Parkinson’s disease: no cure, but helpful treatments available

Parkinson’s disease is a neurologic disease that affects the way a person moves. Brain cells (neurons) are lost or destroyed and, as a result, a messenger chemical called “dopamine” is reduced.

When dopamine levels are low, the clinical signs of the disease occur. The condition will worsen over time. It often starts with a mild tremor in a hand. It also progresses to produce slow and rigid body movements and poor posture.

Incidence

Over 10 million people suffer from Parkinson’s disease worldwide. More than 50,000 patients are diagnosed in the U.S. every year with Parkinson’s disease. There are probably many others who have it and are not diagnosed.

Signs and symptoms

• Shaking hand. A tremor of the hand is often the initial symptom of the disorder.
• Poor balance or easily lost balance
• General slowing of movements
• Shuffling walk with small, short steps.
• Muscle stiffness with a limited range of motion
• Speech changes. Soft speech is commonly seen. Loss of emotional variation in speech is also noted.
• Writing changes. Often handwriting becomes extremely small, called “micrographia.”

Causes

• Genetic. The disease is more commonly seen in family members. There are several identified genes involved in the development of the disease.
• Age. The risk of developing Parkinson’s increased with age, although it can occur in younger people. In fact, five percent of patients are diagnosed before age 50.
• Gender. Men develop the disease almost twice as often as women.

Treatment

There is no cure for Parkinson’s disease. The focus of treatment is on management and control of the signs and symptoms of the disease. It is also important to treat the symptoms and slow the progress of the disease.

Medications

There are several medicines designed to treat the symptoms of Parkinson’s disease. The average cost of treatment is $3,000-$5,000 annually. Surgical intervention can cost upwards of $100,000.

The most common is a medicine called Levodopa, which does a great job initially but loses effect over time. There are several other medications used, including some in combination with Levodopa. Your doctor will recommend the best medicine for your condition.

Deep brain stimulation

This has been shown to help in advanced cases to control unwanted movements from earlier treatments and reduce the other symptoms of Parkinson’s disease. An electrode is planted deep in the brain, and an energy source is worn on the body. Unfortunately, deep brain stimulation treats symptoms and does not alter the course of the disease.

Exercise

Experts stress how important regular and programmed exercise is to slow the progress of the disease and to make it easier to maintain normal movement, balance and flexibility. There are physical therapists who specialize in designing and supervising exercise programs for patients with Parkinson’s disease. Your doctor will recommend a specialized therapist.

Remember, there is no cure for Parkinson’s disease, but it can be effectively mitigated and, with multiple treatment approaches, the quality of life can be improved.

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.