Parkinson's is progressive, which means it gets worse over time. But usually this happens slowly, over a period of many years. And there are good treatments that can help you live a full life.

What causes Parkinson's disease?

No one knows for sure what makes these nerve cells break down. But scientists are doing a lot of research to look for the answer. They are studying many possible causes, including aging and poisons in the environment.

Abnormal genes seem to lead to Parkinson's disease in some people. But so far, there is not enough proof to show that it is always inherited.

Tremor may be the first symptom you notice. It is one of the most common signs of the disease, although not everyone has it. More importantly, not everyone with a tremor has Parkinson's disease. Tremor often starts in just one arm or leg or only on one side of the body. It may be worse when you are awake but not moving the affected arm or leg. It may get better when you move the limb or you are asleep.

In time, Parkinson's affects muscles all through your body, so it can lead to problems like trouble swallowing or constipation. In the later stages of the disease, a person with Parkinson's may have a fixed or blank expression, trouble speaking, and other problems. Some people also have a decrease in mental skills (dementia).

People usually start to have symptoms between the ages of 50 and 60. But in some people symptoms start earlier.

How is Parkinson's disease diagnosed?

Your doctor will ask questions about your symptoms and your past health and will do a neurological exam. A neurological exam includes questions and tests that show how well your nerves are working. For example, your doctor will watch how you move, check your muscle strength and reflexes, and check your vision. In some cases, your doctor may have you try a medicine. How this medicine works may help your doctor know if you have Parkinson's disease. He or she will also ask questions about your mood.

There are no lab or blood tests that can help your doctor know whether you have Parkinson's. But you may have tests to help your doctor rule out other diseases that could be causing your symptoms. For example, you might have an MRI to look for signs of a stroke or brain tumor.

How is it treated?

At this time, there is no cure for Parkinson's disease. But there are several types of medicines that can control the symptoms and make the disease easier to live with.

You may not even need treatment if your symptoms are mild. Your doctor may wait to prescribe medicines until your symptoms start to get in the way of your daily life. Your doctor will adjust your medicines as your symptoms get worse. You may need to take several medicines to get the best results.

Levodopa (also called L-dopa) is the best drug for controlling symptoms of Parkinson's disease. But it can cause problems if you use it for a long time or at a high dose. Sometimes doctors use other medicines to treat people in the early stages of the disease. This lets them delay the use of levodopa. But other medicines have more side effects and don't control symptoms as well as levodopa. And the long-term problems caused by medicine are the same, no matter what medicine is used first.1 The decision to start taking medicine, and which medicine to take, will be different for each person with Parkinson's disease. Your doctor will be able to help you make these choices.

In some cases, a treatment called deep brain stimulation may also be used. For this treatment, a surgeon places wires in your brain. The wires carry tiny electrical signals to the parts of the brain that control movement. These little signals can help those parts of the brain work better.

There are many things you can do at home that can help you stay as independent and healthy as possible. Eat healthy foods. Get the rest you need. Make wise use of your energy. Get some exercise every day. Physical therapy and occupational therapy can also help.

How will Parkinson's disease affect your life?

Finding out that you have a long-term, progressive disease changes your life. It is normal to have a wide range of feelings. You may feel angry, afraid, sad, or worried about what lies ahead. It may help to keep a few things in mind:

• No one can know for sure how your disease will progress. But usually this disease progresses slowly. Some people live for many years with only minor symptoms, such as a tremor in one hand.
• Many people who have Parkinson's disease can and do keep working for years. As the disease gets worse, you may need to change how you work. You can get support to learn ways to adapt.
• It is important to take an active role in your health care. Learn all you can about the disease. Find a doctor you trust and can work with. Go to all your appointments, and get all the treatment your doctor suggests.
• Depression is common in people who have Parkinson’s. If you feel very sad or hopeless, talk to your doctor or see a counselor. Antidepressant medicines can help.
• It can make a big difference to know that you are not alone. Ask your doctor about Parkinson’s support groups, or look for online groups or message boards.
• Parkinson’s affects more than just the person who has it. It also affects your loved ones. Be sure to include them in your decisions. Help them learn about the disease and get the support they need.

What happens?

Treatment may help control symptoms during the early stages of Parkinson's disease and is usually started as soon as symptoms begin to affect a person's ability to work or do daily activities. As the disease progresses, drugs may become less effective. Parkinson's disease also can cause a variety of other symptoms as it advances.

Early disease Tremor is usually the first symptom of Parkinson's disease, appearing in just one limb (arm or leg) or on only one side of the body. Tremor may also occur in the lips, tongue, jaw, and eyelids. As the disease progresses, the tremor usually spreads to both sides of the body, although in some cases the tremor remains on just one side. Joint pain, weakness, and fatigue may occur.

Slow movement, stiff muscles, and poor coordination may occur early on in the disease. Problems with fine motor skills can affect tasks such as writing, shaving, or brushing teeth.

Changes in handwriting are common. A person in the early stages of Parkinson's disease may move slowly and may not make normal, frequent posture adjustments.

Advanced disease

As the disease progresses, problems with posture and balance develop. A person with Parkinson's disease tends to walk in a stooped manner with quick, shuffling steps.

After several years, as muscle stiffness and tremor increase, the person may become unable to care for himself or herself. Weak, stiff muscles eventually may confine the person to a wheelchair or bed.

People who have taken levodopa for several years may not only notice their symptoms getting worse but also may develop additional movement problems. These motor fluctuations can be reduced somewhat by making changes in the person's medicine, but they can be difficult to control and may further complicate treatment.

Dementia may develop in up to one-third of people who have late-stage Parkinson's disease.2Dementia symptoms may include disorientation at night, confusion, and memory loss. Medicines that are used to treat Parkinson's disease can also contribute to this problem.