We offer you support to maintain your quality of life over the long termBeing diagnosed with Parkinson's can come as a real shock. But even though this chronic nerve disease cannot be cured, we can offer you support to maintain your quality of life over the long term. Tailored therapy that focuses on your specific and current needs is key here.
Our team of physicians, therapists and nurses at Schoen Clinic has many years of experience in treating Parkinson's. We will gladly accompany you on your path to recovering your independence.
Causes & symptoms
Parkinson's – causes: How does the disease develop?
In Parkinson's disease as it is narrowly defined, changes occur in the nervous system. Nerve cells that produce dopamine - an important chemical messenger - die off early. This leads to the typical symptoms of Parkinson's. The core symptom is is slower movements and reduction of movement (akinesia).
We still have no explanation for why the nerve cells simply die. Although very rare genetic variants of the disease have been discovered, Parkinson’s disease is not a genetic disease in the classical sense.
A distinction is made between Parkinson's of unknown origin and symptomatic Parkinson's disease, which can have various causes. These include problems with the flow of blood through the brain (“vessel calcification”“), tumours, poisoning, trauma and metabolism-related diseases. Medication, such as the classical neuroleptics, can also trigger or worsen symptomatic Parkinson's.
There is also Parkinson's disease in conjunction with other medical conditions. One important form is atypical Parkinson's, also known as Parkinson's "plus", which is comprised by multiple system atrophy (MSA), dementia with Lewy bodies body (DLB), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD).
Parkinson's symptoms: signs of the disease
Parkinson’s main symptoms:
- Slower movements
- Shorter steps and diminished spontaneous movement (swinging of arms when walking, gestures, “poker face”)
- Difficulties in initiating movements
and at least one of the following symptoms:
- Muscle stiffness
- Tremors while at rest
- Balance disorders
- Back and joint problems
- Involuntary stretching of the torso in a forward motion
- Voice and speech disorders
- Depression and anxiety
- Psychosis, mania, hallucinations, confusion, dementia
- Trouble opening eyelids and cramps
- Impulse control problems, such as hypersexualism, compulsions
- Bladder disorders, erectile dysfunction
- Blood pressure problems, dizziness, constipation, altered perception of pain
- Parkinson's disease with disorders of blood flow through the brain and normal-pressure hydrocephalus (“Parkinson's disease of the lower half of the body”)
Gait disorders (small steps, broad-based, severe difficulties getting started and blocks), impaired movement in the lower half of the body, bladder disorder, especially urinary urgency
- Multiple system atrophy (MSA)
Impotence, urinary incontinence, disorders of circulation regulation (for example, severe sensation of dizziness and/or episodes of fainting when standing up), irregular tremors, abnormal postures (e.g. marked neck tilt), very vivid dreams, including REM sleep behaviour disorder
- Dementia with Levy bodies
Dementia, general Parkinson’s symptoms, inexplicable falls and hypersensitivity to neuroleptics, apathy, orientation difficulties, severe fluctuations in concentration
- Progressive supranuclear palsy
Propensity to fall, especially backwards, severe voice and speech disorders, dementia, slower thought processes, attention disorders, apathy, and in later stages: impairment or paralysis of muscles directing the gaze upwards and downwards
- Corticobasal degeneration or corticobasal syndrome (around the age of 60 years)
Severe lateral asymmetry, cramps, abnormal postures, muscles twitching and a late-starting gait and stance unsteadiness, strange feelings of foreignness of one part of the body, voice and speech disorders and dementia
Diagnosis: How Parkinson's is diagnosed
The diagnosis is based on a detailed medical history and physical-neurological examination on the basis of your symptoms. Parkinson’s disease is likely if at least the core symptom of slowed movement or diminishing movement (akinesia) as well as a further core symptom such as tremors while at rest or muscle stiffness are exhibited.
If you react in certain ways to levodopa, it is considered a further sign of Parkinson’s disease.
Imaging techniques such as magnetic resonance imaging and computer tomography are used to rule out other possible conditions.