Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Page last reviewed: 30 April 2019 Next review due: 30 April 2022
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
Genetics And Environmental Factors
Environmental factors are also significant contributors to the development of Parkinson’s and may, in some cases, work in tandem with genetics to cause the disorder. A study in 2004 showed that people who had a mutation of the CYP2D6 gene and were exposed to pesticides were twice as likely to develop Parkinson’s.
On their own, pesticides, metals, solvents, and other toxicants have each been loosely linked to Parkinson’s. But what’s interesting is that those who had the CYB2D6 mutation and were not exposed to pesticides were not found to be at any higher risk of developing the disorder.
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Costs Of Our Parkinsons Home Care
The cost of care for people living with Parkinsons and advanced neurological conditions will be typically higher, as it is a specialist care at home service.
It is worth considering however that live-in care is often cheaper than the total cost of domiciliary care for people living with Parkinsons. When a person is receiving hourly care, provided by a domiciliary care provider it is likely that you will be charged extras for additional services to support the persons Parkinsons needs on top of the cost of a carer visiting. These extras add up and can become costly over time. The total cost to provide hourly care to someone living with high or complex needs can sometimes exceed the price of an inclusive live-in care service.
Parkinsons care at home is typically in line with and sometimes less than what you would pay for residential care, with the added benefit of receiving one-to-one tailored care for the person living with Parkinsons, which simply cannot be achieved in a care home.
What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
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How Often Does Parkinsons Run In The Family
Most Parkinsons cases have no connection to a genetic cause, but scientists have found that some gene mutations can heighten an individuals risk. Researchers believe that a better understanding of these genes may improve ways of identifying and treating the illness.
The National Institute of Neurological Disorders and Stroke reports that an estimated 15 to 25 percent of people with Parkinsons have a family history of the disorder. The Michael J. Fox Foundation for Parkinsons Research estimates that about 10 percent of cases are linked with a genetic cause.
Parkinsons doesnt stand out as a hereditary disease over and above any other chronic diseases that people deal with, says Rebecca Gilbert, MD, PhD, chief scientific officer for the American Parkinson Disease Association in New York City. But if you have a parent with Parkinsons disease, you have about a fourfold greater risk over the general population.
Still, that risk is relatively small. About 1 percent of the population over 60 has Parkinsons, according to the Michael J. Fox Foundation, and that number rises to about 4 percent for those who have a mother or father with the illness, according to Dr. Gilbert. The overall message is: Just because you have a gene linked to Parkinsons does not mean you will get the disease.
Listen To The Podcast
“He said: ‘Have you got a big mortgage? How many kids have you got? Sorry to say you’ve got Parkinson’s’.
“That was a lousy way of telling it, as if he thought he was God.”
Dave was devastated by the diagnosis, but determined to deal with it differently to his father and not keep it a secret.
“I walked away from the specialist, across Wimbledon Common, and tears were running down my cheeks. But the sun was shining and I thought, the sun’s going to shine for a bit longer yet.”
He allowed himself 24 hours to feel down about the news, although admits the first three months were hard to get through.
Dave and his wife Carolyn, a clinical psychologist decided to tell their sons, then aged seven and four, that their dad had the neurological condition as soon as questions arose, to make it a normal part of family life. Carolyn has since helped to write a guide on talking to children about Parkinson’s.
“We’ve been very open with the kids from day one because, again, just what happened with my dad, just keeping a secret. And I think it’s important that they knew about it.
“They know I’m getting worse and they know it’s very serious, but I’m just ‘Dad’.”
He says the way his children have accepted it makes him feel guilty about the way he viewed his own father when he turned up unannounced to his football games.
“I didn’t like to see him hunched up and looking shaky on the side of the pitch and I’m embarrassed by that reaction now.
Dave’s tips for living with Parkinson’s
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What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
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Hanie Talks About Her Father And Parkinsons Disease
Stephanie Freidberg, a 37-year old American/Belgian clinical psychologist living in Brussels agreed to talk about her father Stephen, his experiences of living with Parkinsons Disease the impact that his illness had on her how it changed their relationship her regrets cherished memories and how caring for him has made her more empathetic.
She hopes that by being so honest about such a deeply emotional subject, others might feel more able to speak about their own experiences of Parkinsons Disease, whether as a patient, family member or friend.
Can you tell us about your father and your relationship?
My father was diagnosed with Parkinsons Disease in 2001. He passed away in 2012. He was a wonderful man. He had it all. One word in particular comes to mind to describe him : decent. He was an extremely decent, fair and moral person. He was also brilliant and extremely good looking. He had a great sense of humour as well. As I say, he had it all. I loved him very much and feel that he was a rock in my life. He died when I was 29 and pregnant with my first child.
How did your father react initially to his diagnosis and how did this change over time?
When and how were you told you that he had Parkinsons Disease? What was your initial reaction? And, how did you come to terms with the news ?
