As we talked about last week, Parkinson’s disease (PD) is a neurodegenerative disease that affects the nerve cells in the brain, primarily the nerve cells that produce dopamine. We talked about the common symptoms of tremors, slow movements, muscle stiffness, and walking and balance problems. Today we will talk about the possible complications of PD, how the diagnosis is made, and the treatment options.
What are the complications that can happen with PD?
Parkinson’s itself is not fatal but complications of PD can be serious. They include:
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Dementia – This usually occurs in the later stages of PD and is not very responsive to medications.
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Depression and emotional changes – Depression is common even in the early stages of PD. Other emotional changes such as anxiety or loss of motivation are also common. These symptoms usually do respond to medications.
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Hallucinations and delusions – Hallucination means that you see or hear something that is not actually there. Delusion means that you believe things that are not true, such as thinking someone (often a loved one) is trying to harm you or steal from you.
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Problems eating – Difficulty swallowing, or difficulty chewing can happen because PD affects the muscles in the mouth and esophagus. This can lead to choking, drooling, and poor nutrition.
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Sleep problems – People with PD can have problems such as waking up frequently throughout the night, waking up very early in the morning, or falling asleep during the day.
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Bladder problems – This can include difficulty urinating or trouble controlling your urine.
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Constipation – Due to a slower digestive tract.
How is Parkinson’s disease diagnosed?
There is no specific test to diagnose PD. Your doctor will make the diagnosis based on your medical history, your signs and symptoms, and a thorough physical and neurological exam. Sometimes it takes time to diagnose PD, especially in the early stages.
Your doctor may want to do some tests to rule out other conditions that may cause similar symptoms. This might include imaging tests of your brain (such as an MRI), or blood tests.
Your doctor may also give you a PD medication to try. Significant improvement with the medication will confirm your diagnosis. This doesn’t happen within a day or two though; it does take some time.
How is Parkinson’s disease treated?
Although PD cannot be cured, it can be treated to manage the symptoms. These treatments include:
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Medications that increase dopamine levels or substitute for dopamine in the brain, including:
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Carbidopa-levodopa (the most effective PD medication) – Levodopa Is converted to dopamine in the brain; carbidopa prevents it from converting to dopamine outside the brain. This medication comes in oral form, inhaled form, and an infusion form.
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Dopamine agonists – mimic the effects of dopamine in your brain.
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MAO B inhibitors and COMT inhibitors – Help prevent the breakdown of dopamine in the brain. These medications interact with many others, so they need to be used carefully.
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Anticholinergic medication – Older medications used to help control tremors. They have significant side effects, so are no longer used as often.
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Amantadine – A medication often used in early PD to control mild symptoms or may be added to other treatment during later stages.
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Deep brain stimulation – A surgical procedure, in which electrodes are implanted into a specific part of the brain. These electrodes are connected to a device that sends electrical pulses to your brain. This is usually offered to patients who have advanced PD with poor or fluctuating response to medications. Although it can provide sustained benefit in controlling PD symptoms, it does not keep PD from progressing.
Lifestyle changes that can help with PD include:
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Exercise – Regular exercise can help maintain muscle strength, flexibility, and balance. It can also improve general well-being and help with depression or anxiety. Tai Chi and Yoga can be particularly beneficial in improving balance and flexibility.
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• which is common in PD.
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Techniques to help avoid falls include –
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Distribute your weight evenly between both feet and don’t lean.
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Avoid carrying things while you walk.
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Do not walk backwards
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Make a U-turn instead of pivoting your body over your feet.
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Dr. Anita Bennett MD – Health Tip Content Editor