What is Parkinson's disease?
Parkinson's disease is a progressive
neurological disorder that causes muscle tremor, stiffness and slowness of
movement. It is most common among older people, affecting more men than women –
however younger people can also have the disease. The disorder is named after
Dr James Parkinson, a London physician who first described the syndrome in
What causes Parkinson's disease?
The disease is caused by the degeneration
of nerve cells (or ‘neurones’) in a part of the brain that controls movement, called
the basal ganglia. Normally, these nerve cells produce dopamine – a chemical
messenger or ‘neurotransmitter’, which is used by the brain to control
movement. In Parkinson’s disease, the production of dopamine is reduced and
muscle tension and movement are affected.
The exact reason for the degeneration of
the nerve cells is not completely understood, although hereditary factors,
brain injury or infection, exposure to toxins and adverse reactions to drugs
may all be risk factors for the disease.
What are the symptoms of Parkinson’s
- Tremors (involuntary shaking) affecting the
hand, arm or leg on one side of the body, especially when resting
- Muscular stiffness.
- Muscle tremor and stiffness affecting both
sides of the body
- Slow movements and stiff, unbalanced walk
- Stooped posture
- Unblinking, fixed expression.
- Slow and hesitant speech
- Writing difficulties (handwriting is
usually very small)
- Increased salivation and drooling.
The disorder can also lead to bowel and
bladder symptoms, such as constipation and increased urination. The onset of Parkinson’s
disease is slow, so the disease may go unnoticed for several years.
How is Parkinson's disease diagnosed?
There are no specific tests at present for
Parkinson’s disease at present, so making an accurate diagnosis can be
Your doctor will examine you and ask about
your symptoms and your medical history. Tests may be recommended to rule out
other diseases that resemble Parkinson's disease and you may be referred to a
specialist in neurological disorders.
Specialised brain scans can be carried out
which may identify dopamine deficiency in the brain, however these are not done
How is Parkinson's disease treated?
There is no cure for Parkinson's disease at
present, but its symptoms can be controlled. Treatment is based on replacing or
enhancing the effects of dopamine in the brain, in order to minimise symptoms.
Medications may work by improving the
effects of dopamine in the brain, impeding dopamine breakdown, replacing the
dopamine that has been lost or delaying its degeneration by slowing down the
enzymes that control this process.
The medications prescribed will depend on
the patient’s age and personal circumstances — for example, medication may not
be prescribed in mild cases because of potential unpleasant side-effects such
as abnormal body movements, nausea, short-term memory loss and confusion.
Exercise is important to increase muscle strength, reduce rigidity and improve
co-ordination. In severe cases, an operation on the brain may be performed to
reduce tremors and rigidity.
What can I do?
- Exercise — regular exercise and
physiotherapy will help to increase mobility and maintain physical strength.
- Eat well — people with Parkinson's may not
eat as often as they did previously. This can be due to their bodies slowing
down or difficulties with swallowing. However, it is important to continue to
eat nutritious and high-fibre food to counteract the constipation that may come
with the disease and to maintain a healthy body weight.
- Stay active — Parkinson's can be an
isolating disease and sufferers can become depressed. It is important that
sufferers stay active and continue to work and socialise. Support groups can
provide practical information as well as advice on coming to terms with the
- Take practical steps to help yourself —
install handrails in your home and remove anything that might cause a fall. Buy
shoes and clothes that use velcro fastenings instead of laces and zips, and
develop alternative ways to communicate if speech becomes difficult for you.
- Join a support group – The Parkinson’s Association
of Ireland has a helpline (1 800 359 359), website (www.parkinsons.ie) and
produces a regular newsletter.
Tips for a Parkinson-friendly house
- Throw out those rugs — they are just
waiting to trip you up.
- Softly, softly — wear low-heeled,
comfortable shoes with non-skid soles and opt for wall-to-wall carpeting.
- Go for the minimalist approach — clear away
clutter and move electrical cords out of your path.
- Layout is everything — arrange your
furniture to give yourself enough room to move around and plan a route through
the house that will always give you something to hold onto in case you lose
- Lighting effects — keep lighting levels
consistent throughout the house to avoid false perceptions about floor levels.
Ensure that all steps and stairs are well lit and consider night-lights for
hallways and bathrooms.
- Hold on — install handrails on all
staircases and consider adding railings in hallways or in other areas where you
don't have something to hold onto.
- It's good to talk — but opt for a cordless
phone that can be carried from room to room or invest in an answering machine
set to the fifth ring or longer, so you don't have to rush to answer it.
- Bath time — install hand rails around your
bathroom to help you balance as you get in and out of the bath or shower and on
the wall next to the toilet.
- Cooking up a storm — place a rubber pad or
wet dishcloth under bowls and pots to keep them stable, use an electric tin
opener and try a wooden cutting board with raised edges to prevent food from
scattering when you cut it.
- Sleep tight — your bed should be about knee
height with the head of the bed slightly elevated (place wooden risers under
the legs or a foam cushion under the mattress) to make it easier for you to sit
up and get out of bed.