Parkinson Disease

There are organizations that can give families help in learning how to manage the illness in its early stages. Exercise is important along with special aids to help movement. Drug therapy is important in later stages of the disease when symptoms become debilitating if left untreated. The drug treatment is complex because dosages have to be carefully regulated and different combinations of drugs have to be used.

Despite certain severe side effects, the drug levodopa (l-dopa) is currently used as the most effective medication in the treatment of Parkinson disease. Some of the adverse side effects are disorders of the digestive system, hemorrhage, disturbances in heart rhythm, depression, confusion, possible psychotic reactions, and delirious episodes. The extent of these reactions appears to be dependent on the amount of medication used. In some patients the mask-like facial expression gives way to distorted facial expressions, and other unusual body movements may result from the use of the drug.

A combination drug called Sinemet composed of levodopa and carbidopa (a drug that alleviates levodopa's side effects) is given in careful dosages often requiring changes in the amount taken. Patients respond differently to this combination drug. Some will be able to take it hourly, others just three times daily.

For all of its adverse side effects, l-dopa has helped many sufferers from Parkinsonism to deal with their illness. Other drugs, which are not as effective but do have fewer side effects, are sometimes used for milder cases of Parkinson disease. Two such drugs are bromocriptine and amantadine. Anticholinergic drugs are used to deal with tremor. These drugs can be used alone or in combination with l-dopa. Sometimes they are used to help diagnose a questionable condition. They are not noted for providing important long-term relief.

Surgerical procedures to inactivate certain areas of the brain have sometimes been helpful in restoring movement for some younger Parkinsonism patients who have stopped responding to various medical therapies. Two such procedures are the thalamotomy and the palidotomy. While symptoms may be dramatically relieved, the outcome of the treatment is still being studied.

Another surgical intervention, widely used in Europe for more than a decade gained United States Food and Drug Administration in 2002. The procedure involves implanting a pacemaker-like device to provide electrical stimulation to areas of the brain deprived of dopamine. Still more research is being done to find a substance which could potentially prevent the cells within the substantia nigra from dying.

Other treatments remain both experimental and controversial, including stem cell transplants, implantation of fetal nerve cells, and the introcudtion of genetically engineered cells into neural tissue.