What Parkinsons Disease symptom did you discover that you hadnt known about before? How would you explain it to people who arent familiar with Parkinsons Disease?
Memory Or Thinking Problems
Having issues with thinking and processing things could mean your disease is progressing. Parkinsons is more than a movement disorder. The disease has a cognitive part as well, which means it can cause changes in the way your brain works.
During the final stage of the disease, some people may develop dementia or have hallucinations. However, hallucinations can also be a side effect of certain medications.
If you or your loved ones notice that youre getting unusually forgetful or easily confused, it might be a sign of advanced-stage Parkinsons.
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What Are The Chances Of Getting Parkinsons If My Siblings Have It
Three older siblings have Parkinsons disease, but the three younger siblings have shown no symptoms yet. Genetic testing for Parkinsons can give answers.
Dr. Zbigniew K. Wszolek responds:
The chance that you have the genetic form of Parkinson’s disease is relatively high, but it’s impossible to say how high without knowing more about your family history. For example, knowing if you have a parent or grandparent with Parkinson’s can clarify whether your family carries one of five major genes thought to cause the disease.
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The best advice I can give you would be to visit a genetic clinicavailable at most major universitieswhere you can undergo a test to learn whether you are a genetic carrier or not. A genetic counselor can also explain to you the pros and cons of testing. It’s important to realize that knowing you are a mutation carrier will not change anything, because we don’t have a treatment available to halt progression of the disease. But some people are interested in genetic testing because they feel they can use the information to modify their lifestyle some may choose not have children, for example, while others may decide to join clinical trials. Also, knowing whether or not you are a gene carrier may bring some peace of mind.
What Can I Do
Have family chats once a month or even once a week. Use this time to share with your parents how Parkinsons makes you feel. They can also explain some of what they are going through. This will help you understand each other better, and you can try to find ways to help each other and reduce stress.
Talk to someonewhoever you feel a connection with. This could be a friend, relative, teacher or counselor. You may have concerns or worries you dont feel comfortable telling your parents about. Expressing these feelings might help you feel better, and the person might have good advice.
Get involved. Sometimes we feel better when we can DO something to improve a situation. Go to a local Moving Day®, organize your own fundraiser to support PD research through Parkinsons Champions or raise awareness of PD at your school, church or other community center. The Parkinsons Foundation can help with ideas on how to get involved.
Connect with other people your age. You are not the only one with a parent with Parkinsons disease. If your parents are in a Parkinsons support group, they might know other people with PD with children who would like to talk or hang out. Even your parents doctor may know of other children to connect with. Connect online with others in the same situation. Some groups already existtry searching for the groups Young Adult Children of Parkinsons Patients or Parkinsons, Children Living With THEM, or create your own!
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Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.
Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.
Is Parkinson’s Considered A Hereditary Disease
Nope, Parkinson’s isn’t considered a hereditary disease in most people. According to the Parkinson’s Foundation, about 90% of people with the disease have no genetic link.
And while there are some genetic markers for Parkinson’s, they don’t guarantee that a person will get the disease. A genetic mutation is just one of several risk factors for Parkinson’s disease. There may also be lifestyle choices and environmental factors involved in the development of the disease. In fact, most people with Parkinson’s disease aren’t aware of any other family member with the condition, according to the National Human Genome Research Institute .
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In rare cases, Parkinson’s disease can run in families. When three or more relatives get the diseaseespecially under the age of 50, which is considered early onsetexperts believe members of the family may have a genetic predisposition to Parkinson’s.
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Medication Not Working The Way It Used To
In the early stages, taking medicine works well to get rid of symptoms. But as Parkinsons progresses, your medication works for shorter periods of time, and symptoms return more easily. Your doctor will need to change your prescription.
Dr. Valerie Rundle-Gonzalez, a Texas-based neurologist, says to pay attention to how long your medicine takes to kick in and when it stops working. She says you should feel like symptoms significantly improve or are almost gone while on medication.
Lessons I Learned From Being A Caregiver To My Mom
One of the first things I immediately learned about Parkinsons disease is that not only does it turn a patients life upside down, but that previously effortless tasks can become physical hazards. With my mother at home most of the time, it was very important that I became educated on the potential dangers within the household. Without a doubt, stairs have posed one of the biggest threats to my mom since she has gotten Parkinsons. Anywhere we go, whether its up the stairs to her bedroom, to the second floor of a parking garage, or even just one step up through the front door, I found that its best for me to accompany her to help keep her steady and to catch her in case she loses her balance.
Another hazard that posed a great threat to my mom was the bed she slept in. With getting a good nights rest being very beneficial for those with Parkinsons my family had to learn how to adjust the bed my mother slept in to ensure that she would be safe through the night. Since it can be a common symptom for my mom to jerk and move a lot in her sleep due to vivid dreaming and restless leg syndrome, we decided to invest in a bed rail to ensure she did not accidentally roll out of bed. We also bought pillows to support her neck which was especially crucial after her cervical realignment surgery.
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