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Comprehensive information about Parkinson's disease, including its definition, prevalence, signs and symptoms, pathophysiology, causes, prognosis, complications, diagnosis, pharmacological and non-pharmacological treatment, patient support, and further resources. It also includes external websites and references.
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Definition There are several conditions described as Parkinsonism, and idiopathic Parkinson’s disease (also called Parkinson’s or Parkinson’s disease) is one of these conditions.
The National Institute for Health and Care Excellence (NICE) clinical knowledge summary (CKS) describes Parkinson's disease as ‘a chronic, progressive neurodegenerative condition resulting from the loss of the dopamine-containing cells of the substantia nigra’.^1
Pathophysiology
The diagram below shows the location of the substantia nigra and the dopamine pathway in the brain.
The following video from Parkinson’s UK answers some of the most common questions about Parkinson’s disease.
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Signs and symptoms As described by Parkinson’s UK, there are multiple physical symptoms of Parkinson’s disease, and these can be split into two classifications: motor and non-motor symptoms.
Motor symptoms (affecting movement):
Non-motor symptoms (do not affect movement):
For details about each of these symptoms, visit the Parkinson’s UK Parkinson’s symptoms page.
In the following Parkinson’s UK video, we meet Ron who experiences freezing and memory loss while working on his farm.
Parkinson’s UK – Parkinson's freezing
In the following Parkinson’s UK video, Dr Robin Fackrell explains how we can manage non-motor symptoms.
Parkinson’s UK – Managing hidden Parkinson's symptoms
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Prognosis and complications
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Pharmacological treatment Pharmacological treatments work by increasing the level of dopamine in the brain. The aim of treatment in Parkinson’s disease is to control symptoms and maintain functional ability, but this should be carefully balanced against the side effects of pharmacological treatments. Due to the variation in symptoms between people who suffer from Parkinson’s disease, treatment plans need to be tailored to the individual. The treatment of Parkinson’s disease is symptomatic. In addition, as it is a degenerative condition, constant review and treatment adjustments are needed as the disease progresses.
Pharmacological treatment options are covered in the NICE guidance Parkinson’s disease in adults [NG71] and the Scottish Intercollegiate Guidelines Network (SIGN) national clinical guideline Diagnosis and pharmacological management of Parkinson’s disease****.
The British National Formulary also offers a Parkinson's disease treatment summary page with links to the individual treatment monographs.
The Parkinson’s UK Medicine optimisation for patients with Parkinson's film supports the Get It On Time campaign and explains the importance of medicines optimisation for people with Parkinson's. It is aimed at those working in a hospital setting, but the important messages around managing Parkinson’s disease medicines can be applied to all settings.
Parkinson’s UK – Medicine optimisation for patients with Parkinson’s
The following Parkinson’s UK video is a simple explanation of the use of pharmacological treatments in Parkinson's disease. It may be helpful when thinking about how to explain the action of medicines used in Parkinson’s disease.
Parkinson’s UK – Parkinson's drugs explained
Swallowing difficulties As dysphagia is a complication of Parkinson’s disease, it is important to consider the route and formulation of medicines.
UK Medicines Information’s (UKMi) How can medicines be managed for Parkinson’s disease patients with swallowing difficulties? and Parkinson’s UK’s ‘Nil by mouth’ medication dose calculators and guidelines both offer recommendations for managing medicines for those with Parkinson’s disease and swallowing difficulties.
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Non-pharmacological treatment
The Parkinson’s UK Therapies page describes how a range of different teams can offer therapies that help people with Parkinson’s disease to manage their symptoms.
Parkinson’s UK suggests Deep brain stimulation as an alternative treatment option for those whose symptoms that are not controlled by medicines.
In the following HAVAS LYNX video, we meet Matt, who talks about his experience of Parkinson’s disease and his deep brain stimulation therapy.
HAVAS LYNX – Living with Parkinson's, Matt Eagles
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Last review: January 2022 Next review due: November 2022
