Parkinson's

  • I am 44 years old and I have just been diagnosed as having Parkinson's disease. Should I start treatment? What is the best medication?

    There is no advantage in either starting treatment early, or in delaying treatment. The appropriate time is when your symptoms are interfering with your life. The aim of medication is to improve the symptoms where you can manage with them, but not to get rid of the symptoms completely, that is, to use the smallest reasonable dose of medication.


    The type of medication to start on is controversial, between a dopamine agonist (eg, ropinirole) or a preparation contain L-Dopa (Madopar or Siminet) You need to discuss these options with your neurologist.

  • I have one grandmother ( on my mother’s side ) with Alzheimer’s Disease and my other grandmother has Parkinson’s Disease. Am I likely to inherit these disorders?

    You have a slightly increased risk of developing either PD or AD. Rarely, these disorders can be strongly inherited, but in this case the age of onset of symptoms is much younger – in the 30’s and 40’s, rather than in the 70’s. I presume that your grandparents are in the older age group so that you do not have any strong predisposition to either disorder.

  • In Parkinson's disease, do symptoms occur before the onset of tremor or motor symptoms?

    Yes, but the symptoms are non-specific, that is they occur without PD developing. For example, loss of smell and taste may precede the onset of PD by years, but more commonly occurs without PD developing later on. REM sleep disorders (nightmares or "active" dreams) may occur years before the onset of PD. Depression may also occur before the development of motor symptoms.

  • Is there a test to confirm the suspected diagnosis of Parkinson's disease?

    No. In PD, the MR scan is normal and there is no blood test or spinal fluid assessment that is abnormal in PD.

  • How early can the diagnosis of Parkinson's disease be made?

    The diagnosis can sometimes be made when the person has very little disability and before the family recognises any significant problems.

  • How do you make the diagnosis of Parkinson's disease?

    By the history of gradual onset of motor symptoms, e.g tremor or slowness of movement, and the examination. The symptoms usually start on one side and gradually get worse over months. The examination findings are of rest tremor (often one hand), slowing of repetitive hand movements, reduced facial expression and reduced arm-swing while walking, but with normal strength, tendon reflexes and sensation.

  • Why is Parkinsons disease called a brain disability/impairment, when there are obvious physical impairments associated to the limbs of those inflicted with the illness? Treatment is for brain activity but suggests psychological reactions indicating Lewis disease and Parkinsons disease.

    In Parkinsons disease, there is degeneration of the nerve cells in the basal ganglia of the brain. These nerve cells are essential for the normal functioning of the motor system and when damaged in PD, the result is the tremor and slowness of movements. The damaged nerve cells send their messages using the transmitter dopamine and the treatment is to prescribe L-dopa (which enters the brain cells and is changed to dopamine) or similarly-acting medications.

  • Why is Parkinsons disease called a brain disability/impairment, when there are obvious physical impairments associated to the limbs of those inflicted with the illness?

    In Parkinsons disease, there is degeneration of the nerve cells in the basal ganglia of the brain. These nerve cells are essential for the normal functioning of the motor system and when damaged in PD, the result is the tremor and slowness of movements.The damaged nerve cells send their messages using the transmitter dopamine and the treatment is to prescribe L-dopa (which enters the brain cells and is changed to dopamine) or similarly-acting medications.

  • Are there any new trends or medicine for the Parkinsons Disease patient?

    No new medications for Parkinsons Disease have become available in the past year.

    You will be aware that there are several effective medications available, but they need to be tailored to the indidual patient and usually this is best done on the advice of a neurologist.

  • Should Parkinson's treatment be started with L-Dopa or a Dopamine agonist?

    The advantage of L-Dopa is that it is generally more effective and the patient feels better than when taking a dopamine agonist. The disadvantage is that L-Dopa causes involuntary (dyskinetic) movements in some patients. It is worthwhile discussing this problem with your neurologist.