PD is caused by a loss of certain nerve cells in the brain. The loss of these cells causes a decrease in the amount of a brain chemical called dopamine. Low dopamine levels cause PD symptoms.
The brain cells may be lost because of genetic defects, the environment, or some combination of the two. A small amount of people with PD have an early-onset form. This type is caused by an inherited gene defect.
Secondary PD has similar symptoms but is caused by several factors such as:
Antipsychotic drugs, such as
- Antinausea/gastric motility medications such as prochlorperazine and metoclopramide
- Cardiovascular drugs, such as some calcium channel blockers and antiarrhythmic drugs
- Valproic acid
(a medication used for seizures,
Carbon monoxide poisoning
- Manganese poisoning
- IV drug abuse contaminated by MPTP (a type of neurotoxin)
(medicine to treat schizophrenia and high blood pressure)
- Insecticide exposure
The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no tests to definitively diagnose PD. The doctor will ask many questions. This will help to rule out other causes of your symptoms.
Tests to rule out other conditions may include:
- Blood tests
- Urine tests
CT scan—a type of x-ray that uses a computer to make pictures of structures inside the head
MRI scan—a test that uses magnetic waves to make pictures of structures inside the head
PET scan—a scan that makes images that show the amount of activity in the brain. A special kind of PET scan called a DAT scan may be used in the evaluation of PD.
Currently, there are no treatments to cure PD. There are also no proven treatments to slow or stop its progression. Some medications may help to improve symptoms. Over time, the side effects of the medication may become troublesome. The medications may also lose their effectiveness.
Examples of medicines include:
(Cogentin) and biperiden (Akineton)
Monoamine oxidase inhibitors, such as
(Mirapex), Cabergoline (Dostinex), Rotigotine (Neupro),
Depression or hallucinations may also occur with PD and its treatment. Medicines may be prescribed to attempt to treat these conditions. The drugs may include:
- Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressant (such as,
medicine (such as,
are common in those with PD. Bisphosphonates are medications that may help reduce this risk.
Constipation, drooling, and
lightheadedness when standing
are common and may improve with medications or other treatments.
Different brain operations are available, and many more are being researched including:
- Deep brain stimulation (DBS)—implanting a device to stimulate certain parts of the brain; can decrease tremor and rigidity
- Thalamotomy and pallidotomy—destroying certain areas of the brain to improve tremor when medication does not work (not as common as deep brain stimulation)
- Nerve-cell transplants (research only)—to increase amount of dopamine made in the brain
Therapy can improve muscle tone, strength, and balance. It will include exercises and stretches.
Consider joining a support group with other people with PD. It will help to learn how others are learning to live with the challenges of PD.
If you are diagnosed with PD, follow your doctor's