Parkinson’s Disease & Other Movement Disorders

Parkinson’s disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.

Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. People with PD may experience:

  • Tremor, mainly at rest and described as pill rolling tremor in hands. Other forms of tremor are possible
  • Bradykinesia
  • Limb rigidity
  • Gait and balance problems

The cause remains largely unknown. Although there is no cure, treatment options vary and include medications and surgery. While Parkinson’s itself is not fatal, disease complications can be serious. The Centers for Disease Control and Prevention (CDC) rated complications from PD as the 14th cause of death in the United States.

What Are the Symptoms of Parkinson’s Disease?

Parkinson’s disease is a movement disorder that progresses slowly. Some people will first notice a sense of weakness, difficulty walking, and stiff muscles. Others may notice a tremor of the head or hands. Parkinson’s is a progressive disorder and the symptoms gradually worsen. The general symptoms of Parkinson’s disease include:

  • Slowness of voluntary movements, especially in the initiation of such movements as walking or rolling over in bed
  • Decreased facial expression, monotonous speech, and decreased eyeblinking
  • A shuffling gait with poor arm swing and stooped posture
  • Unsteady balance; difficulty rising from a sitting position
  • Continuous “pill-rolling” motion of the thumb and forefinger
  • Abnormal tone or stiffness in the trunk and extremities
  • Swallowing problems in later stages
  • Lightheadedness or fainting when standing (orthostatic hypotension)

Treatments for Parkinson’s Disease

If you have Parkinson’s disease, you have a lot of choices for treatment. There’s no cure, but medicine and sometimes surgery can help.

Medicine can often keep your symptoms in check for years. Your doctor may suggest you try one of these drugs:

Levodopa. You may hear your doctor call this this L-dopa. It’s a drug that doctors prescribe most often for Parkinson’s.

When you have Parkinson’s, your brain gradually stops making dopamine — a chemical that helps send signals in your brain. Levodopa may improve your symptoms because it causes your body to make more dopamine.

To curb nausea and other possible side effects from levodopa, doctors usually suggest you take a drug called carbidopa along with it. A combination drug with both medicines is called Sinemet.

Rarely, some people can’t handle carbidopa and need to take levodopa alone. If that’s the case for you, it’s important not to take it at the same time as food or vitamins that have vitamin B6, which can affect how well your medicine works.

Most doctors try to delay starting people on levodopa as long as possible because the drug tends to stop working as well after a while. Sometimes, if you’ve been taking levodopa for several years, the medicine’s effects can wear off and you develop movement problems called “motor fluctuations.” These problems can happen gradually or suddenly.

Safinamide (Xadago) is an add-on medicine that may be prescribed when those taking levdopoa and carbidopa have a breakthrough of Parkinson’s symptoms that were previously under control. Studies show that adding this drug helps individuals experience longer times with reduced or no symptoms. The most common side effects are trouble falling or staying asleep, nausea, falls, and uncontrolled, involuntary movements.