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Parkinson's disease is a progressive disorder of the central nervous system, meaning symptoms get worse over time. Its symptoms -- tremors (often starting in one hand), slowed movement, rigidity -- are caused when nerve cells in the brain that produce a chemical called dopamine start to break down and die. Dopamine is a neurotransmitter, or messenger, that sends messages to the parts of the brain that control movement. Parkinson' s disease affects men and women equally, usually after age 60. About 10% of people with the disease are under age 40. No cure is available, but drug therapy can help reduce the symptoms.
Symptoms can start very gradually and not be noticed for years. Often they start on one side of the body.
Secondary symptoms may include the following:
Researchers aren' t sure why some people get Parkinson' s. In people with Parkinson' s, brain cells that produce the chemical messenger dopamine start to die. Dopamine send signals to the areas of the brain that deal with muscle activity and movement. The brain starts to lose the ability to tell the body when and how to move. Risk factors include having a relative with Parkinson's, being exposed to certain pesticides and herbicides, getting older, and lower levels of estrogen in women.
Because no test can positively identify Parkinson's, your health care provider may rely mostly on interviews with you and your family. Your health care provider may order brain scans to measure dopamine activity. Tests may be needed to rule out other conditions that cause similar symptoms.
Exercise, especially intensive exercise, has been shown to improve symptoms and help maintain balance and mobility. Walking, swimming, jogging, or even dancing may help. Because people with Parkinson's disease have low levels of vitamin D, they are at risk of osteoporosis. Lifting weights can help reduce that risk. Your doctor may recommend an exercise program for you.
Several drugs treat the symptoms of Parkinson's, but they do not cure the disease. Your doctor may change medications and adjust dosages frequently. Certain drugs used for the treatment of other diseases, especially glaucoma, heart disease, and high blood pressure, may also be used to help treat Parkinson's disease. Sometimes doctors may try to delay drug therapy, because the drugs tend to become less effective over time. Among the drugs used are:
Psychotherapy can help you cope with associated conditions such as depression. Speech, physical, and occupational therapy may help.
Don' t try to treat Parkinson' s disease with alternative therapies alone. Used with conventional medications, alternative therapies may help provide some relief of symptoms and slow progression of the disease.
A low protein diet helps the body use levodopa and carbidopa most efficiently, so your doctor may suggest that you limit the protein you eat, and eat most protein in the evening and little at breakfast or lunch. Your doctor should monitor your diet to make sure you get enough nutrients. A fiber supplement may help avoid constipation, which is a common symptom of Parkinson's.
Many supplements may interact with medications you take for Parkinson's, or may only be effective at particular doses. Do not take any supplements, even vitamins, without your doctor's guidance.
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink two to four cups per day. You may use tinctures alone or in combination as noted.
Consult a trained homeopath who can determine the right remedy for you and change it when your symptoms change.
May help with increasing circulation and decreasing muscle spasm. Cranio-sacral therapy, an osteopathic form of body work that focuses on the brain and spinal column, may decrease tremors and improve function.
May help people with Parkinson's improve motor skills and balance, and help them walk better.
Tai chi and yoga can improve balance, flexibility, and range of motion in people with Parkinson's disease. They may also improve emotional well-being.
Traditional Chinese Medicine views disease as caused by internal imbalances. It has historically been used to treat Parkinson's with acupuncture and individually prepared herbal remedies. One study showed that acupuncture improved symptoms significantly in a small group of people with Parkinson's. In particular, scalp acupuncture and acupuncture with electrical stimulation have shown positive results in some cases. People with Parkinson's may also get sleep and rest benefits from acupuncture. If you consult a Traditional Chinese Medicine practitioner, make sure your doctor is aware of any suggested treatment.
Since Parkinson's disease gets worse as time goes on, you will need to be under constant medical care. Drug treatments often become less effective over time, and you must keep a close eye on your symptoms.
Exercise will also help you improve mobility.
Barichella M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson's disease. Mov Disord. 2009 Oct 15;24(13):1881-92. Review.
Chen LW, Wang YQ, Wei LC, Shi M, Chan YS. Chinese herbs and herbal extracts for neuroprotection of dopaminergic neurons and potential therapeutic treatment of Parkinson's disease. CNS Neurol Disord Drug Targets. 2007 Aug;6(4):273-81. Review.
Earhart GM. Dance as therapy for individuals with Parkinson disease. Eur J Phys Rehabil Med. 2009 Jun;45(2):231-8. Review.
Hass CJ, Collins MA, Juncos JL. Resistance training with creatine monohydrate improves upper-body strength in patients with Parkinson's disease: A randomized trial. Neurorehabil Neural Repair. 2007;21(2):107-15.
Hauser RA, Zesiewicz TA. Advances in the pharmacologic management of early Parkinson disease. Neurologist. 2007;13(3):126-32.
Joh TH, Park HJ, Kim SN, Lee H. Recent development of acupuncture on Parkinson's disease. Neurol Res. 2010 Feb;32 Suppl 1:5-9.
Lees A. Alternatives to levodopa in the initial treatment of early Parkinson's disease. Drugs Aging. 2005;22(9):731-40.
Samantha J, Hauser RA. Duodenal levodopa infusion for the treatment of Parkinson's disease. Expert Opin Parmacother. 2007;8(5):657-64.
Sheffield JK, Jankovic J. Botulinum toxin in the treatment of tremors, dystonias, sialorrhea and other symptoms associated with Parkinson's disease. Expert Rev Neurother. 2007;7(6)637-47.
Vaidya AB, Rajagopalan TG, Mankodi NA, Antarkar DS, Tathed PS, Purohit AV, Wadia NH. Treatment of Parkinson's disease with the cowhage plant-Mucuna pruriens Bak. Neurol India. 1978 Dec;26(4):171-6.
Yuan H, Zhang ZW, Liang LW, Shen Q, Wang XD, Ren SM, Ma HJ, Jiao SJ, Liu P. Treatment strategies for Parkinson's disease. Neurosci Bull. 2010 Feb;26(1):66-76.
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