Tremor & Parkinsonism
What is it? How does it happen?
Tremors are defined as inadvertent movement of the body, and may be seen in isolation, or may be part of a bigger disease pathway, such as Parkinsonism. Tremors are caused by malfunction in the movement centers of the brain, which produces movement of the body (or lack of movement, in some cases) involuntarily. This appears as a tremor.
Parkinsonism is more than an isolated tremor- in fact, not all Parkinson’s patients have a tremor. The overwhelmingly most common symptom of Parkinson’s is slowness. Think of trying to wade through a rapidly flowing river- you must wade slowly and carefully to avoid a fall. It feels as if there is an external force moving your body, throwing off your balance, and making your steps awkward. This is much like Parkinson’s- except, rather than an external force (such as the rapidly flowing river in the above example), it is an internal force creating this feeling (the malfunction of the movement centers in the brain).
Parkinson’s Disease is a progressive neurodegenerative disease. Over time, the condition continues to worsen. The cause is not fully elucidated.
What Does Parkinson's Disease look like?
Signs and symptoms
Progressive onset of (usually) a combination of:
- Falling and tripping
- Tremor (involuntary movements or shaking)
- Balance problems
- Slowness of movement
- Unsteady Gait
- Changes in facial expression
- Handwriting changes
- Late finding: memory loss, dementia
Who typically gets it?
There are a number of risk factors for Parkinsonism; some are related to your lifestyle, but some are out of your control, such as genetics. Here, we will talk about the most common risk factors.
What can be done if I am have Parkinson's Disease?
Medications focus on symptomatic relief, and are aimed at maintaining quality of life and functionality. Symptoms including tremors, freezing up, "off" phenomenon are things your doctor may discuss with you, which can help to "hone" in your dose. Because the disease is progressive, it may feel at times like you are trying to keep up with your disease- this is the natural course with Parkinson's, and should be discussed with your doctor.
Physical, Occupational, and Speech therapy are all used in concert. Finding a therapist who is well versed in Parkinson's will help you to acheive your goals. Psychology and Psychiatry can be incredibly helpful when there may be some psychological overlay, as well. This is a unique condition which can require smooth neuropsychiatric care.
DBS & Surgical treatment
Used for refractory cases, particularly in younger patients, Deep Brain Stimulation (DBS) and surgical interventions are performed typically at academic or tertiary care centers with Movement Disorder specialists.
Caring for the Caregiver
The most important aspect of treatment and care for the dementia patient is the caretaker. This is an important conversation to begin early, even if it may seem too soon, in order to fully understand the patient and family's wishes. In the early stages, this may be checking in with the family member daily, but it will eventually progress to one of many situations: moving in with them, arranging for round-the-clock home nursing staff, assisted living facilities, nursing facility with a dementia unit. The best choice for your family member is likely going to be unique for each family, and it is important to have your specific need in mind, as well.
Caregiver fatigue is a very real concern. No matter how you choose to care for your family member, be certain it is sustainable and healthy for all involved.
How can MIND help?
Not only do we consult on your case to perform a Root Cause Analysis, and we will look for additional ways to maintain good quality of life and mental acuity as long as possible. .
The Bottom Line
Parkinson’s Disease is a progressive neurodegenerative disease. The cause is still not completely known.
There is no cure, but there are treatments and therapies. The goal of care is to preserve quality of life, safety, and functionality.
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