Parkinson's disease
Alternative names:
paralysis agitans; shaking palsy
Treatment:
There is no known cure for Parkinson's disease. Treatment is aimed at controlling the symptoms. Medications control symptoms primarily by controlling the imbalance between the transmitters.
The medications used vary, depending on the case. The type of medication, the dose, and the amount of time between doses, or the combination of medications used may need to be adjusted as symptoms change. Many of the medications can cause severe side effects, so monitoring and follow-up by the health care provider is important.
Deprenyl may be started early in the disorder to slow progression of symptoms and reduce the need for other medications. Amantadine and/or anticholinergic medications may be used to reduce early or mild tremors. Levodopa is a medication that the body converts to dopamine. It may be used to increase the body's supply of dopamine, which may improve movement and balance. Carbidopa is a medication that reduces the side effects of Levodopa and makes the Levodopa work better.
Additional medications to help reduce symptoms or control side effects of primary treatment medications include antihistamines, antidepressants, bromocriptine, monoamine oxidase inhibitors, and others.
Good general nutrition and health are important. Exercise should continue, with the level of activity adjusted to meet the changing energy levels that may occur. Regular rest periods and avoidance of stress are recommended because tiredness or stress can make symptoms worse. Physical therapy, speech therapy, and occupational therapy may help promote functioning, positive attitude, and independence.
Simple aides, such as railings or banisters placed in commonly used areas of the house, special eating utensils, or other devices, may be of great benefit to the person experiencing difficulties with daily living activities.
Social work or other counseling services may help in coping with the disorder, and with obtaining assistance as appropriate (safety equipment, Meals-on-Wheels, volunteer services, or other assistance).
Emotional support for the person with Parkinson's and everyone involved may help in coping with the changes caused by the disease. This may include the National Parkinson's Foundation or another group. See Parkinson's disease - support group.
Experimental or less common treatments may be recommended. For example, surgery to destroy tissues responsible for tremors may reduce symptoms in some people. Transplantation of adrenal gland tissue (and fetal brain tissue) to the brain has been attempted, with variable results.
Expectations (prognosis):
Untreated, the disorder progresses to total disability, often accompanied by general deterioration of all brain functions. It may result in an early death if untreated.
Treated, the disorder impairs people in varying ways. Most people respond (to some extent) to medications. The extent of symptom relief, and how long this control of symptoms lasts, is highly variable. The side effects of medications may be severe.
Complications:
- disability, varying degrees
- difficulty swallowing/eating
- difficulty performing daily activities
- injuries from falls
- side effects of medications
Calling your health care provider:
Call for an appointment with your health care provider if symptoms occur that are suggestive of Parkinson's disease.
Call for an appointment with your health care provider if symptoms of Parkinson's disease worsen or progress, or if new symptoms appear, including possible side effects of medications (see also the specific medication): Also call for an appointment with your health care provider if the condition deteriorates and the caregiver is unable to care for the person at home.
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