Lowrey… stated about this article: ( Posted on August 13, 2018 by MyParkinsonsTeam) Volumes of objective, clear and succinct info about PD, with out the border line hysteria often associated with cognitive impairment. Most refreshing! Many thanks for sharing this.
I agree! But, knowing my readers, I have broken the article into three days, to hopefully avoid overload and ‘shut down’ without reading… day 2 will be “Secondary Parkinsonism” Day 3 outlines five “Atypical Parkinsonisms.”
Parkinsonism is a syndrome, or collection of symptoms, characterized by motor issues – bradykinesia (slowed movements), tremors, loss of balance, and stiffness. There are many types of parkinsonism classified by their cause and how they progress. Knowing which type of Parkinson’s someone has helps neurologists prescribe effective treatments and better predict how the disease will progress.
There is no conclusive test to identify what type of parkinsonism someone has. For some people, years may elapse between experiencing the first symptoms and receiving a definitive diagnosis of a specific type. Since all parkinsonisms share similar motor symptoms, Parkinson’s diagnosis can be very difficult. A correct diagnosis is more likely when performed by an experienced neurologist who specializes in movement disorders. Some people have multiple chronic conditions, making it difficult for doctors to identify whether parkinsonian symptoms are caused by a disease or a medication. In some cases, it is possible to have more than one type of parkinsonism.
The most common type of parkinsonism is Parkinson’s disease (PD), which accounts for about 80 percent of cases. No one is sure what causes most cases of Parkinson’s disease, so it is also known as idiopathic Parkinson’s. Idiopathic means “cause unknown.”
Deep inside the brain, regions called the basal ganglia and substantia nigra work together to ensure that the body moves smoothly. The substantia nigra produces a neurotransmitter – a chemical that helps nerves communicate – called dopamine. Messages sent by the brain to muscles to cause movement pass through the basal ganglia with the help of dopamine. In Parkinson’s disease, cells in the substantia nigra gradually stop producing dopamine and die off. With too little dopamine, the basal ganglia cannot facilitate movement as well. Researchers believe parkinsonian symptoms begin when the level of dopamine falls to about half of normal levels.
Subsets of Parkinson’s disease include:
- Late-onset Parkinson’s disease
Symptoms develop after age 50.
Most PD is late-onset.
- Early-onset or young-onset Parkinson’s disease
Symptoms develop before age 50.
Accounts for approximately 10 percent of PD cases
Tends to have slower progression, more medication side effects
Dystonia (painful spasms and abnormal postures) is more common in early-onset PD.
- Juvenile-onset Parkinson’s disease
Symptoms develop before age 20.
Often strong family history of Parkinson’s
- Familial Parkinson’s
Directly caused by genetic variants inherited from parents
Accounts for 10 to 15 percent of Parkinson’s disease cases
Parkinson’s disease dementia (PDD)
Between 50 and 80 percent of those with Parkinson’s disease eventually develop Parkinson’s disease dementia. On average, most people begin to develop PDD about 10 years after they receive a Parkinson’s disease diagnosis. PDD is often confused with Alzheimer’s and dementia with Lewy bodies. Parkinson’s disease dementia is usually diagnosed when motor symptoms occur first, at least a year before dementia symptoms.
Antipsychotics such as Haldol (Haloperidol) and Thorazine (Chlorpromazine)
Anti-nausea medications such as Reglan (Metoclopramide)
Antidepressants in the serotonin specific reuptake inhibitors (SSRI) class such as Prozac (Fluoxetine) and Zoloft (Sertraline)
Calcium channel blockers such as Flunarizine and Cinnarizine (not approved for use in the U.S.)