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Read articleParkinson's disease is a slowly progressive condition in which the brain loses cells that control smooth movement, producing tremor, stiffness and slowness. Treatment does not cure it, but it can restore a great deal of independence for many years.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Tremor of a hand at rest, often described as pill-rolling, which reduces on movement
- Slowness in everyday tasks — buttoning a shirt, turning in bed, rising from a chair
- Stiffness of the arms and legs
- Small, cramped handwriting
- Shuffling short steps, stooped posture and reduced arm swing
- Soft, monotonous voice and reduced facial expression
- Constipation, disturbed sleep and low mood, often appearing before the tremor
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- A persistent tremor at rest, especially on one side
- Repeated falls, or freezing of the feet while walking
- Difficulty swallowing, or choking on food and water
- Sudden worsening of movement, confusion or hallucinations in a treated patient
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Neurological examination — the diagnosis is primarily clinical
- Review of all current medicines, since some cause similar symptoms
- MRI or CT of the brain to exclude other causes
- Thyroid function and vitamin B12 levels
- Assessment of response to treatment, which itself supports the diagnosis
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Medication to replace or mimic the missing brain chemical, adjusted over time
- Physiotherapy for balance, gait training and prevention of falls
- Speech and swallowing therapy where the voice or swallowing is affected
- Home modification — removing loose mats, adding grab bars and better lighting
- Attention to constipation, sleep, blood pressure on standing and depression
- Family education, because the condition is managed at home far more than in hospital
This page is general information, not a diagnosis
Parkinson's Disease can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Neurology department. If a symptom is sudden or severe, call 9281862028.
