Treatment for Parkinson's Disease and Movement Disorders
Parkinson's disease is a disorder of the central nervous system, involving the degeneration and loss of nerve cells in the basal ganglia of the brain. With the loss of these cells an individual loses the ability to coordinate normal movement. People with Parkinson's disease have low concentrations of dopamine in the brain which unfortunately impairs certain abilities.
There are a number of related movement disorders, including hemifacial spasms, Huntington's chorea and Tourette's syndrome. It is important to differentiate between these disorders and Parkinson's in order to plan treatment appropriately.
Symptoms of Parkinson's disease may include the following:
- Tremors: The tremor, or shaking, usually begins in the arm or leg, often the hand or fingers. A back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor, is common. A characteristic of Parkinson's disease is tremor of the hand that occurs when the hand is relaxed (at rest).
- Slowed movement (bradykinesia): Over time, Parkinson's disease may reduce the ability to move and slow movement. This may make simple tasks difficult and time-consuming. Steps may become shorter during walking; it may be difficult to get out of a chair. Also, feet may stick to the floor during attempts to walk, making it difficult to move.
- Rigid muscles: Muscle stiffness may occur in any part of the body. The stiff muscles can limit range of motion and cause pain.
- Impaired posture and balance: Posture may become stooped, or balance problems may result from Parkinson's disease.
- Loss of automatic movements: There may be a decreased ability to perform unconscious movements, including blinking, smiling or swinging arms on walking. The ability to gesture when talking may disappear.
- Speech problems: Speaking softly, quickly, slurring or hesitating before talking are all possible symptoms. Speech may become monotonous; losing normal inflections.
- Writing problems: Writing may become difficult and appear small.
A person experiencing any of these symptoms should see a doctor. Below are some steps a patient should take in preparing for an initial visit with a doctor:
- Write down any symptoms she or he are experiencing, even including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins and supplements, being taken.
- Ask a family member or friend to accompany the patient, if possible. Sometimes it can be difficult for a patient to retain all of the information that might be provided during an appointment. An accompanying person might retain information that a patient forgets at times.
- Write down questions to ask the doctor.
There is no single test that definitively diagnoses Parkinson's disease. Patients are often diagnosed based on medical history, a review of signs and symptoms and neurological and physical examination.Often a Parkinson's disease diagnosis is tested through close monitoring of whether or not a patient improves when taking the appropriate medication.
Medication and Treatment
Unfortunately there is currently no cure for Parkinson's disease but medications such as levodopa can help control symptoms, often dramatically. Treatment may also include lifestyle changes, especially ongoing aerobic and anaerobic exercise. In some cases physical therapy that focuses on balance and stretching also is important.
Click here for more information about medications for Parkinson's disease.
People with advanced Parkinson's disease who have unstable responses to medication may consider a surgical option such as deep brain stimulation (DBS).
DBS involves the surgical implantation of electrodes into a specific part of the brain. The electrodes are connected to a generator implanted in the chest that sends electrical pulses to the brain and that may help improve many Parkinson's disease symptoms. It can help stabilize medication fluctuations, reduce or eliminate involuntary movements (dyskinesia), reduce tremor, reduce rigidity, and improve slowing of movement. Surgery may involve risks, including infections, stroke or brain hemorrhage.
The Parkinson's Disease Program at New York Methodist Hospital
The Parkinson's Disease Program at New York Methodist Hospital offers the only comprehensive diagnostic and treatment program for Parkinson's and other movement disorders in Brooklyn. In addition to excellent neurological care, the program offers numerous ancillary services including physical and occupational therapy, swallowing and speech-language pathology, psychiatric and mental health services, neurosurgical procedures and educational services. In addition, our staff is actively involved in Parkinson’s research. Our care team will provide each patient with a comprehensive treatment program specifically tailored to meet each person's needs.
For more information, please contact our program coordinator at 646.704.1792 or download our brochure.
For the Institute of Neurosciences, call 866.DO.NEURO (866.366.3876).