Parkinson’s disease


Parkinson's disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.

Alternative Names

Paralysis agitans; Shaking palsy


Parkinson's disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults. It affects both men and women.

In some cases, Parkinson's disease runs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.

Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why these brain cells waste away is unknown.

Parkinson's disease

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Parkinson's disease

Parkinson's is rare in children. It may occur because the nerves are not as sensitive to dopamine.

The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (called secondary parkinsonism) or certain medications.


Symptoms may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, and can include:

Symptoms include:

Other symptoms may include:

Exams and Tests

Your health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. They become more clear as the illness gets worse.

A doctor's examination may show:

Reflexes should be normal.

Tests may be needed to rule out other disorders that cause similar symptoms.


There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.

Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wears off, and symptoms can return. If this happens to you, your health care provider may need to change the:

Work closely with your doctors and therapists to find a treatment program that works best for you. Never change or stop taking any medications without talking with your doctor.

Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.

Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.

Medications used to treat movement-related symptoms of Parkinson's disease include:

Other medications may include:

Lifestyle changes may be helpful for Parkinson's disease:

Surgery may be an option for some patients with Parkinson's disease. These surgeries do not cure Parkinson's, but may help ease symptoms.

Support Groups

Support groups may help you cope with the changes caused by the disease.

See: Parkinson's disease - support group

Outlook (Prognosis)

Untreated, the disorder will get worse until a person is totally disabled. Parkinson's may lead to a deterioration of all brain functions, and an early death.

Most people respond to medications. How much the medications relieve symptoms, and for how long can be very different in each person. The side effects of medications may be severe.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if:

Also tell the health care provider about medication side effects, which may include:

Also call your health care provider if the condition gets worse and home care is no longer possible.


Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.

Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.

Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, et al. Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Mar 16;74(11):924-31.

Review Date: 9/26/2011
Reviewed By: A.D.A.M. Health Solutions Editorial Team, Ebix, Inc.: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network (9/26/2011).
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