Parkinson's Disease 

Specialists at Neurology One offer expert diagnosis and specialized treatment for people with Parkinson’s disease. A person with this neurological disorder will gradually experience changes in their movement, speech, mood, and thinking processes.

At Neurology One, a team of the best Board Certified and Fellowship Trained neurologists in Orlando, nurses, physical therapists, and rehabilitation experts work together to control and treat the condition effectively. As each person with Parkinson’s disease experiences different problems and challenges, we understand the importance of an individual treatment plan for maintaining the quality of life. This is why Neurology One offers a Clinical Team approach to provide the best care, ensuring continuity with your healthcare team.  

We understand the challenges associated with this condition can be stressful for patients and family members. Therefore, we meet regularly with patients and their caregivers to provide up-to-date information about the treatment and disease. A comprehensive treatment plan is developed after a thorough evaluation of the patient.

Although there is no cure for Parkinson’s, our goal is to help patients and families find the best medication to improve their daily condition and quality of life. We use a multidisciplinary approach, using the input of Physical Therapists, Occupational Therapists, Speech and Swallow experts, Neuropsychologists, Neurosurgeons, Social Workers and Psychiatrists among others and we have access to the latest medications and surgical therapies, such as deep brain stimulation (DBS), MR focused ultrasound and Levodopa Infusions if conservative treatment alone is ineffective

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurological disorder that impairs mobility and could impair cognition. The first signs that bring a person for medical attention are usually tremors, problems with dexterity and gait abnormalities. The symptoms result from a decrease in dopamine in the brain. 

Dopamine is a critical neurotransmitter that facilitates smooth and coordinated movement of the muscles. 

The substantia nigra is the part of the brain responsible for producing dopamine. In Parkinson’s disease, the cells of the substantia nigra die. This results in a decrease in dopamine levels. The symptoms of Parkinson’s appear when they drop to 60 to 80 percent.

There is usually a gradual onset of symptoms that worsen over time. When the disease progresses, speaking and walking become difficult.

This is mostly an age-related degenerative brain condition; however, some cases may result from genetic mutations Abnormal protein deposit in the brain causing this disease. This condition causes slowed movements, balance problems, tremors and more. There are many different ways to treat the condition, but it isn’t curable.

More than 10 million people worldwide live with Parkinson’s disease, including about 1 million in the U.S. Although Parkinson’s disease most commonly affects people over 50, it can also affect younger people. Approximately 10 percent of Parkinson’s diagnoses occur before age 50. 

What are the symptoms?

Muscle control loss is one of the most well-known Parkinson’s disease symptoms. However, Parkinson’s disease symptoms are not limited to muscle control problems.

Motor-related symptoms

Motor symptoms – These symptoms are related to movement and include:

Slowed movements:

The presence of this symptom is necessary to diagnose Parkinson's disease. A person with this condition describes it as muscle weakness, but it is actually a problem of muscle control, not physical weakness.

A tremor:

This occurs when muscles are at rest. 70-80% of Parkinson's disease cases experience this rhythmic shaking of muscles even when they aren't being used.

Rigidity or stiffness:

Parkinson's disease is characterized by lead-pipe rigidity and cogwheel stiffness. Body parts with lead-pipe rigidity move with constant, unchanging stiffness. A combination of tremor and lead-pipe rigidity leads to cogwheel stiffness. The movements appear jerky and stop-and-go.

Unstable posture or walking gait:

Due to Parkinson's disease's slowed movements and stiffness, people tend to hunch over or stoop. It's noticeable when someone walks because they will take shorter, shuffling strides and not move their arms as much. It may take several steps to turn while walking.

Other motor symptoms include:

Blinking less frequently than usual:

Reduced facial muscle control can also cause this symptom.

Small or cramped handwriting:

It is caused by muscle control problems and is referred to as micrographia.

Drooling:

This is another symptom of facial muscle weakness and swallowing impairment.

Mask-like facial expression:

A condition in which facial expressions change very little or not at all.

Trouble swallowing:

It occurs when throat muscles are less controlled. As a result, pneumonia and choking are more likely to occur.

An unusually soft voice:

Due to a lack of muscle control in the throat and chest, this occurs.

Non-motor symptoms

It is possible to experience symptoms unrelated to movement or muscle control.

Non-motor symptoms include:

  • Autonomic nervous system symptoms. These include low blood pressure when standing up), and gastrointestinal problems such as constipation. Other symptoms include urinary incontinence and sexual dysfunction.
  • Depression.
  • Loss of sense of smell
  • Sleep problems 
  • Focus and thinking difficulties (Parkinson’s dementia).

