Parkinson’s disease is a progressive neurological disorder that results when some of the nerve centers in the brain lose their ability to regulate the movement of muscles.

Patients may have rigid muscles and tremors and difficulty walking and swallowing.

Parkinson's disease is one of the most common diseases to affect movement in people over age 55. The cause is unknown, although Parkinson’s-like conditions can be seen after stroke, encephalitis, carbon monoxide or manganese poisoning, and head trauma.

Parkinson’s can seriously impair the quality of life of a patient in any age group. In addition to motor symptoms, Parkinson’s can cause various non-motor problems that have significant physical and emotional impacts on patients and their families.

More than 650,000 people in the U.S. have Parkinson’s disease.

Parkinson's Disease Symptoms

Tremor of the hands and sometimes the head are major Parkinson’s disease symptoms. The tremor is an involuntary rhythmic shaking, often accompanied by continuous rubbing together of the thumb and forefinger.

If the disorder worsens, the patient may gradually stop making some movements that are normally automatic, such as swinging arms when walking.

It becomes difficult to write legibly, speak clearly, begin to do something, change positions, get out of a chair or walk balanced. Other possible symptoms of Parkinson's disease are drooling, abdominal cramps, slight limp, stooped posture or mild tremor.

Parkinson’s Disease Treatment

Medication is often prescribed as a Parkinson's disease treatment to help restore the proper balance of chemicals in the body.

However, the main goal of Parkinson's disease treatment is to keep movements as normal as possible with the smallest amount of medication, since many medications can cause side effects.

Physical therapy is an important part of treatment for Parkinson’s. Speech and occupational therapy are also helpful.

Cases that do not respond to medication may require surgery, often aimed at interrupting abnormal movements.

Parkinson’s Disease Treatment: Surgical Options

One procedure is pallidotomy, a computer-assisted neurosurgery, aimed at reducing tremor, rigidity and other symptoms by destroying the areas of the brain that caused these symptoms. Another option is thalamotomy, which involves making a lesion in the thalamus, the area of the brain that is the source of tremor. Both procedures are irreversible and may have permanent side effects.

Deep brain stimulation (DBS) is a procedure where electrodes are placed in specific areas of the brain. The electrodes block the abnormal brain circuitry seen in patients with neurological conditions such as Parkinson’s disease, essential tremors, and dystonia.

DBS does not destroy the overactive cells, like other movement disorders treatments such as pallidotomy and thalamotomy surgeries. Rather, it temporarily blocks the abnormal signals and is a reversible process. In DBS, a lead is permanently implanted into your brain and connected to a generator, which is attached under the skin of your chest.

An alternative to making a lesion with an electrode is to use highly focused radiation. Two types of devices can be used to deliver stereotactic radiosurgery, namely the Gamma Knife® and the LINAC-Scalpel.

Focused ultrasound is an incision-free brain surgery that can provide same-day hand tremor relief for Parkinson’s disease and essential tremor. Atrium Health Wake Forest Baptist is the only health system in the Triad that offers focused ultrasound.

Guided by magnetic resonance imaging (MRI), focused ultrasound waves are used to precisely target the area of your brain that controls your tremor. By carefully heating and removing these cells, we can safely reduce or stop hand tremor symptoms with a single procedure.

This procedure may also be referred to as high-intensity focused ultrasound (HIFU), MRI-guided focused ultrasound or incisionless brain surgery. Unlike deep brain stimulation, focused ultrasound doesn’t require any surgical incisions. 

Wake Forest Baptist Multidisciplinary Approach

The treatment of movement disorders at Wake Forest Baptist is a collaborative effort between neurologists and neurosurgeons.

Quality of life is further enhanced by the participation of physical, occupational and speech therapists, and otolaryngologists who have special expertise in speech and swallowing difficulties.