Parkinson’s disease is caused by gradual deterioration in certain nerve centers inside the brain. The centers are those that control movement, particularly semi-automatic movements such as swinging your arms while walking. Deterioration of these nerve centers upsets the delicate balance between two body chemicals, dopamine and acetylcholine, which are essential for controlling the trans­mission of nerve impulses within this part of the nervous system. The resultant lack of control produces the symptoms of Parkinson’s disease.Nobody knows what causes the more common forms of the illness. In rare cases the nerve degeneration results from such factors as carbon monoxide poisoning or high levels of certain metals in body tissues. Sometimes Parkinson’s disease is the result of an earlier infection of the brain, such as encephalitis . High doses of certain drugs used in treating psychiatric conditions such as schizophrenia sometimes produce the symptoms of Parkinson’s disease.

What are The Symptoms?

One characteristic symptom is a type of tremor (sometimes incorrectly spoken of as “palsy,” which actually means paralysis). There is an involuntary, rhythmic shaking of the hands, the head, or both, often accompanied by a continuous rubbing together of thumb and forefinger. Such tremors are most severe when the affected part of the body is not consciously in use. Once you begin to consciously move the involved body part the tremor disappears or diminishes. If the disorder worsens, there is a gradual loss of most automatic physical movements such as the natural swinging of the arms that makes walking smooth, or the ability to write legibly or move your mouth and tongue so as to speak clearly. It becomes increasingly difficult to initiate new movements, or to change from one position to another. There is no pain, numbness, or tingling, simply a decreasing ability to move. Falls may be frequent because it is difficult to retain balance while walking. Simple activities such as rising from a chair can become hard to manage. Further symptoms include excessive salivation, abdominal cramps, and sometimes in the later stages of the disease, deterioration of memory and thought processes.

What are The Risks?

Most people who have Parkinson’s disease are elderly or in late middle age. Men are slightly more susceptible than women, and there is some evidence that Parkinson’s disease runs in families. Because the disease does not affect nerves that supply the heart or other vital organs, it is not directly life­threatening. A slowly progressing disability, however, can lead to mental depression.

What Should be Done?

There is no immediate cause for concern if, after age 50, you develop a mild tremor. Many people do so as they grow older. Consult your physician, however, if you have other symptoms of Parkinson’s disease, or if the tremor worsens. Special diagnostic tests are not always necessary. Your doctor may be able to make a diagnosis based on a general physical examination.

What is the Treatment?

Self-help: Encouragement and support from family and friends can be very helpful. Practical changes in the house, for example, bath­rail supports, special banisters along regular routes, and chairs with high arms will help you get around more easily and be more comfortable. Try to exercise regularly, and keep your spirits up by remaining or becoming as engaged in activities as possible.

Professional help: Modern drug treatment can do much to relieve the symptoms of Parkinson’s disease, particularly stiffness and immobility. In mild cases drugs are not usually prescribed, because they may have some troublesome side-effects. But your physician will probably want to see you about every six months to observe the progress of your condition. If drug treatment becomes necessary, medications that re-establish the balance of dopamine and acetylcholine within the affected area of the brain are usually prescribed. Some of these drugs tend to make the mouth unpleasantly dry, but that may seem more like a benefit than a side- effect if excessive salivation is a symptom of the disease in your case. New drugs are constantly being developed, but none has yet proved to be completely effective against the tremor that occurs in the disease. If tremors become a serious problem, it is sometimes possible to operate on the portion of the brain that is responsible for the problem, especially in younger people.

What are the Long-Term Prospects?

As yet no treatment has been found that slows down the progression of Parkinson’s disease, but the relief from symptoms that the various treatments give has kept many people with this disease in reasonable health.