What is Parkinson’s?

Parkinson’s Disease is a progressive neurological condition affecting the brain. It is one of the more common neurological conditions, affecting around 1 in every 500 people in the UK. The number of people with Parkinson’s is increasing each year as the UK population ages. The Parkinson’s Team is currently aware of over 1700 people living with Parkinson’s in Coventry and Warwickshire, although statistically there may be more than this.

 

What causes Parkinson’s?

The symptoms of Parkinson's are caused, in part, by a reduced level of dopamine within the brain. Dopamine is a chemical used to transmit messages between brain cells. Brain cells within the region called the basal ganglia begin to deteriorate and levels of dopamine start to fall. When levels reach about 60% of normal, movement symptoms begin to develop. It is not yet known why the cells start to deteriorate.

Changes to other neuro-transmitter pathways in the brain may lead to additional (often non-motor) symptoms in Parkinson’s. As well as dopaminergic deficiency, symptoms may arise because of problems in the serotonergic, cholinergic and noradrenergic pathways.

 

How is it diagnosed?

Parkinson's should be diagnosed by a doctor with experience in Parkinson's, usually a neurologist or care of the elderly physician. It is diagnosed clinically, on the basis of finding the signs and symptoms of Parkinson's. If the diagnosis is not clear, investigations such as brain imaging might be used.

 

Symptoms and signs

Parkinson’s causes both 'motor' and 'non-motor' symptoms. Motor (or movement) symptoms consist of:

• Tremor - an involuntary shaking which can involve arm, leg and/or head. It usually affects one side of the body before the other
• Rigidity – stiffness of the limbs
• Bradykinesia – slowness of movement, for example, difficulty turning over in bed or doing up buttons
• Postural instability - impaired postural reflexes making it difficult to adjust or maintain balance

Not all of these symptoms will affect people at diagnosis. For example, only 70% will have a tremor. Non-motor symptoms can include depression and anxiety, pain, fatigue, loss of sense of smell, sleep disturbance, bladder problems and constipation. However, everyone is different and how you are affected by the symptoms of Parkinson's compared to others will vary.

Parkinson's is slowly progressive. The symptoms change as the condition develops. Drug prescriptions and therapies also change to reflect this progression.

During all stages of Parkinson's Disease, people are regularly reviewed by the Parkinson's team with support, as needed, from the specialist nurses, physiotherapists, occupational therapists, speech and language therapists and dieticians.

 

Other types of Parkinsonism

There are other conditions that have similar symptoms (ie Parkinsonism) to Parkinson's Disease but where the cause is different. There may be additional clinical features and/or disease progression is different. These disorders either do not respond at all or respond poorly to treatment with levodopa.

These other Parkinsonian conditions include: drug-induced Parkinsonism, Vascular Parkinsonism and the Atypical Parkinsonisms (Dementia with Lewy Bodies, Progressive Supranuclear Palsy, Multiple System Atrophy and Corticobasal Degeneration). If any of these conditions are relevant to you, your Consultant will discuss this with you.

 

Updated  30 January 2018

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