Parkinson's disease is a brain disorder. It occurs when certain nerve cells (neurons) in a part of the brain that controls movement die or become impaired. Normally, these cells produce a vital chemical known as dopamine. Dopamine allows smooth, coordinated function of the body's muscles and movement. When approximately 80 percent of the dopamine-producing cells are damaged, the symptoms of Parkinson's disease appear.
Parkinson’s disease usually affects people over the age of 50. It is a movement disorder that is chronic and progressive, meaning that symptoms continue and worsen over time. Nearly one million people in the United States are living with Parkinson's disease.
The cause of Parkinson’s is unknown. Although there is presently no cure, our specialists help patients manage its symptoms with treatment options such as medication and surgery. Our collaborative team of doctors includes neurologists with particular expertise in Parkinson’s diagnosis and treatment.
Symptoms of Parkinson’s
Symptoms of Parkinson's disease vary from patient to patient. They may also appear slowly and in no particular order. Many years may pass before symptoms interfere with normal activities. If you suspect you have early signs of the disease, know that you may not develop all of these symptoms.
The diagnosis of Parkinson’s does not come from a test, but instead requires a careful medical history and a physical examination to detect the primary signs of the disease, including:
- Rigidity: Stiffness when the arm, leg or neck is moved back and forth
- Resting tremor: Tremor when a body part is relaxed, such as in the hand, foot or chin
- Bradykinesia: Slowness in initiating or maintaining movement
- Loss of postural reflexes: Patients have poor balance and may fall
Other, more subtle symptoms of Parkinson's may include:
- Small cramped hand-writing
- Decreased arm-swing or scuffing of the foot on the affected side when walking
- Decreased facial expression
- Lowered voice volume
- Feelings of depression or anxiety
- Episodes of feeling “stuck in place” when initiating a step
- Increase in dandruff or oily skin
- Less frequent blinking or swallowing
- Vivid or active dreaming
Diagnosis and Treatment
Making an accurate diagnosis of Parkinson’s —particularly in its early stages—can be difficult. You may have already experienced this frustration. If you think you may have Parkinson’s, it’s important to seek the care of a neurologist who specializes in the disease.
There is no X-ray or blood test that can confirm Parkinson's disease. To diagnose Parkinson’s, our specialists will carefully review your health history and perform an examination. During this exam, your doctor may look to see if your expression is animated, whether a tremor is present in your limbs, if you walk normally or with short steps, and whether your arms swing easily.
Our doctors may also perform a blood test and brain scan (MRI) to rule out other conditions that have similar symptoms.
Treatment of Parkinson’s
Doctors at Sentara are committed to helping patients facing Parkinson’s restore lost motor functions. Sentara patients can work with board-certified movement specialists and even participate in research and clinical trials. And because our approach to treatment is uniquely holistic, a patient can explore medical treatment, physical therapy, and meet with a speech specialist — all on the same floor.
Many of the movement symptoms associated with Parkinson’s are caused by lack of dopamine—a simple organic chemical produced by the brain. Current medicines work primarily as dopamine replacement and can improve tremor, rigidity and slowness associated with Parkinson's disease. Many new medicines are being studied that may work in different ways to treat symptoms and slow the progression of the disease. It is common for people with Parkinson’s to take a variety of these medications.
Surgical Treatment and Deep Brain Stimulation
Currently, the most commonly used surgical treatment of Parkinson’s is a procedure called deep brain stimulation (DBS). This procedure is performed by a neurosurgeon experienced in this type of surgery. Our specialists will help to determine if you are a good candidate for this surgery.
During this surgery, doctors will place electrodes in the specific areas of your brain. A device called an impulse generator or IPG (similar to a pacemaker) is implanted under your collarbone to provide an electrical impulse to a part of the brain involved in motor function.
While deep brain stimulation is not a cure for Parkinson’s, and it does not slow disease progression, it can dramatically relieve some symptoms and improve your quality of life. Studies show benefits lasting at least five years. We currently offer monthly DBS clinics for patients. This allows us to finely tune your treatment, reducing your tremors and your need for medications.