Parkinson’s disease: Your questions answered

Parkinson’s disease is a condition that occurs in 1 in 500 people, affecting an estimated 127,000 people in the UK.

Here, Dr Tabish Saifee, leading London-based consultant neurologist, provides an expert insight into the condition, including symptoms and treatment.

What is Parkinson’s disease?

Parkinson’s disease is a neurodegenerative brain condition caused by the gradual loss of nerve cells in the part of the brain that produces dopamine, a neurotransmitter (chemical messenger) that helps to regulate coordination and movement. The loss of dopamine-producing cells leads to symptoms, which mainly affect speed of movement.

In addition, Parkinson’s disease can also cause ‘non-motor’ symptoms that do not relate to movement. These symptoms can affect sleep, sense of smell, bowel function, urine, speech, and mood, among others.

What parts of the brain are affected?

Areas deep in the brain, called the basal ganglia and the midbrain, are known to be affected. However, Parkinson’s disease can also affect other areas of the brain. This might occur in a sequential order, causing symptoms.

How quickly does Parkinson's disease usually progress?

Parkinson's disease can develop at any age, but most people start to experience symptoms after the age of 60. Unfortunately, life expectancy after diagnosis is usually between 10 to 20 years.

Despite this, Parkinson’s disease progresses slowly and usually responds well to treatment. Symptoms can also be kept to a minimum in the early stages of the condition with the help of treatment.

What is the difference between a tremor that occurs in Parkinson’s disease and other types of tremors?

A Parkinson’s disease tremor, called a rest tremor, starts in the hand or leg. It often presents when the limb is relaxed or supported and it is not being used, for example, when lying in bed or watching TV. This is different to almost all other types of tremors, which occur when muscles are active or are being contracted.

How can treatment help to manage symptoms, such as tremors?

Medication for Parkinson’s disease can help to replace the natural levels of dopamine in the brain and improve movement-related symptoms. Other treatments, tailored to a patient’s individual needs, can be used to treat symptoms like constipation, mood changes and sleep problems.

Treatment for Parkinson’s disease usually involves the input of a multidisciplinary team of specialists, including neurologists, physiotherapists, speech and language therapists, psychologists, and occupational therapists.

When are procedures, such as deep brain stimulation, recommended?

During the last stages of Parkinson’s disease, some patients will develop extra movements associated with the effects of dopamine replacement. Other patients will experience unexpected fluctuations in their dopamine levels. For some patients, tremors will continue to be severe and persisting, despite first-line treatment.

When this occurs, patients may be recommended advanced therapies. This includes deep brain stimulation, which works as a pacemaker for the brain.

If you or a loved one are experiencing symptoms of Parkinson’s disease, do not hesitate to book an appointment with Dr Saifee today via his Top Doctors profile to receive expert diagnosis and treatment.