University of South Alabama

Dr. Daniel Dees, assistant professor of neurology at the University of South Alabama College of Medicine, said approximately 1.5 million Americans suffer from Parkinson’s Disease (PD), a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.

“Parkinson’s Disease is common and happens to a lot of different people,” Dr. Dees said. “The average age of onset is 55 to 60 but can also occur in younger or older patients.”

Dr. Dees said both genetic factors and environmental factors, such as pesticides, can work together to cause PD.

“In patients with PD, their brain is unable to make a chemical called dopamine,” he said, “and that’s why you start having the movement problems and the tremors.”

According to Dr. Dees, cardinal signs of PD include:

• Rest Tremor – shaking that commonly starts on one side of the body; may occur in hand, arm, foot, leg, chin, lips or tongue; improves when moving the effected limb; increases with stress and anxiety
• Bradykinesia – slowness of limb movements or repetitive movements; slowed everyday movements such as walking, eating, dressing
• Rigidity – stiffness of arms, legs, trunk; may cause aching and muscle pain
• Postural Instability – impaired balance; stooped posture; characterized by falls; occurs in mid and later stages of disease

Other signs and symptoms include a soft voice, gait and postural abnormalities, lack of arm swing, and small handwriting. Speech therapy and physical therapy can often help with some symptoms of PD.

Dr. Dees said there are also non-motor problems associated with PD. “Your sleep can become disturbed, and most patients with PD become horribly constipated,” he said. “Later in the course, non-movement problems start to become more bothersome than the movement problems.”

Dr. Dees said several drugs are currently available to treat PD. “Levodopa is one of the oldest and still the best in most cases,” he said.

Another group of medicines – called dopamine agonists – are also available. “Agonists are excellent for PD, but they may cause hallucinations and swelling in your feet,” he said. “As a result, they’re not for everybody.”

Dr. Dees said USA plans on offering deep brain simulation (DBS) for PD in approximately six months.

DBS uses a surgically implanted, battery-operated medical device called a neurostimulator – similar to a heart pacemaker – to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause PD symptoms.

With DBS, an electrode is inserted through a small opening in the skull and implanted in the brain. A wire is passed under the skin of the head, neck, and shoulder to connect the electrode to the neurostimulator, or “battery pack,” which is usually implanted under the skin on the chest.

“One great thing about DBS with PD is that you can kind of consider it like a medicine that’s always on,” Dr. Dees said.

You may be a good candidate for DBS if you respond to medications, if you are in the moderate to advanced stage of the disease, and if you do not suffer from dementia/confusion.

“Just like any medication, DBS isn’t for everyone,” Dr. Dees said. “But in those that are candidates for the procedure, it can really do some wonderful things.”

Dr. Dees said DBS makes a big difference in patients’ quality of life. “You’re able to go out and do your hobbies again and do simple things like grocery shopping or going to the post office,” he said. “That’s really where your benefits are, and that’s our goal.”

Dr. Dees recently gave an overview of Parkinson’s Disease and other common movement disorders at the August Med School Café lecture. To view video of the lecture in its entirety, click here.

The first USA Parkinson's support group meeting will take place Oct. 4, 2012, at 1 p.m. at the Medical Park 4 clinic - 3301 Knollwood Drive. To learn more or to make an appointment with Dr. Dees, call (251) 660-5108.

 

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