As many as 1 million Americans live with Parkinson’s disease (PD), according to the Parkinson’s Disease Foundation. That’s more than those diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease combined.
In fact, our country sees about 60,000 men and women diagnosed with Parkinson’s each year. That doesn’t include the thousands of cases that go undetected. There is a long way to go to fully understand this disease and educate the public about the most common misconceptions related to Parkinson’s disease, according to Dr. James Battista, a neurologist at Novant Health Neurology and Sleep who specializes in movement disorders, including Parkinson’s disease.
Parkinson's Disease is a movement disorder in which the brain stops producing a neurotransmitter called dopamine. As the level of dopamine decreases, so does a person’s ability to control physical movement. It typically affects people 55 and older. Symptoms include slowness of movement, stiffness, the loss of spontaneous facial expression which leaves the patient with a constant look of seriousness.
Battista noted there are three common misconceptions regarding Parkinson’s disease.
Misconception No. 1 – Popular and effective drug wears off over time.
Many patients with Parkinson’s disease are prescribed carbidopa-levodopa, which is considered a dopamine replacement. According to Battista, some doctors and patients think this medicine will only be effective for five years. So these doctors will not prescribe it. Likewise, patients refuse to take it, fearing they will use up an effective treatment too soon.
“This medication continues to work,” Battista said.” What some may start to see at that time is that the medication is wearing off sooner. Though when the medicine works, it gives good results. This is why the medication may need to be dosed more frequently or other medications added to extend the benefit of it.”
Misconception No. 2 – Some patients believe they should hold off on starting carbidopa-levodopa until symptoms are severe.
“This is a common mentality that many take, due to the stigma of the medication losing effectiveness and the development of dyskinesia, or involuntary muscle movements, the longer someone is on the medication,” Battista said. “As a result, carbidopa-levodopa is sometimes held until the symptoms are severe. Quality of life may suffer during those years and then when they are started on medication, it's not like the clock is turned back. The goal of treatment is to maintain that quality and it will be determined whether the medication is indicated.”
Misconception No. 3 – Parkinson's disease is the same from one person to the other in regards to symptoms, disease progression and benefits from medications.
This is the idea that everyone with Parkinson’s disease ends up in wheelchair.
“Parkinson's disease varies greatly from individual to individual, and it is important not to conclude that symptoms will become severe and quality of life will be poor,” he said. “Many patients feel that their symptoms progress right after their diagnosis and many times it is the anxiety related to having the symptoms that temporarily exacerbates them. Once a patient comes to terms with the diagnosis and realizes that they can maintain a quality of life, those symptoms may improve slightly as the exacerbating factor (stress of the diagnosis) has been removed.”
What are the symptoms of Parkinson’s disease?
PD generally affects those who are age 55 and older, Battista said. However, a small percentage of patients, age 40 and younger, are diagnosed every year as well. Often, these younger individuals have someone in their family who has had the disease. While there is no way to prevent Parkinson’s disease today, Battista considers it a lifelong and very individualized disease that has the following main symptoms.
- Slowness of movement: Parkinson’s disease may cause men or women to find it difficult to do daily tasks, such as buttoning a shirt or brushing their teeth. They may also appear to lose their spontaneous facial expressions, called “facial masking.” Even the volume of their voice or projection may decrease significantly.
- Resting tremor: Early on, they may notice a slight tremor in a finger, hand or foot on one side of the body when they are resting or not actively doing anything at all.
- Stiffness: Normally, muscles stretch when they move and then relax. PD can cause muscles to be stiff all of the time, causing pain. For instance, people with the disease may walk without swinging their arms back and forth. In some cases, Battista said, patients have seen an orthopedist for arm or shoulder pain and been misdiagnosed with rotator cuff injuries.
- Walking and mobility: Walking can require more effort, causing men or women’s steps to become shorter and even shuffle. Keeping up with others and maintaining balance when turning can be difficult.
Although PD itself is not fatal, complications from the disease can be serious. A person may experience having problems sleeping, thinking or swallowing, according to the Parkinson’s Disease Foundation. Additional issues include pain, depression, constipation, fatigue and bladder problems.
For more information about Parkinson’s disease, visit novanthealth.org/neuroscience.