When civil rights leader the Rev. Jesse Jackson in November announced he’d been diagnosed with Parkinson’s disease, he joined a long list of famous people — and thousands of other Americans — who live with the neurological condition.
Dr. Gregg Shalan of Methodist Dallas Medical Center says people with Parkinson’s have "bradykinesia" or slowness of movement. They can also have tremors or rigidity, which is an increased muscle tone.
Symptoms will worsen over time. When that happens depends on the individual. But there are treatments to help manage Parkinson’s.
“Like any chronic disease, when you come to face it, it’s important to face it head on," Shalan said, "and start recognized treatments as early as possible, getting the care from someone who’s qualified to provide it.”
On Parkinson’s: Some symptoms are more difficult to manage than others. For example, the tremor that often brings Parkinson’s to the forefront is one of the easier symptoms to manage pharmacologically than the rigidity or slowness of movement. Toward the later stages of parkinsonism, we see something call postural instability, which means people can just fall over and that can be a very difficult sign to manage.
On what causes Parkinson’s: We don’t really know for sure. We know it’s a degenerative disease. We know there is a predisposition from genetics, although that’s a small number of people. Most of the time it’s called "sporadic," which means it just happens. There are a number of theories about environmental agents such as manganese and pesticides, but that hasn’t been super well proved.
On how Parkinson’s progresses over time: What we generally see are the symptoms becoming worse and worse. The tremor becomes more noticeable. It occurs more throughout the day. It can also become less responsive to medications. The same can be said for the slowness of movement and for the muscle tone.
On dying with Parkinson’s: It’s almost always from complications from the disease. One of the worst things about parkinsonism is mobility because it’s a disease of movement. So falls are very, very common and can lead to things like broken hips or head injuries.
On treatment of Parkinson’s: There’s no cure. There are medications of different classes that we will use in patients depending on their symptoms and also depending on their age. Parkinson’s disease is a shortage of a neurotransmitter called dopamine, and so we have medications that can stimulate the production of dopamine. We have medications that actually replace the dopamine — that’s probably the most effective medication. We generally tend to start that in older patients, usually 65 and older.