity, also called increased muscle tone, means stiffness or inflexibility of the muscles. Muscles normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of motion. For example, a person who has rigidity may not be able to swing his or her arms when walking because the muscles are too tight. Rigidity can cause pain and cramping.

Bradykinesia

Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. People who have bradykinesia may walk with short, shuffling steps (this is called festination). Bradykinesia and rigidity can occur in the facial muscles, reducing a person's range of facial expressions and resulting in a "mask-like" appearance.

Postural instability or impaired balance and coordination: People with Parkinson's disease often experience instability when standing or impaired balance and coordination. These symptoms, combined with other symptoms such as bradykinesia, increase the probability of falling. People with balance problems may have difficulty making turns or abrupt movements. They may go through periods of "freezing," which is when a person feels stuck to the ground and finds it difficult to start walking. The slowness and incompleteness of movement can also affect speaking and swallowing.

Secondary symptoms of Parkinson's can be, for many, as troublesome as the primary movement symptoms of the disease. PDF receives many inquiries about secondary symptoms, and you can often find information about these problems in our educational materials and in our newsletter, the PDF News & Review. Secondary symptoms of Parkinson's include stooped posture, a tendency to lean forward or backward and speech problems, such as softness of voice or slurred speech caused by lack of muscle control. Non-motor symptoms, such as depression, also affect the life of a person with Parkinson's.


Parkinsons Disease Symptoms

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