What is the Cause of Parkinson's Disease? Parkinson's disease is a degenerative condition where the brain starts to loose cells which produce dopamine. It usually occurs in patients over the age of 50. With advancing age the prevalence of the disease increases. There are patients who have Parkinson's disease under the age of 50 but it is a very rare condition.

What are the symptoms of Parkinson's disease?
There are four main symptoms of Parkinson's disease. This includes tremor, which could occur in any of the limbs and even involve the head and face. The tremor usually starts in one limb and over time progresses to the other limbs. The tremor usually occurs when the limbs are at rest. Another symptom of Parkinson's disease is rigidity or stiffness of the limbs. The patients also start to have slowness in their movements which is known as bradykinesia. The family and the patient start to notice that it takes the patient longer periods of time to do their usual activities. The patient's notice that they start to loose their balance and walking becomes more difficult. They start to take small steps and walk slower than before. Not all of these symptoms need to be present for the diagnosis of Parkinson's disease to be made. There are other associated symptoms with Parkinson's disease which include depression, difficulty swallowing, difficulty in speaking and a soft voice, chewing difficulties, urinary problems and constipation, and difficulty sleeping and nightmares.

How is the diagnosis made?
The diagnosis of Parkinson's disease is made by the symptoms that the patient presents with and the physician's examination of the patient. The essential factor is to make sure that the patient doesn't have another condition that is mimicking Parkinson's disease, since many other diseases might look like Parkinson's disease. The workup that is generally done is to exclude other diseases that might be mimicking Parkinson's disease. Making the right diagnosis is an essential part of the process given that the right diagnosis will be needed for deciding on the proper treatment.

What are the different treatments for Parkinson's disease?

There are currently no cures available for Parkinson's disease. However there are a wide variety of treatment for Parkinson's disease which could be used to dramatically improve the symptoms. Since Parkinson's disease is caused by a decrease in the amount of dopamine in the brain, most of the treatments are aimed at increasing dopamine. These drugs include synthetic dopamine which includes different forms of Sinemet. The second class of drugs include drugs that are similar to dopamine but are not dopamine itself, the most popular one is Mirapex. Another class of drugs are drugs which prevent the breakdown of dopamine in the body; they indirectly increase the body's dopamine levels. Another class of drugs decreases the amount of acetylcholine in the brain. They also tends to help Parkinson's patients. Which drugs will be used has to be determined by the neurologist depending on the patient's characteristics and the side effect profiles of the drugs. In the hands of an expert most patients with Parkinson's disease will have very good control of their symptoms for years.

What happens if medications don't work?
There are now very effective surgical options which could be used in patients in which drugs stop being effective. In the surgery, a technique is used where an electrode is implanted in the brain. This technique is called deep brain stimulation. With proper patient selection, patients could have reduction of their symptoms where drugs stopped being effective. The patient could have better control of their symptoms with lower doses of medication.

What is the prognosis?
The symptoms of Parkinson's disease start slowly and progress over time. Every patient has a different rate of progression. Although some people become severely disabled, others have minor symptoms. 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.