The most recognizable features of Parkinson’s disease are tremor, rigidity and stiffness, slowing of movements, and balance problems. The motor symptoms of Parkinson’s disease are related to the loss of the neurotransmitter dopamine in certain brain structures. There are many other non-motor symptoms of Parkinson’s disease which have been increasingly recognized as a major determinant of quality of life in Parkinson’s disease. The effects of Parkinson’s disease can be seen in nearly every organ system. Examples of such symptoms include sleep disturbances, loss of sense of smell, constipation, mood disturbance and dizziness.
A new diagnosis of Parkinson’s disease is made each year in 13.4 of 100,000 people, which means that approximately 180 Mainers will be diagnosed each year. Parkinson’s disease is more common in older individuals, present in 1.5% of people over age 55. Men are also more likely to be diagnosed with Parkinson’s disease in a ratio of 2:1. While there are some forms of Parkinson’s disease that are hereditary, a large majority of cases are not inherited and occur sporadically without any family history.
Although Parkinson's disease can't be cured, medications can markedly improve symptoms. Medication selection and adjustment is tailored to each individuals needs as their disease progresses. Maintaining an active lifestyle is very important in Parkinson’s disease. Regular exercise will help people with Parkinson’s disease to maintain their mobility and can also help alleviate some of the non-motor symptoms of Parkinson’s disease. In some cases, deep brain stimulation (DBS) can be performed to help control the motor symptoms of Parkinson’s disease, and to increase the amount of time that people with Parkinson’s disease are able to function smoothly throughout their day.
Atypical Parkinsonian syndromes are characterized by symptoms that are similar to Parkinson’s disease. Early on in one’s disease course it can be difficult to differentiate Parkinson’s disease from atypical Parkinsonism. The atypical Parkinsonian syndromes include multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies. The atypical Parkinsonian syndromes are far less common than Parkinson’s disease. The symptoms of atypical Parkinsonism typically show little improvement with the standard medical therapies used to treat Parkinson’s disease and people with atypical Parkinsonism tend to suffer from higher levels of disability than what is seen in Parkinson’s disease. Some of the clues that one has an atypical Parkinsonian disorder include suffering from falls early after symptom onset, prominent light-headedness or passing out from fluctuating blood pressure, and early memory or behavior problems. Treatment of atypical Parkinsonism involves the use of medications to help control the non-motor symptoms of these disorders. Rehabilitative therapies such as speech therapy and physical therapy are also very important in maintaining quality of life for people with atypical Parkinsonism.
Essential tremor is a condition that causes rhythmic shaking of various parts of the body, most commonly the arms and hands. The tremor of essential tremor is most pronounced with use of the arms, in contrast to the resting tremor seen in Parkinson’s disease. As much as 70% of cases of essential tremor are familial. Although it is a “benign” tremor, it can become severe enough to cause disability in performing basic functions such as grooming, eating, and drinking. It can also limit some people’s ability to perform their jobs or participate in their hobbies. Essential tremor affects nearly 4,000 Mainers and another 300 will be affected each year.
Treatment options include medications and physical or occupational therapy. A surgical procedure, deep brain stimulation (DBS), may be an option for people whose tremors are severely disabling and who have inadequate relief of symptoms from medications.
Dystonia occurs when there is sustained muscle contraction that leads to twisting and bending of the affected body part. In most cases only a single body part is affected. The most common part of the body affected in dystonia is the neck. This condition is called cervical dystonia and it can lead to abnormal positions of the head, head tremor and neck pain. Dystonia can also be generalized, affecting multiple body parts. Because dystonia is relatively rare compared to other movement disorders it is difficult to know the exact prevalence of it.
Medications can sometimes improve dystonia symptoms. Relief from excessive muscle contraction can also be achieved through local injections of therapeutic nerve toxins. In some patients with generalized dystonia who are unresponsive to medication, surgery may be used to help control symptoms.