(PD; Paralysis Agitans; Shaking Palsy)
- Slowing down of movements—bradykinesia
- Tremor at rest
- Muscle rigidity
- Loss of reflexes that maintain posture and equilibrium
|Part of the Brain Affected by PD—Yellow Section|
|Copyright © Nucleus Medical Media, Inc.|
- Family members with PD
- Exposure to toxins, such as insecticides, carbon monoxide , or manganese
- Certain medications, such as antipsychotics, antiseizures, antiemetics, or cardiovascular medications
- Certain health conditions, such as:
- IV drug use
- Problems with dexterity
- Difficulty with activities of daily living
- Stiffness and rigidity of muscles, usually beginning on one side of the body
- Tremors are present at rest, improve with movement, and are absent during sleep
- Slowness of purposeful movements
- Neuropsychiatric symptoms, such as:
- Difficulty and shuffling when walking
- Poor balance
- Tendency to fall
- Loss of smell
- Sleep problems
- Flat, monotonous voice
- Trouble speaking (often speaking with a low volume)
- Increasingly mask-like face, with little variation in expression
- Drooling and excessive salivation
- Shaky, spidery, or small handwriting
- Seborrhea (a skin problem that causes a red rash and white scales)
- Trouble chewing and swallowing
- Urinary symptoms (frequency and urgency)
- Bowel movement symptoms (straining, constipation)
- Blood tests
- Urine tests
- Dopamine agonists
- Monoamine oxidase inhibitors
- COMT inhibitors
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressants
- Deep brain stimulation (DBS)—implanting a device to stimulate certain parts of the brain; can decrease tremor and rigidity
- Thalamotomy and pallidotomy—destroying certain areas of the brain to improve tremor when medication does not work (not as common as deep brain stimulation)
- Nerve-cell transplants (research only)—to increase amount of dopamine made in the brain
National Parkinson Foundation http://www.parkinson.org
Parkinson's Disease Foundation http://www.pdf.org
Health Canada http://www.hc-sc.gc.ca
Parkinson Society Canada http://www.parkinson.ca
Alvarez MV, Evidente VG. Understanding drug induced parkinsonism: Separating pearls from oysters. Neurology. 2008;70(8):e32-e34.
Li F, Harmer P, Fitzgerald K, et al. Tai chi and postural instability in patients with Parkinson’s disease. N Engl J Med. 2012;366(6):511-519.
Liu R, Gao X, Lu Y, Chen H. Meta-analysis of the relationship between Parkinson disease and melanoma. Neurology. 2011;76(23):2002-2009.
Managing your PD. Parkinson’s Disease Foundation website. Available at: http://www.pdf.org/en/managing%5Fpd. Accessed August 28, 2015.
Nielsen NM, Rostgaard K, Hjalgrim H, Aaby P, Askgaard D. Poliomyelitis and Parkinson disease. JAMA. 2002;287(13):1650-1651.
NINDS Parkinson's disease information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/parkinsons%5Fdisease/parkinsons%5Fdisease.htm. Updated July 27, 2015. Accessed August 28, 2015.
Obeso JA, Rodriguez-Oroz MC, Goetz CG, et al. Missing pieces in the Parkinson’s disease puzzle. Nat Med. 2010;16(6):653-661.
Parkinson disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 14, 2014. accessed August 28, 2015.
Parkinson's disease. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Parkinsons%20Disease.aspx. Accessed August 28, 2015.
Perlmutter JS, Eidelberg D. To scan or not to scan: DaT is the question. Neurology. 2012;78(10):688-689.
Ristić AJ, Vojvodić N, Janković S, Sindelić A, Sokić D. The frequency of reversible parkinsonism and cognitive decline associated with valproate treatment: a study of 364 patients with different types of epilepsy. Epilepsia. 2006:47(12):2183-2185.
Samii A, Nutt JG, Ransom BR. Parkinson's disease. Lancet. 2004;363(9423):1783-1793.
Schenkman N, Hall DA, Barón AE, Schwartz RS, Mettler P, Kohrt WM. Exercise for people in early- or mid-stage Parkinson disease: A 16-month randomized controlled trial. Phys Ther. 2012;92(11):1395-1410.
Siderowf A, Stern M. Update on Parkinson's disease. Ann Intern Med. 2003;138(8):651-658.
Wider C, Wszolek CK. Movement disorders: Insights into mechanisms and hopes for treatments. Lancet Neurology. 2009;8(1):8-10.
1/4/2011 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Spinks A, Wasiak J, Bernath V, Villaneuva E. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2009;(4):CD002851.
4/7/2014 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Marras C, Hincapié CA, Kristman VL, et al. Systematic review of the risk of Parkinson's disease after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis. Arch Phys Med Rehabil. 2014;95(3S):S238-S244.
9/3/2014 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Wippold FJ, Brown DC, Broderick DF, et al. American College of Radiology (ACR) Appropriateness Criteria for dementia and movement disorders. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/DementiaAndMovementDisorders.pdf. Updated 2014. Accessed August 28, 2015.
11/10/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Shanahan J, Morries ME, Bhriain ON, Saunders J, Clifford AM. Dance for people with Parkinson disease: what is the evidence telling us? Arch Phys Med Rehabil. 2015;96(1):141-153.
- Reviewer: Rimas Lukas, MD
- Review Date: 08/2015 -
- Update Date: 11/10/2015 -