Parkinson's disease is a progressive neurodegenerative condition of unknown aetiology (idiopathic) (1,2).
It is the second most common neurodegenerative disorder after Alzheimer's disease (3).
The disease results from the degeneration of dopaminergic neurones in the substantia nigra. Clinically the disease becomes evident when approximately 80% of the dopaminergic neurons are lost (2).
Patients with Parkinson's disease classically present with the symptoms and signs associated with parkinsonism (1) :
- hypokinesia ( poverty of movement)
- bradykinesia (slowness of movement)
- rest tremor
Parkinson's disease should be suspected in those presenting with tremor, stiffness, slowness, balance problems and/or gait disorders (1)
Parkinson's disease is a progressive neurodegenerative condition resulting from the death of dopamine-containing cells of the substantia nigra in the brain. There is no consistently reliable test that can distinguish Parkinson's disease from other conditions that have a similar clinical presentation. The diagnosis is primarily based on a clinical history and examination (1).
Parkinson's disease can be seen in over 120,000 people in UK (2) and affects around 1% of people over the age of 55.
Symptoms usually start between 60-70 years old, but one in 20 of all newly diagnosed disease can be seen in patients younger than 40 years (young-onset Parkinson's disease) (2).
The most common cause of Parkinsonism is Parkinson's disease and it is important for GP's to be able to differentiate between other forms of Parkinsonism and Parkinson's disease (4).
Parkinson's disease is due to the degeneration of dopaminergic neurones in the substantia nigra.
Parkinson's disease has historically been recognised as a primary movement disorder; however, other symptoms may be prominent, such as depression, cognitive impairment and dementia. In the later stages of the disease, people may develop pain and autonomic disturbances (such as dizziness and fainting, and problems with sweating, heart rate, digestion, vision and sexual function)
- these other symptoms are sometimes described as the 'non-motor' manifestations of Parkinson's disease
Review of diagnosis
- review the diagnosis of Parkinson's disease regularly, and reconsider it if atypical clinical features develop. (People diagnosed with Parkinson's disease should be seen at regular intervals of 6-12 months to review their diagnosis.) (1)
The condition may progress to cause significant impairments, adversely affecting quality of life and, indirectly, the quality of life of family and carers.
- 1.NICE (July 2017). Parkinson's disease in adults
- 2. Parkinson's disease society. The professional's guide to Parkinson's disease
- 3. Nutt JG, Wooten GF. Diagnosis and initial management of Parkinson's disease. NEJM 2005; 353:1021-1027
- 4. Frank C et al. Approach to diagnosis of Parkinson's disease. Can Fam Physician. 2006;52(7):862-868