Diagnosing

Neurologists use the history and clinical examination, supported by brain imaging technology to diagnose Parkinson’s disease, as no definitive test can be used to determine whether a person has the disease.

Causes of Parkinson’s disease

There is no known cause of Parkinson’s disease. Genetics and environment may both play a role. Low levels of dopamine and norepinephrine are linked with Parkinson’s.

However, research has identified groups of people more likely to develop parkinsonism, which include:

  • Sex. Men are one and a half times more likely to develop Parkinson’s than women.
  • Race. White people have a higher prevalence of Parkinson's disease than Black or Asian people
  • Age. The onset of Parkinson's usually occurs between the ages of 50 and 60. About four percent of cases occur before the age of 40.
  • Family history. There is an increased risk of Parkinson's disease in people with close family members with the disease.
  • Toxins. Some toxins may contribute to Parkinson's disease risk.
  • Head injury. Parkinson's disease may more likely develop in people with head injuries.

Parkinson’s disease stages

Parkinson’s is a progressive disease, so the signs and symptoms usually worsen with time.

To categorize its stages, many doctors use the Hoehn and Yahr scale. This scale divides symptoms into five stages. This tool helps healthcare professionals understand the severity of disease signs.

Stage 1

The mildest form of Parkinson's disease is stage 1. You may not even notice any symptoms because it's so mild. It may not yet affect your day-to-day life or tasks. Even if you experience symptoms, they may only affect one side.

Stage 2

It can take months or even years to progress from stage 1 to stage 2. There will be differences in everyone's experience.

In this moderate stage, you may experience the following symptoms:

  • muscle stiffness
  • tremors
  • changes in facial expressions
  • trembling

Having stiff muscles can make daily tasks more difficult, causing you to take longer to complete them. However, during this stage, balance problems are unlikely to occur.

Both sides of the body may experience symptoms. You may notice changes in posture, gait, and facial expressions.

Stage 3

Symptoms reach a turning point at this middle stage. Symptoms may be more noticeable, but you won't experience new ones. Additionally, they may interfere with all of your daily activities. There is a noticeable slowdown in movement, which slows down activities. Falls become more common due to balance issues. It is generally possible for people with Parkinson's disease stage 3 to maintain their independence and complete their tasks without assistance.

Stage 4

Changes are significant as stage 3 progresses to stage 4. Standing without a walker or assistive device will be extremely difficult at this point. There is also a significant slowdown in muscle movements and reactions. It can be unsafe to live alone, even dangerous.

Stage 5

At this stage, severe symptoms require round-the-clock assistance. Standing will be difficult. A person may need a wheelchair. During this stage, Parkinson's patients may become confused, delusional, or hallucinatory. In the later stages of the disease, complications can occur.

Treatment at Neurology One

In Orlando, Neurology One provides extensive care to patients with Parkinson’s. Neurology One has more than 25 years of experience in diagnosing and managing Parkinson’s disease. Our highest priority is to meet the needs of the patient and his or her family.

As part of our management approach for people with Parkinson, we combine gold-standard interventions with the latest discoveries in scientific literature and innovative research. It is the practice of all our physicians and nurse practitioners to provide evidence-based care. To improve quality of life, we strive to educate patients and their families about Parkinson’s. 

Parkinson’s is treated with a combination of:

  • Changes in lifestyle
  • Prescription medications
  • Therapies

Treatment options available for Parkinson’s disease include:

  • Deep brain stimulation
  • Speech therapy
  • Physical therapy
  • Medicine treatment
  • Individualized treatment plan
  • Occupational therapy
  • Support for caregivers
  • Social services
  • And neuropsychology services

Getting enough sleep, exercising, and eating a balanced diet is essential. Occupational therapy, physical therapy, and speech therapy can also improve communication and self-care.

In almost all cases, medication will be needed to treat the disease’s physical and mental symptoms.

Parkinson’s prognosis

Parkinson’s complications can reduce the quality of life and prognosis significantly. For example, individuals may experience falls or blood clots in their legs and lungs. These complications can be fatal. An effective treatment increases your chances of survival and improves your prognosis.

Although Parkinson’s cannot be slowed down (yet), you can work to overcome the obstacles and complications to achieve a better quality of life. The best neurologists in Orlando, including clinically trained neurologists and specialists in movement disorders, offer expertise on Parkinson’s disease.