In 1998, then 37-year-old actor Michael J. Fox revealed to the public that he had Parkinson’s disease. Through his revelation, this silent, debilitating disease that affects 1 million people in the United States was suddenly brought into the homes of everyone in America.
Parkinson’s is a progressive, neurological disease that affects the way you move. Nerve cells in the brain that produce dopamine – a chemical that helps control movement and allows muscles to move smoothly – break down in a person with Parkinson’s, resulting in difficulty moving.
“The three main symptoms of Parkinson’s are tremor, stiffness and slow movement,” said Dr. Michael Kitchell, neurologist at McFarland Clinic. “As the disease progresses other motor and non-motor symptoms may manifest – difficulty swallowing and speaking, masked face (no emotion), memory trouble, difficulty controlling bowls/bladder or depression.”
Diagnosis of Parkinson’s can be very difficult since there is no lab or blood test that can be done. An appointment will be scheduled with a neurologist to review medical history and symptoms.
“Parkinson's is diagnosed by clinical symptoms and signs. There must be bradykinesia (slowness). Tremor and rigidity are often present (75-80 percent), but the history and exam has to rule out other causes. Imaging is normal,” said Dr. Kitchell.
Currently there is no known cause for Parkinson’s disease. It affects all ages, races and genders. Symptoms mostly begin at age 50 to 60, although in some patients they appear earlier.
There are many problems treating this disease, says Dr. Kitchell – either trouble with medication (side effects and fluctuations like wearing off) or many other non-motor symptoms. Levadopa (a medicine that converts to dopamine in the brain) is the most effective drug used during treatment. Other medicines are needed to manage the non-motor symptoms of Parkinson’s. Over the course of the disease, medicines will constantly need to be adjusted, adds Dr. Kitchell, but Levadopa is always the last to go.
Surgery is an option for some patients with Parkinson’s disease, says Dr. Kitchell, though few people are ideal candidates. Deep brain stimulation (DBS) is the preferred non-drug treatment. Electrical impulses are generated by wire electrodes and sent to a target area in the brain. According to Dr. Kitchell, DBS is very effective in treating Parkinson’s but Levadopa or other drugs are still needed.
There is a 6 percent chance that this disease is hereditary, says Dr. Kitchell. Other risk factors, including environmental (exposure to pesticides or metals), are being studied to determine what actually causes Parkinson’s. Research is difficult and time-consuming.
“The treatments are many, and complex enough that most non-neurologists cannot treat the patient easily,” said Dr. Kitchell. Working closely with your physician is key to managing the symptoms of this disease, he added.
Being diagnosed with Parkinson’s disease can weigh on you emotionally. Managing your overall health is important to coping with this disease.
“Every day I see a Parkinson’s patient, I urge them to be more active – use it or lose it,” said Dr. Kitchell.