Vascular (Multi-Infarct) Parkinsonism
What is Parkinson disease? — Parkinson disease is a brain disorder that affects movement. It gets worse over time and can affect other brain functions, too, such as learning and memory.
What are the symptoms of Parkinson disease? — At first, Parkinson disease often causes only mild symptoms. As it gets worse, the symptoms can affect a person's ability to work or do everyday activities. When it becomes even more severe, people with the disease sometimes need help taking care of themselves.
Parkinson disease can make people:
Shake (doctors call this "tremor")
Become stiff or rigid
Lose their balance or have a hard time walking
Parkinson disease can also make some people:
Lose the ability to think clearly
At times, lose touch with reality or see things that aren't there (these are called "hallucinations")
Feel depressed, anxious, or less interested in everyday life
Have problems with sleep, such as insomnia (trouble falling or staying asleep) and daytime sleepiness
Lose the ability to smell
The disease can even cause problems such as constipation, sweating, trouble urinating, trouble swallowing, and sexual problems. Some people with Parkinson disease get something called "orthostatic hypotension." This is the medical term for a sudden drop in blood pressure that happens when a person stands up. This drop in blood pressure can make the person feel dizzy or lightheaded, or even pass out.
Is there a test for Parkinson disease? — No, there is no test. But doctors can usually tell if a person has Parkinson disease based on his or her symptoms. Sometimes doctors use tests to make sure that the symptoms are not caused by something else.
How is Parkinson disease treated? — There are several medicines that can improve the symptoms of Parkinson disease. Researchers are also studying drugs that might help keep Parkinson disease from getting worse. But for now, no treatment can cure the disease.
The medicines used to treat Parkinson disease symptoms can sometimes cause serious side effects. For this reason, people often start taking them only after their symptoms start to really bother them.
If you are thinking about treatment, ask your doctor or nurse to help you understand the risks and benefits of the medicines you might take. Here are some questions to ask your doctor that might help you decide what to do about treatment:
Which medicines would you suggest I take?
What are their side effects?
How much are my symptoms likely to improve with each medicine?
What happens if I do not take the medicine?
People with Parkinson disease that does not improve with other treatments can sometimes get a treatment called "deep brain stimulation" (also called "DBS"). People who get DBS must first have surgery to place wires into a part of the brain that helps control muscle movement. The wires are attached to a device that gets implanted under the skin, usually near the collarbone. It sends electrical signals to the brain to reduce abnormal movement.
Is there anything I can do on my own to feel better? — Yes. You can:
Exercise or do physical therapy, so that your body is less affected by stiffness and other symptoms.
Join social support groups, where you can talk to other people who understand your situation.
Make your home safer, so that you are less likely to fall (figure 1). For example, get rid of loose rugs and clutter, and make sure all electrical cords are neatly tucked away.
If you still drive, have yourself tested to make sure it is safe for you to keep driving.
Learn about Parkinson disease and its treatment. That way you can be actively involved in your care.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15524 Version 7.0
Release: 28.2.2 - C28.105
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