Parkinson’s Disease

Parkinson's disease is a disorder affecting the central nervous system. Degenerative in nature, Parkinson's has no real cure; though its progress can be slowed down. Statistics say that one in every 100 people aged 60 or above is prone to this chronic illness. Once afflicted with Parkinson's, the patient slowly loses his ability to control body movements.

Signs and Symptoms

These are the early clinical symptoms of Parkinsons disease:

• Gradual decline in dexterity
• Uncontrollable body shaking
• Diminishing ability to swing the arm on the affected side
• Squishy voice
• Expressionless face
• Disturbed sleep
• Rapid eye movement (REM) behavior disorder (RBD; a loss of normal atonia
  during REM sleep)
• Diminishing ability to smell
• Symptoms of malfunctioning autonomic nervous system (autonomic dysfunction)
   -- constipation, sweating abnormalities, sexual dysfunction, seborrheic dermatitis)
• Lack of strength, sickness, or lack of energy
• Depression or anhedonia
• Slow, clumsy thought process

Motor Symptoms

As the motor areas of the brain are affected, the following signs show up:

• Lack of symmetric movement of hands, legs
•Trembling of upper body parts even while resting
• Increasing bradykinesia (slow movement), stiff muscle, and difficulty in walking
• Flexed axial posture -- strides become shorter
• Unstable stance -- loses balance while standing or walking

Nonmotor Symptoms

The patient shows nonmotor signs and symptoms as well in the initial stages. By analysing the motor and nonmotor signs and symptoms, doctors can easily diagnose Parkinson's disease. An early detection would mean better quality of life for the patient.


Parkinson's is not a disease that can be diagnosed through laboratory tests or scans. Mostly, the disease is diagnosed clinically by doctors.The diagnosis is more or less complete if the patient suffers from signs such as involuntary tremor at rest, rigidity or bradykinesia.

Managing Parkinson’s Disease

There's no complete cure for Parkinson's -- all you can do is control the signs and symptoms and ensure the body is not adversely affected.

Treating symptoms using drugs

Drugs help control motor signs of the disease for up to 6 years

• Levodopa/carbidopa -- the standard medication for Parkinson's symptoms
• Monoamine oxidase (MAO)–B inhibitors: useful in the early stages
• Dopamine agonists (eg, ropinirole, pramipexole): used for monotherapy in the initial stages       and adjunctive therapy in advanced stages
•Anticholinergic agents (eg, trihexyphenidyl, benztropine): supplementary drugs to treat tremor

Medications for nonmotor symptoms

•Sildenafil citrate (Viagra): To treat erectile dysfunction
•Polyethylene glycol: For constipation
•Modafinil: to keep the patient awake during daytime
•Methylphenidate: For fatigue (make sure this drug is not abused as it's addictive)

Deep Brain Stimulation

In the early stages, the brain can be surgically stimulated. Though the surgery does not damage brain tissues, the symptoms might come back later. The surgery depends on the severity of the disease and how adversely it has affected the patient. It's possible to have bilateral procedures done without worsening the adverse symptoms.

Dr. Sanjiv C.C is a senior neurologist who is an expert in Parkinsons diagnosis and management. He is available for consultation in the city of Bangalore at Apollo Hospital, Jayanagar.

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