Parkinson Disease: What You Should Know

Am Fam Physician. 2013;87(4):online

See related article on Parkinson disease.

What is Parkinson disease?

Parkinson disease is a brain disease that usually affects older people. It happens when the parts of the brain that control your muscles are damaged. It can cause shaking and stiffness, and make you move more slowly.

Who gets it and what causes it?

About one in every 100 people older than 60 years will get Parkinson disease. We don't know exactly what causes it. It isn't contagious, and you usually won't inherit it from your parents or pass it on to your children. If you develop Parkinson disease after age 50, there is no greater chance that your children or other relatives will get the disease.

What are the symptoms?

The first symptom most people notice is a shaking or tremor in the hand. It is usually worse on one side. This is sometimes called a “pill-rolling” tremor, because it looks like a person is rolling a small object, like a pill, in his or her hand. Most people notice this shaking when they are relaxed, but it gets better with movement. Some patients will also move more slowly and have stiff muscles. Many people will have trouble with balance and walking.

How will my doctor diagnose it?

Your doctor will talk with you about your symptoms and examine you. If your doctor isn't sure you have Parkinson disease, he or she may ask you to see a specialist such as a neurologist. Because diagnosing this disease can be hard, especially in the early stages, your doctor will go over your symptoms and reexamine you to be sure the diagnosis is correct during follow-up visits.

How is it treated?

No treatment is needed in the early stages of disease. When your symptoms begin to prevent you from doing everyday activities, your doctor will talk with you about different treatments. Some medicines can help people with early Parkinson disease. Your doctor will talk with you to help decide which drug is best for you.

As the disease progresses, some people have more trouble with walking and other activities, even though they are taking medicine. Your doctor will recommend extra medicines to help with your symptoms. Your doctor may also suggest physical, occupational, and speech therapy to help you function as well as you can. Some people will eventually have severe symptoms that medicine can't help. For these patients, a device called a deep brain stimulator can be implanted into the brain to improve symptoms.

Even though Parkinson disease is not curable, there are many treatments that can help you and your family live a good life. In addition to your family doctor and neurologist, there are support groups sponsored by the National Parkinson Foundation that can help you.