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What is Parkinson's disease?
Parkinson's disease is a movement disorder of the nervous system that worsens over time. The nervous system is a network of nerve cells that controls many parts of the body, including movement.

Symptoms begin slowly. The first symptom may be a barely noticeable tremor in one hand, or sometimes in a foot or jaw. Tremor is common in Parkinson's disease. However, the disorder can also cause stiffness, slowness of movement, and balance problems, increasing the risk of falls.

In the early stages of Parkinson's disease, the face may show little or no expression. The arms may not swing when walking. Speech may become weak or slurred. Symptoms worsen over time.

Symptoms
The symptoms of Parkinson's disease can vary from person to person. The first symptoms may be mild and may not even be noticeable. Symptoms often begin on one side of the body and then affect both. Symptoms are often more severe on one side than the other. Some symptoms of Parkinson's disease are similar to those of other disorders.

Symptoms of Parkinson's disease may include:

Tremor: This rhythmic tremor usually begins in the hands or fingers. Sometimes, the tremor begins in the foot or jaw. You may rub your thumb and index finger back and forth. This is known as a pill tremor. Your hand may shake at rest or under tension. You may notice less tremor when performing a task or moving.

Slowed movement, also called bradykinesia: Parkinson's disease can slow your movements, making even simple tasks difficult. You may have difficulty getting up from a chair, showering, or dressing. Your face may have less expression. You may have difficulty blinking.

Muscle stiffness: You may have muscle stiffness anywhere in your body. Your muscles may feel tense and aching, and arm movements may be short and jerky.

Poor posture and balance: You may slouch. You may fall or have trouble keeping your balance.

Loss of automatic movements: You may have less ability to perform some movements you normally do without thinking, such as blinking, smiling, or moving your arms when walking. Changes in speech: You may speak softly or quickly, slur your words, or hesitate before speaking. Your speech may be flat or monotonous, lacking typical speech patterns.

Changes in handwriting: You may have difficulty writing, and your handwriting may appear cramped and small.

Non-motor symptoms: These can include depression, anxiety, constipation, and sleep disturbances. They can also include replaying dreams, frequent urination, difficulty smelling, thinking and memory problems, and intense fatigue.

Causes of Parkinson's disease?
Parkinson's disease is a chronic, progressive neurological disorder that currently affects approximately one million Americans. It affects a small, dark portion of the brain called the substantia nigra. This is where most of the dopamine used by the brain is produced. Dopamine is the chemical messenger that transmits messages between the nerves that control muscle movement and those involved in the brain's pleasure and reward centers. As we age, it is normal for cells in the substantia nigra to die. This process occurs very slowly in most people.

But in some people, the loss occurs rapidly, marking the onset of Parkinson's disease. When 50–60% of the cells have disappeared, symptoms of Parkinson's disease begin to appear.

Risk Factors
Several environmental factors can increase the risk of developing Parkinson's disease.

These include:

• Previous head trauma: A head injury from contact sports, for example, can increase the risk of developing the disease.
• Exposure to toxins: Such as pesticides, solvents, metals, and other pollutants.
• Sex: Men are more likely to develop the disease than women.
• Age: The disease usually occurs in people 60 years of age or older.
• Some medications and drugs: Some medications can cause parkinsonism, a condition in which a person experiences tremors and other symptoms but does not have Parkinson's disease.

Symptoms usually appear after age 60. If a person develops symptoms before age 50, doctors call it early-onset Parkinson's.

Diagnosis
Currently, there is no specific test for Parkinson's disease. Doctors can diagnose the disease by evaluating a person's medical history and symptoms. This may involve a physical exam to assess movement, balance, and coordination.

In the early stages, Parkinson's disease can cause symptoms similar to those of a stroke, Lew body dementia, head trauma, and brain tumors. To rule out these conditions, doctors may order:

• Blood tests to rule out thyroid problems or liver damage
• MRI or CT scans to rule out stroke or brain tumors
• Lumbar punctures to rule out infections
• DatScan

Treatment
There is no cure for Parkinson's disease, but treatments can help manage symptoms. These treatments include:

• Physical therapy
• Occupational therapy and psychological therapy
• Medications to control tremors
• Surgery, including neuromodulation and focused ultrasound

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