neurology: general information

WHAT IS PARKINSON’S DISEASE?

Deep in the brain, nerve cells produce the substance dopamine. This substance allows parts of the brain to “talk” to each other. This is how the body receives instructions. With Parkinson’s, nerve cells in the brain die. As a result, there is less dopamine. Signals are therefore less effectively transmitted. The “autopilot” malfunctions. As a result, movement becomes less natural. Patients have to become more conscious of this. Movements become less smooth, and only the most essential movements remain.

WHAT ARE THE SYMPTOMS?

Parkinson’s disease causes movement problems such as tremors, stiff muscles, slow movements, and a mask-like appearance. The latter means that there is little movement in the face. Other known symptoms include: less initiative, poor speech, sleep problems, difficulty thinking, and mood disorders.

Parkinson’s disease symptoms can be different for everyone. Early symptoms may be mild, and you may not even notice them. Symptoms often begin on one side of the body, then affect both sides. Symptoms are usually worse on one side than the other. Some Parkinson’s disease symptoms are similar to those of other disorders.

Parkinson’s symptoms may include:

Tremor. This rhythmic shaking usually begins in the hands or fingers. Sometimes tremor begins in the foot or jaw. You may rub your thumb and forefinger back and forth. This is known as a pill-rolling tremor. Your hand may tremble when it’s at rest or when you’re under stress. You may notice that you shake less when you’re doing some sort of task or moving around.

Slowed movement (bradykinesia). Parkinson’s disease may slow your movement, making simple tasks more difficult. It may be hard to get out of a chair, shower, or get dressed. You may have less expression in your face. It may be hard to blink.

Rigid muscles. You may have stiff muscles in any part of your body. Your muscles may feel tense and painful, and your arm movements may be short and jerky.

Poor posture and balance. Your posture may become stooped. You may fall or have balance problems.

Loss of automatic movements. You may be less able to make certain movements that you typically do without thinking, including blinking, smiling, or swinging your arms when you walk.

Speech changes. You may speak softly or quickly, slur, or hesitate before talking. Your speech may be flat or monotone, without typical speech patterns.

Writing changes. You may have trouble writing, and your writing may appear cramped and small.

Nonmotor symptoms. These may include depression, anxiety, constipation, and sleep problems. They also may include acting out dreams, needing to urinate often, trouble smelling, problems with thinking and memory, and feeling very tired.

WHAT ARE THE CAUSES?

In Parkinson’s disease, nerve cells in the brain called neurons slowly break down or die. Cells in the brain called neurons slowly break down or die. Many Parkinson’s disease symptoms are caused by a loss of neurons that produce a chemical messenger in the brain. This messenger is called dopamine. 

Decreased dopamine leads to irregular brain activity. This causes movement problems and other symptoms of Parkinson’s disease. People with Parkinson’s disease also lose a chemical messenger called norepinephrine that controls many body functions, such as blood pressure. 

The cause of Parkinson’s disease is unknown, but several factors seem to play a role, including: 

Genes. Specific genetic changes are linked to Parkinson’s disease. But these are rare unless many family members have had Parkinson’s disease. 

Environmental factors. Exposure to certain toxins or other environmental factors may increase the risk of later Parkinson’s disease. One example is MPTP, a substance that can be found in illegal drugs and is sometimes sold illegally as "synthetic heroin." Other examples include pesticides and well water used for drinking. But no environmental factor has proved to be a cause.

• Radiculopathies;
• Amyotrophic lateral sclerosis (ALS);
• Myasthenia gravis;
• Nerve pain and peripheral nerve tumors.
• Spinal cord disorders and myelopathies;
• Inflammatory conditions like Guillain-Barré syndrome;
• Sleep disorders;
• Tremors;
• Meningoencephalitis (infectious or autoimmune);
• Neuro-oncological syndromes;

And many other complex neurological conditions.

ACCURATE DIAGNOSIS IS THE FIRST STEP

Effective treatment starts with a clear and precise diagnosis. Depending on your symptoms, your neurologist may recommend a range of tests. We work closely with other departments to provide a thorough and coordinated evaluation.

TREATMENT OPTIONS

We offer a range of treatments tailored to your specific condition, including:

• Lumbar Punctures & Therapeutic Injections: We provide lumbar punctures and targeted injections, including for carpal tunnel syndrome and occipital neuralgia, often in collaboration with our Pain Management team.
• Botulinum Toxin (Botox) Injections: Used for spasticity after stroke, chronic migraines, dystonias, and other neurological conditions.

Patients who require advanced neurological interventions such as surgery or other procedures will be referred to another specialist or surgeon after assessment and the creation of a care plan in consultation with the patient.

COMPREHENSIVE AND COMPASSIONATE CARE

At SMMC, our goal is to improve your quality of life through personalized, compassionate care. From diagnosis to treatment, we are here to support you every step of the way. For more information, please contact the Neurology Department using the information on the back of this brochure.