Living with Parkinson's: Symptoms and treatment of this mysterious - but not life-ending - disease

Parkinson's disease has some worrisome symptoms, like tremors and stiffness, but doctors say this common neurological disease is easy to treat and far from the end of the world. Remember that actor Michael J. Fox has had the disease for 20 years and pro boxer Muhammad Ali has lived with Parkinson's since 1984 -- both have continued to be active and successful public figures.

"The disease doesn't mean a death sentence," says Dr. A. Basit Chaudhari, a neurologist at SoutheastHEALTH in Cape Girardeau. Like many other diseases, says Chaudhari, Parkinson's disease has a psychological effect, and people believe the worst. "By the grace of God, they can still do quite a lot," says Chaudhari.

Though little is known about the cause of the disease, and there is no cure, medications can nearly eliminate the symptoms of Parkinson's disease.

Common symptoms of Parkinson's disease include resting tremors, usually on one side of the body; stiffness in the body; and slow, awkward movements because of that stiffness, says Dr. Andrew Godbey, a neurologist at Saint Francis Medical Center in Cape Girardeau. Stooped posture, shuffling gait, a soft, husky voice and trouble making facial expressions are also common, says Chaudhari, as is "freezing phenomenon" -- when a person begins a movement but is unable to finish it.

"Way before the onset of tremors and stiffness, people may have trouble with sleeping disorders, a loss of smell and constipation," Godbey adds, citing some of the newest Parkinson's research. These symptoms might occur up to 20 years before the tremors and stiffness begin, he says.

Though the cause of Parkinson's disease is uncertain, it may be linked to trauma or head injuries (as could be the case with Ali), toxins like mercury or manganese, or protein buildup in areas of the brain affecting movement, says Chaudhari.

"We don't know exactly what it does; we just know that it's not functioning very well," says Godbey of the protein. "Whatever it is slowly accumulates in a pattern for Parkinson's disease. The longer you have it, the more accumulation there is, and more areas of the brain are affected." Parkinson's disease becomes more prevalent as we age, he adds.

There is a great deal of research on neuroprotecting agents, say Chaudhari and Godbey, though again, not much is known yet on this subject.

What doctors have identified is a lack of the neurotransmitter dopamine in people with Parkinson's disease, and medications are available to regulate this imbalance and treat the symptoms of the disease. With this treatment, says Chaudhari, patients "can possibly avoid symptoms, improve the quality of existence and do quite a lot of things." Godbey adds that Parkinson's disease is a slow progression over 20 to 25 years; patients may have dementia and more difficulty with movement, but usually after 15 or 20 years in with the disease.

"For the first five to 10 years patients have a very good response (to the medications)," he says. "There will be continuing degradation later on because of the accumulation of protein."

Deep brain stimulation -- a surgery in which doctors place small electrodes in the brain -- might also help, says Godbey. Patients who have had this treatment seem to be "doing well, moving well and responding to medications well," he says.

Patients can also benefit from physical therapy and staying active, says Chaudhari.

"Being well informed is an important part. The American Parkinson's Disease Association is a very good resource," says Godbey. "People need more information about what the disease is and what to expect, and that they can actually get better with medications and do well. It's not a horrible outcome. You can have a good many, many years of quality living with Parkinson's disease."