Are all tremors a symptom of Parkinson’s? Read on to learn about the causes, symptoms, diagnosis, and management of Parkinson’s disease.
What is Parkinson's disease?
Parkinson’s disease is a disorder affecting the brain and nerves that progressively worsens over time. It is associated with generalised slowing of body movements and symptoms such as tremors at rest and stiffness of arms and legs.
What causes Parkinson's disease?
The exact cause of Parkinson’s disease is unknown. However, post-mortem findings in Parkinson’s patients have shown that there is damage to the part of the brain called ‘substantia nigra’, leading to the depletion of an important substance called dopamine. Dopamine is a chemical messenger that enables communication between different parts of the brain. When dopamine is inadequate, it affects the functioning of a part of the brain called the ‘basal ganglia’ that controls muscle movements.
This results in symptoms such as stiffness of the muscles and tremors.
What are the symptoms of Parkinson's disease?
A tremor in the hands and legs while at rest is one of the most common symptoms of Parkinson’s disease. The tremor typically occurs on one side and disappears while performing tasks such as lifting a pen, but returns when the hands and fingers are not moving. Parkinson’s disease affects each person differently, and not everyone necessarily experiences tremors. The other symptoms include:
- Stiffness of the hands and legs
- Loss of smell
- Sleep disturbances: acting out dreams (often unpleasant ones) with vocal sounds and violent hand and leg movements
- Changes in mood and depression
- Increased salivation and drooling
- Constipation
- General slowness of body movements (taking longer to do simple tasks)
- Fatigue
- Inability to walk steadily
- Progressive reduction in the size of handwriting
- Difficulty in swallowing
- Retention of urine
- Erectile dysfunction
How is Parkinson's disease diagnosed?
The diagnosis is mainly based on the symptoms and clinical findings. Sometimes your doctor may recommend imaging, such as an MRI, to rule out other probable causes of your tremor.
Is Parkinson's disease curable? What are the treatments for Parkinson's disease?
There is no known cure for Parkinson’s disease. However, some treatments help to reduce the symptoms:
- Medicines (levodopa, carbidopa, selegiline): These medicines offer symptom relief for an average of 3-6 years, after which the disease begins to progress again and the person becomes unresponsive to medicines
- Supportive therapies: Physiotherapy, occupational therapy, and speech therapy help the patients to cope with the disease in their day-to-day lives
- Deep brain stimulation: Through a surgical procedure electrodes are inserted into certain parts of the brain. The electrodes are connected through wires to a small electrical device implanted in the chest. These stimulate areas of the brain that regulate movements and thus reduce symptoms such as tremors, muscle stiffness, and slowness of movement
Am I a candidate for deep brain stimulation?
Deep brain stimulation is a surgical procedure that works to reduce specific symptoms of Parkinson’s disease (it’s important to note that it’s not a curative treatment). It can be a treatment option for you if:
- You’ve had Parkinson’s for longer than 4 years
- The prescribed medicines have proven to be ineffective in controlling symptoms
- You have excessive, uncontrolled, abnormal movements
You may not be a candidate for DBS if you’re suffering from memory loss. Further, DBS doesn’t help you with balance problems or non-motor issues such as decreased smell.
Your doctors will examine your disease status and the medicines that you are taking. You will also be required to undergo a brain scan a memory and thinking test to evaluate your cognitive abilities.
How do I manage the symptoms of Parkinson's disease?
- Take your medicines as prescribed
- Go for supportive therapy
- Exercise: This eases muscle rigidity, improves strength, and helps with flexibility and balance
- Diet: Eat healthy foods that have a high fibre content and consume sufficient water to help with constipation
- Join a support group: Since Parkinson’s disease is a progressive condition that worsens over time, being part of a support group may help you share your experiences and difficulties with people who can empathise with you
What are the side effects of medicines taken to treat Parkinson's disease?
Some side effects of anti-Parkinson’s medicines are:
- Nausea
- Vomiting
- Headache
- Abdominal pain
- On-off effect on long-term use (abrupt change from being able to move (on) to being immobile (off))
- Dry mouth
If you have severe side effects, inform your doctor. Your physician may prescribe a medicine that is more suitable for you.
What are the risk factors for Parkinson's disease?
- Older age
- Heredity
- Exposure to pesticides, herbicides
- Living industrial plants
I have a tremor. Does this mean I am suffering from Parkinson's disease?
Not all tremors indicate Parkinson’s disease. The typical tremor in Parkinson’s is called a resting tremor because it occurs while your hands and legs are at rest. These tremors usually begin on one side of your body and spread to the other side as the disease progresses. The body parts affected include your hands, arms, fingers, legs, and jaws. The tremors in Parkinsonism do not commonly affect the head, neck, or vocal cords (giving rise to a shaky voice). However, if you do have tremors, it’s always better to consult a neurologist to understand the cause.
