Parkinson Disease
Also known as Parkinsons, PD
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is parkinson disease?
Parkinson disease is a progressive neurological condition caused by loss of dopamine producing neurons in the substantia nigra. The classic features are slowness of movement, tremor at rest and rigidity. Non motor symptoms such as constipation, loss of smell and sleep disturbance often begin years before movement problems appear.
Causes
- Degeneration of dopaminergic neurons in the substantia nigra
- Accumulation of alpha synuclein as Lewy bodies
- Genetic mutations in a minority of cases
- Environmental exposures including certain pesticides
- Interaction of ageing and genetic susceptibility
Symptoms
- Tremor at rest, often starting in one hand
- Slowness of movement known as bradykinesia
- Muscle rigidity
- Postural instability and falls in later disease
- Reduced arm swing and shuffling gait
- Small handwriting and reduced facial expression
- Constipation and loss of sense of smell
- Acting out dreams during sleep
Risk factors
- Age over 60
- Male sex
- Family history of Parkinson disease
- Pesticide or herbicide exposure
- Previous significant head injury
Diagnosis
- Clinical diagnosis based on bradykinesia plus tremor or rigidity
- Response to dopaminergic treatment supporting the diagnosis
- MRI to exclude other causes
- DaTscan in uncertain cases
- Review of medicines that can cause parkinsonism
Treatment
- Levodopa combined with carbidopa, the most effective symptomatic therapy
- Dopamine agonists and MAO B inhibitors
- Physiotherapy focused on gait and balance
- Speech and language therapy for voice and swallowing
- Occupational therapy and falls prevention
- Deep brain stimulation for selected patients with motor fluctuations
- Management of constipation, sleep and mood
Self care
- Take levodopa exactly on time, since delays cause sudden immobility
- Carry your own medicines into hospital and insist on timed doses
- Exercise vigorously and regularly, which genuinely helps symptoms
- Practise large deliberate movements when walking
- Use visual or rhythmic cues to overcome freezing
- Manage constipation actively with fluids and fibre
- Remove trip hazards and review footwear
When to see a doctor
Book an appointment if:
- Medication wearing off before the next dose
- New involuntary movements
- Increasing falls or freezing episodes
- Swallowing difficulty or coughing while eating
- Hallucinations or confusion
- Low mood, anxiety or sleep disturbance
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Parkinson disease cannot currently be prevented
- Regular vigorous exercise is associated with slower symptom progression
- Reduce pesticide exposure where practical
- Protect the head from injury
- Treat constipation and sleep problems early
Outlook
Parkinson disease is progressive, but the rate varies enormously and many people live for two decades or more after diagnosis. Levodopa remains highly effective for years, though motor fluctuations develop over time. Deep brain stimulation helps carefully selected patients. Exercise, physiotherapy and speech therapy meaningfully affect long term function.
Common questions
Does everyone with Parkinson disease have a tremor?
No. Around one in five people never develops a noticeable tremor. Slowness of movement is the required feature for diagnosis, not tremor.
Why is medication timing so important?
Levodopa has a short duration of action, and as the disease progresses the benefit can wear off before the next dose. Taking doses precisely on time, including in hospital, prevents distressing immobility.
Does exercise help?
Yes, substantially. Regular vigorous exercise improves gait, balance and quality of life, and some evidence suggests it may slow symptom progression. It is considered part of core treatment rather than optional.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.