4 June 2020 Author : Ana Calado Parkinson’s disease is the second most common degenerative disease of the central nervous system. It affects about 6.2 million people worldwide and it is estimated that in Portugal it can affect about 22 thousand people. The disease is more common in people over 60, although it can occur in any age. When it occurs in people under 50, it is called juvenile Parkinson’s disease, and represents about 10% of cases. Parkinson is a very rare condition in children and adolescents. In rare cases Parkinson's disease is hereditary, but in most cases the cause of the disease is unknown, although genetic and environmental factors are thought to be involved. What are the symptoms of Parkinson’s disease? The i nitial symptom s can be: Tremor, which is an involuntary rhythmic movement, usually at rest, that can affect several regions of the body such as the hands, arms, legs, or chin. Not all Parkinson's patients have tremor; Stiffness, noticeable as the limbs and trunk are “stuck”, lack of flexibility of the limbs or joints; Bradykinesia, that is, slowness of voluntary movements; Difficulty walking. Motor symptoms occur when degeneration (cell death) occurs in a small area of the brain, called the substantia nigra , with the consequent decrease in the production of a neurotransmitter (a chemical substance) called dopamine. Dopamine is important for transmitting signals between the substantia nigra and the other areas of the brain which are responsible for producing smooth and coordinated movements. In Parkinson's disease, non-motor symptoms may also appear, such as changes in odor, sleep disorders, depression, anxiety, pain, fatigue, or constipation. Over time, the symptoms slowly worsen , and other symptoms may develop such as: Postural instability; Difficulty in maintaining balance; Difficulty in speech and swallowing; Cognitive problems. Diagnosis and treatment There are no tests that can diagnose Parkinson's disease . The diagnosis is based on the symptoms and medical observation by a specialist, usually a neurologist. Some diagnostic tests can help to rule out other diseases with similar symptoms or to support the clinical diagnosis. Currently, Parkinson's disease has no cure and there are no drugs that can prevent it. There are therapies that can improve symptoms : The most used medication is levodopa, an antiparkinsonian drug that is very effective in reducing motor symptoms in the early stages of the disease. There are other drugs that can be used, alone or in combination, such as dopamine agonists and other drugs that delay dopamine degradation. Exercise and physical therapy programs can help patients improve their mobility and flexibility and are shown to be effective in improving some symptoms. There are medications and strategies to improve some of the non-motor symptoms. Deep brain stimulation surgery can be considered in patients with advanced Parkinson's disease, when drugs are no longer sufficient to improve motor symptoms. For advanced stages of the disease, there are other ways to administer the medication that reduce complications and improve symptoms. Examples are pumps that release dopamine agonists (apomorphine) subcutaneously (under the skin). Meet the neurology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
