Parkinson's Disease

Parkinson's disease (PD) is a progressive brain disorder in which nerve cells that produce dopamine slowly die off. Dopamine helps control movement — so PD causes tremor, stiffness, slowness and balance problems. It usually appears after age 60, though younger-onset forms exist.

Four classic motor features

• Tremor at rest — often in one hand first, "pill-rolling."
• Rigidity — stiff muscles, stooped posture.
• Bradykinesia — slowness of movement, shuffling walk, reduced arm swing, smaller handwriting.
• Postural instability — balance problems, falls (later in the illness).

Non-motor features — sometimes appear first

• Loss of smell.
• Constipation.
• Sleep problems — acting out dreams (REM sleep behaviour disorder).
• Soft voice, less facial expression.
• Depression, anxiety.
• Later: memory and thinking changes; low BP on standing; bladder urgency.

Diagnosis

Made mainly by a neurologist based on examination and history. There is no single blood test or scan that confirms PD. Some conditions mimic it (drug-induced parkinsonism from certain anti-vomiting or antipsychotic medications; vascular parkinsonism; other neurodegenerative diseases) — a specialist opinion matters.

Treatment

• Levodopa remains the most effective medicine. Several other drug classes are used, depending on stage and side-effect profile.
• Deep Brain Stimulation (DBS) — a surgical implant that helps selected patients with advanced PD. Available in several Indian centres.
• Physiotherapy — specifically designed programmes (including LSVT BIG) improve balance, posture and walking.
• Speech therapy — for the soft voice (LSVT LOUD).
• Occupational therapy — adaptations at home.
• Regular aerobic exercise — cycling, fast walking, boxing-style classes, tai chi — improves function and possibly slows progression.

Living well with Parkinson's

• Take medication on time, every time — timing strongly affects symptoms.
• Address constipation, mood and sleep — they worsen motor symptoms if ignored.
• Fall-prevention at home (see Falls page).
• Family and carer support is central — PD affects the whole household.
• Parkinson's support groups — several active chapters in Indian cities — help with practical advice.

India-specific note

PD in India is often under-diagnosed — slowness and tremor are misattributed to "old age" or vitamin deficiency. Anyone with persistent one-sided tremor, slow movements, or a changed walk should see a neurologist. Effective treatment can preserve independence for years.