Diagnosis is Key to Treating Parkinson’s Disease



What do Michael J. Fox, Billy Graham, Janet Reno, and the late Vincent Price, Jim Backus, Pope John Paul II and Salvador Dali have in common with about one million Americans? They all were diagnosed with Parkinson’s disease.

Every year more than 50,000 Americans are diagnosed with Parkinson's disease, a progressive,  slowly developing central nervous system disorder. It often starts with mild resting tremor but other symptoms include stiffness, slowing down of movement and later on, balance problems. It is not uncommon for this disease to first affect just one side of the body in the beginning.

“Friends and family may notice that the patient’s face exhibits less emotion, that the person blinks less frequently, or is perceived to smile less. Speech may commonly become softer. Also, the family members may see that the patient swings one arm less than the other one while walking,” says Ilia Itin, MD, a movement disorders specialist at the Cleveland Clinic Neurological Institute at Lakewood Hospital. These symptoms that may be rather mild and barely noticeable in early stages are likely to gradually get worse with time.

“The symptoms of Parkinson's disease can be subtle especially in early stages and thus, making it hard to diagnose,” say Dr. Itin.

It is estimated that up to 25 percent of all Parkinson’s disease cases are misdiagnosed early on.

The exact cause of Parkinson's disease is unknown at the present time. The disease is caused by gradual cell degeneration in small area in the lower part of the brain called “substancia nigra”. Brain cells in this area utilize chemical called “dopamine” to communicate with other areas of the brain. Brain pathways that use dopamine are involved in controlling movements. Lack of this chemical messenger produces symptoms of Parkinson’s disease and hence, many symptoms of Parkinson’s disease can be related to impaired or “broken down” movements.

Unfortunately, there is currently no cure for Parkinson's disease. However, there are medications available that can treat symptoms effectively. These drugs help replenish or “mimic” dopamine in the brain that is missing in Parkinson’s disease. Next step in management of Parkinson’s disease may involve brain surgery. The special surgical procedure called DBS (“Deep Brain Stimulation”) although not curative nonetheless may help to ameliorate symptoms in some severely affected Parkinson’s disease patients. Rehabilitation measures such as physical therapy (PT) and occupational therapy (OT) may also be beneficial.

“Diagnosis is key to proper treatment,” says Dr. Itin. “Therefore, it is very extremely important that the physician be experienced in evaluating and diagnosing patients with Parkinson’s disease. The treatment decisions made early in the illness can have profound implications on the long-term success of the treatment.” If there is any question, the patient should see a specialist, preferably a neurologist trained in movement disorders.

Fortunately, the Cleveland Clinic Neurological Institute at Lakewood Hospital offers west-side residents world-class neurological care close to home. The Institute is home to some of the world’s most advanced treatments for neurological conditions and is staffed with a team of highly skilled physicians and other healthcare providers who treat patients with Parkinson’s disease and other neurological disorders.

For more information, call 216.529.7110.

Click here for a handout on the key services available at the Cleveland Clinic Neurological Institute at Lakewood Hospital.