Parkinson’s disease – myths, reality and recommendations

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Myth 1: Parkinson’s disease is a purely ‘motor’ disorder

Many of the typical early signs and symptoms of Parkinson’s disease include slowing, tremor and loss of mobility, all of which are motor symptoms and signs. However, there are many other symptoms that people with Parkinson’s disease can suffer from such as urinary symptoms, drop in blood pressure, speech and swallowing difficulties, mood and memory problems, fatigue and pain. These are important to recognize because they can interfere with people’s lives and yet many can be treated.

Myth 2: Only older people are diagnosed with Parkinson’s

Most people diagnosed with Parkinson’s disease are over the age of 60 years. However, it’s entirely possible to be diagnosed earlier in life. Young-onset Parkinson’s occurs when an individual receives a diagnosis of Parkinson’s disease in their 40s (or even younger e.g. 20s or 30s).

Myth 3: Parkinson’s disease is purely genetic or purely due to environmental factors

Whilst most patients with Parkinson’s disease have the sporadic variety (i.e. the condition comes on for no apparent reason), a small proportion (<10%) may have inherited the relevant gene(s) from a parent. Such genetic causes of Parkinson’s disease are much more common in some populations. In addition, there are several known genes that have variations in people that can act as risk factors for the disease. There are also some environmental factors which are known to play a role in the development of Parkinson’s disease, such as prolonged exposure to pesticides, repeated head injury, levels of exercise and many others. However, most of these only subtly change the risk of developing Parkinson’s disease and are not in themselves ‘causes’. 

Myth 4: The only brain chemical lost in Parkinson’s disease is dopamine

Whilst the most commonly recognized motor symptoms and signs of Parkinson’s relate predominantly to loss of brain cells producing dopamine, the levels of many other neurotransmitters become abnormal in the disease, for example, serotonin, acetylcholine, noradrenaline (norepinephrine), each of which can manifest with other symptoms.

Myth 5: The progression of Parkinson’s disease is predictable

The way in which different people first notice symptoms of Parkinson’s varies as does the rate at which their symptoms progress. There is not a reliable, accurate way of predicting how quickly or slowly an individual patient’s symptoms will progress. Some forms were classically thought to progress slowly such as ‘tremor-dominant Parkinson’s’ but such generalizations may not be accurate for the whole course of the condition.

Myth 6: Besides taking medications, you can’t do anything to help with treatment

Lifestyle modifications can have a beneficial effect on the symptoms of Parkinson’s disease. Eating healthily and appropriately and exercising can be beneficial in managing Parkinson’s symptoms and the longer-term outlook. Staying active can help maintain a sense of independence, as well as increase muscle strength, flexibility and balance.

Myth 7: Once you’re diagnosed with Parkinson’s, there’s little to no hope

People with Parkinson’s disease can lead fulfilling lives. The disease is progressive, and there is not yet a treatment to slow, stop or reverse the disease but the symptomatic treatments are very effective and can allow for significant improvements in the quality of people’s lives. Apart from a range of very effective oral medications, there are also advanced therapies for when the oral medications alone are not effective. These can be treatments such as deep brain stimulation, intestinal dopamine pumps and subcutaneous pumps.

Myth 8: Levodopa should be delayed for as long as possible

There are some patients and doctors who are concerned about using levodopa or other Parkinson’s medications and feel that they should be withheld for as long as possible to avoid the medications becoming ineffective. However, there is little evidence to support this and most Parkinson’s experts would recommend treatment to start when symptoms become apparent and affect people’s lives. Treatment is particularly effective in the earlier part of the disease course. Effective treatment at this stage can mean people continue to live their normal lives, undertaking the work or activities they wish to, whilst minimizing the impact of the disease.

References

This article is for information only and should not be used for the diagnosis or treatment of medical conditions. myHealthSpecialist makes no representations as to the accuracy or completeness of any of the information in this article, or found by following any link from this article. Please consult a doctor or other healthcare professional for medical advice.

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Dr Tabish Saifee, Consultant Neurologist

Book an appointment with Dr Tabish Saifee

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