Parkinson's disease
A progressive disorder caused by loss of dopamine-producing nerve cells, leading to slowness, stiffness and tremor, plus many non-movement symptoms.
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About 10 million people; the fastest-growing neurological disease.
What happens in the body
Alpha-synuclein clumps (Lewy bodies) accumulate and dopaminergic neurons in the substantia nigra die, reducing dopamine in the striatum.
Causes
- Mostly unknown; genetic forms (LRRK2, GBA, SNCA)
Risk factors
- Age
- Male sex
- Pesticide exposure
- Family history
Symptoms
- Slowness of movement (bradykinesia)
- Resting tremor
- Muscle rigidity
- Shuffling walk and poor balance
- Small handwriting, soft voice, reduced facial expression
- Loss of smell, constipation, acting out dreams, depression
Diagnosis — tests and examinations
- Clinical examination
- Response to levodopa
- DaTscan in uncertain cases
Treatment
Medicines and medical treatment
- Levodopa with carbidopa (most effective)
- Dopamine agonists, MAO-B inhibitors, COMT inhibitors
- Treatment of non-motor symptoms
Operations and procedures
- Deep brain stimulation
- Continuous levodopa infusion pumps
Self-care, home remedies and lifestyle
- Regular exercise (strongly beneficial)
- Physiotherapy, speech and occupational therapy
- Fall prevention
Possible complications
- Motor fluctuations and dyskinesia
- Falls
- Dementia
- Swallowing problems and pneumonia
Prevention
- Physical activity may reduce risk
Outlook
Progressive but many live for decades with good symptom control.
When to see a doctor
See a doctor for new tremor, slowness or stiffness.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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