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What is Parkinsonism?

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Parkinsonism is a neurological syndrome characterized by rigidity (a sharp increase in muscle tone), hypokinesia (slowness of movement), and tremors of rest, expressed in the limbs’ tremors. This syndrome is formed as a result of damage to certain structures of the brain and slowly progresses.

The most famous and common form of parkinsonism is Parkinson’s disease. This is the so-called primary parkinsonism associated with the degeneration of neurons in the substantia nigra, which regulates muscle tone and many autonomic processes.

However, this is not the only form of parkinsonism; the syndrome can develop due to atherosclerosis of the cerebral vessels, toxic effects, encephalitis, etc.

According to modern concepts, parkinsonism syndrome can be divided into the following categories:

  • Primary (idiopathic) parkinsonism. It includes Parkinson’s disease and a unique genetically determined form of early parkinsonism, the so-called juvenile parkinsonism.
  • Secondary parkinsonism. This syndrome develops as one of the clinical manifestations of several independent diseases and lesions of the central nervous system. The most famous variants of secondary parkinsonism are vascular, toxic, post-traumatic, post-infectious.
  • Parkinsonism in multisystem neurodegenerative diseases. Among the diseases that naturally manifest themselves as syndromes, this parkinsonism should first of all be called progressive supranuclear palsy, multiple systemic atrophy, dementia with Lewy bodies, and cortico-basal degeneration.
  • Parkinsonism in hereditary diseases of the central nervous system. This is a vast group of diseases of various genesis, including hepatolenticular degeneration, neuroferritinopathy, dopa-sensitive dystonia, the rigid form of Huntington’s disease, several forms of lipidosis, mitochondrial encephalopathies, etc.

About 10-15% of all cases of parkinsonism occur in Parkinson’s disease.

Parkinson’s symptoms

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s. It is mainly typical for the elderly, but there is also a juvenile form of parkinsonism, which occurs before 20. The disease affects men more often than women.

The main symptoms of Parkinson’s disease result from the death of large dopamine-producing neurons in the compact substantia nigra of the midbrain. Due to the mechanisms of neuroplasticity, symptoms in people with Parkinson’s appear only in the case of death of more than half of the cells of the substantia nigra, which corresponds to a decrease in the level of dopamine in the striatum by 80-85%. Usually, due to the processes of natural aging of the body, starting from the 5th decade of life, from 4.7 to 6% of the cells of the substantia nigra per decade die, which determines the age-dependent nature of Parkinson’s disease.

The main manifestations of parkinsonism are:

  • Tremors in the arms or legs, tremors of the head, lower jaw, etc.
  • Inconsistency in the movement of the arms and legs while walking.
  • Impaired ability to maintain balance.
  • Stiffness of the muscles of the spine, limbs, neck, and slowness of voluntary movements.
  • Gait in small, accelerating steps.
  • Fixation of the body in the so-called supplicant position (the body is tilted forward, the head is lowered to the chest, arms, and hands in a bent position).
  • The poverty of facial expressions, rare blinking.
  • Difficulty performing complex manipulations.

Moreover, autonomic disorders are noted (for example, greasy face, increased sweating, salivation) and mental changes (emotional dullness, spontaneity).

As parkinsonism develops, the muscle tone increases so much that the patient loses the ability to do anything on his own; most of the time, he is in the supine or sitting position.

Parkinsonism Diagnostics

Heart and spine problems

With parkinsonism, changes occur in the brain structures, particularly the degeneration of the cells of the substantia nigra of the brain. This structure is responsible for muscle tone and regulates motor function. With its participation, respiration processes, cardiac activity occurs, and vascular tone is maintained.

Many factors can provoke these changes:

  • Infectious diseases.
  • Atherosclerosis.
  • Poisoning by various substances, including carbon monoxide, lead, mercury.

The hereditary factor also plays a role, but in this case, parkinsonism begins earlier, including in adolescence.

Although this disease has several characteristic external manifestations, the doctor has comprehensive information about the patient’s condition, laboratory diagnostics, general and clinical blood tests, determination of blood glucose, cholesterol, bilirubin, creatinine, beta-lipoproteins, triglycerides are necessary.

Besides, for examining patients with suspected parkinsonism, instrumental diagnostics, electromyography, and electroencephalography are used, which allows specialists to determine the cause of tremors and exclude muscle diseases, to diagnose disorders of brain activity. In addition, to diagnose parkinsonism, specialists refer patients to MRI of the brain, MRI angiography of intracranial arteries.

The examination is carried out in a complex; therefore, the patient is also referred for consultation to narrow specialists (ophthalmologist, physiotherapist, and others).

Early diagnosis is the key to the success of preventive neuroprotective therapy, methods of which are being intensively developed in leading laboratories around the world.

Treatment of Parkinson’s disease

Headache after injury and illness

Currently, parkinsonism refers to diseases that cannot be cured. However, some drugs can slow down the development of pathology, prolonging the period of a full life for people with Parkinson’s.

In the later stages of the disease, symptomatic treatment is carried out, which is designed to reduce parkinsonism manifestations. Patients have been prescribed muscle relaxants, vasodilators, and nootropic drugs. Medicinal electrophoresis and exercise therapy are also recommended.

Currently, there are six main groups of antiparkinsonian drugs:

  • Levodopa preparations.
  • Dopamine receptor agonists.
  • Inhibitors of catechol-ortho-methyltransferase.
  • Monoamine oxidase inhibitors B.
  • Amantadine.
  • Central anticholinergics.

Significant progress has been made in the development of surgical treatments for Parkinson’s disease. Two currently used neurosurgical approaches relate to methods of functional neurosurgery and are aimed at interrupting pallido-thalamo-cortical neuronal circuits. In many cases, the use of these operations is accompanied by a decrease in the severity of tremors and other motor manifestations of Parkinson’s disease.

Deep electrical stimulation has undoubted advantages over operations. In addition, it is characterized by fewer complications and a more pronounced effect on all the main clinical manifestations of parkinsonism. In the world, the experience of deep electrical brain stimulation in Parkinson’s disease has existed for more than 20 years. It shows the achieved clinical improvement, maintaining a decent quality of life in operated patients.

The whole range of therapeutic measures aims to increase motor activity in people with Parkinson’s, reduce muscle stiffness and hyperkinesis, and clinically stabilize neurological symptoms.

New technologies for the treatment of Parkinson’s disease are evolving thanks to advances in fundamental neuroscience. Thus, experimental technologies of gene and cell therapy using recombinant viral vectors and nanoliposomal delivery systems are gradually being introduced more and more. However, in the presence of a clear symptomatic effect of neurosurgical interventions, the most important and still unresolved problem is assessing the neuroprotective potential of these operations. The most critical breakthrough in recent years has been the intensive study of non-dopamine antiparkinsonian compounds that act on adenosine, serotonin, opiate, cannabinoid receptors, making it possible to achieve better control over the diverse symptoms of Parkinson’s disease, especially in its advanced stages.

If you have symptoms of Parkinson’s disease or problems with blood pressure, then seeing your doctor early can help detect the disease at the beginning stage. The sooner you start treatment, the longer you can live a fulfilling life.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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