Parkinson's: Information & Parkinson's Specialists

Parkinson’s disease can 

• take various forms,
• occur with varying degrees of severity, and
• progress through different stages.

Nevertheless, there are key symptoms that can be attributed to the disease. The so-called Parkinson’s triad describes the symptoms

• Akinesia/bradykinesia: immobility or involuntary movements
• Rigor: Increased muscle tone
• Tremor: Involuntary shaking

In addition to these key symptoms, other movement impairments may occur, such as

• postural instability,
• instability, and
• impaired facial expressions, which lead to the so-called “mask-like face” typical of Parkinson’s disease.

In addition to the limitations in movement, degenerative changes in mental function may also occur. Many people with Parkinson’s have difficulty concentrating or develop dementia. Furthermore, people with Parkinson’s may

• be depressed,
• have difficulty swallowing, or
• painful abnormal sensations when touched

.

These symptoms may or may not all occur together.

A neurologist assesses the symptoms using the UPDRS, the Unified Parkinson's Disease Rating Scale. Using this scale, the expert can

• assess the severity,
• the progression, and
• the stage of Parkinson’s disease

. Only with a correct and thorough diagnosis can the disease be treated properly and effectively.

In addition to the Parkinson’s triad, the onset of dementia as the disease progresses is one of the most feared symptoms. For patients, knowing what lies ahead is extremely distressing. The loss of mental faculties and reduced mobility cause many patients great anxiety. For them, both mean that they can no longer lead an independent life.

But family members, too, learn to cope with the mental and physical changes in the person with Parkinson’s.

Often, a pathological cause of Parkinson’s disease can be detected in the brain after the person’s death. However, research has still not been able to determine what actually triggers these changes.

The cause of Parkinson’s disease could be what are known as Lewy bodies. These are deposits in brain cells responsible for dopamine production. Because of these deposits, the nerve cells slowly die off, and dopamine can no longer be produced. This dopamine deficiency causes the stimulating effect of the basal ganglia on the cerebral cortex to diminish.

The deposits form as a result of misfolded proteins that cannot be properly transported out of the cell.

In particular, the impairment of motor function can be effectively treated with medication. To this end, the neurologist prescribes medications to the patient that replace the dopamine that is no longer produced or is produced in insufficient quantities. This can largely resolve the motor dysfunction.

These medications must be taken regularly and at specific times of day. This is the only way to achieve the desired effect.

In patients with the Parkinson’s triad who suffer from

• severe tremors,
• a slow and unsteady gait, and
• a forward-leaning posture,

properly adjusted medication can lead to an almost complete resolution of symptoms.

In addition, physical therapy, for example, can improve restricted movement patterns. In any case, it is important that every treatment be supervised by an experienced neurologist. The neurologist monitors the course of the disease and intervenes when necessary.

Parkinson’s disease remains incurable, and the progression of the disease with age still cannot be halted. However, with the right medication and supportive therapy, the course of the disease can certainly be positively influenced. The patient can then live well with the disease.

Neurologists are the right people to consult if Parkinson’s disease is suspected. Specialists in neurology have completed five years of training. This makes them experts in the diagnosis and treatment of neurological disorders, which include Parkinson’s disease. Typically, the primary care physician refers the patient to a neurologist’s office.

Although the disease is highly treatable, only about half of those affected seek treatment. The reason for this is a late and often incorrect diagnosis. Especially in the early stages, it can be challenging to correctly identify the symptoms.