Paralysis agitans; Shaking palsy
Nerve cells use a brain chemical called dopamine to help control muscle movement. With Parkinson disease, the brain cells that make dopamine slowly die. Without dopamine, the cells that control movement can't send proper messages to the muscles. This makes it hard to control the muscles. Slowly, over time, this damage gets worse. No one knows exactly why these brain cells waste away.
Parkinson disease most often develops after age 50. It is one of the most common nervous system problems in older adults.
Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg is stiff and dragging. Jaw tremor has also been an early sign of Parkinson disease. Symptoms may affect one or both sides of the body.
General symptoms may include:
Movement problems may include:
Symptoms of shaking (tremors):
Other symptoms may include:
Exams and Tests
Your health care provider may be able to diagnose Parkinson disease based on your symptoms and a physical exam. But the symptoms can be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse.
The examination may show:
Your provider may do some tests to rule out other conditions that can cause similar symptoms.
There is no cure for Parkinson disease, but treatment can help control your symptoms.
Your provider will prescribe medicines to help control your shaking and movement symptoms.
At certain times during the day, the medicine may wear off and symptoms can return. If this happens, your provider may need to change any of the following:
You may also need to take medicines to help with:
Parkinson medicines can cause severe side effects, including:
Tell your provider right away if you have these side effects. Never change or stop taking any medicines without talking with your provider. Stopping some medicines for Parkinson disease may lead to a severe reaction. Work with your provider to find a treatment plan that works for you.
As the disease gets worse, symptoms such as stooped posture, frozen movements, and speech problems may not respond to the medicines.
Surgery may be an option for some people. Surgery does not cure Parkinson disease, but it may help ease symptoms. Types of surgery include:
Certain lifestyle changes may help you cope with Parkinson disease:
Parkinson disease support groups can help you cope with the changes caused by the disease. Sharing with others who have common experiences can help you feel less alone.
Medicines can help most people with Parkinson disease. How well medicines relieve symptoms and for how long they relieve symptoms can be different in each person.
The disorder gets worse until a person is totally disabled, although in some people, this can take decades. Parkinson disease may lead to a decline in brain function and early death. Medicines may prolong function and independence.
Parkinson disease may cause problems such as:
When to Contact a Medical Professional
Call your provider if:
If you take medicines for Parkinson disease, tell your provider about any side effects, which may include:
Also call your provider if the condition gets worse and home care is no longer possible.
Armstrong MJ, Okun MS. Diagnosis and treatment of parkinson disease: a review. JAMA. 2020 Feb 11;323(6):548-560. PMID: 32044947 www.ncbi.nlm.nih.gov/pubmed/32044947/.
Fox SH, Katzenschlager R, Lim SY, et al; Movement Disorder Society Evidence-Based Medicine Committee. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord. 2018;33(8):1248-1266. PMID: 29570866 www.ncbi.nlm.nih.gov/pubmed/29570866/.
Jankovic J. Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 96.
Okun MS, Lang AE. Parkinsonism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 381.
Radder DLM, Sturkenboom IH, van Nimwegen M, et al. Physical therapy and occupational therapy in Parkinson's disease. Int J Neurosci. 2017;127(10):930-943. PMID: 28007002 www.ncbi.nlm.nih.gov/pubmed/28007002/.
Review Date: 2/4/2020
Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Stony Brook University School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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