Parkinson’s Disease

What is Parkinson’s disease?

Parkinson's disease is a movement disorder caused by a problem in the brain. It is one of the most common diseases affecting movement in people over age 55. Parkinson's disease is a life-long condition that gets worse over time. Parkinson's disease happens when nerve cells in parts of the brain die or stop working properly. The nerve cells in the brain stop making an important chemical called dopamine. Without enough dopamine, brain cells fire out of control and you lose the ability to control muscle movements. The exact cause of Parkinson's disease is unknown. Possible causes include:

• Damage to cells caused by free radicals, which are harmful chemicals created by the body when your cells process oxygen
• Infection in the brain
• Being exposed to poisons such as carbon monoxide
• Changes in the genes passed from parents to children. Genes are in each cell of your body. They contain the information that tells your body how to develop and work.
• Long-term use of certain medications that can lead to a Parkinson’s like disorder

What can I expect in the hospital?

You may need to stay in the hospital because:

• You have a medical condition which is making your Parkinson’s symptoms worse
• You have symptoms of Parkinson’s disease that need immediate treatment or an adjustment to your treatment
• You have fallen or injured yourself due to Parkinson’s symptoms
• You have chosen to have surgery to treat your Parkinson’s symptoms

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• Your strength, range of motion, and ability to feel pain will be checked regularly.

Testing

There are no tests that can confirm the diagnosis of PD. However, tests may be done to rule out other diseases. If other medical conditions have been ruled out, Parkinson’s disease may be diagnosed based on your symptoms. Testing may include:

• Blood tests to check for infection.
• Blood, urine, or other tests to monitor how well your organs are functioning and check for other conditions that may be causing your symptoms.
• Neurologic examination: Testing to check your strength, sensation, balance, reflexes, thinking, and memory. Some parts of this test may be repeated many times a day while you are in the hospital.
• Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the brain.
• Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the brain.

Treatment

The treatment for Parkinson’s depends on your symptoms and how well you respond to treatment.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
• Your provider may prescribe medicine to:
  • Help your body make and use dopamine effectively
  • Control tremors and reduce other symptoms of Parkinson’s
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may start a rehabilitation program while you are in the hospital to help you have better use and control of your muscles. The rehabilitation program may include:
  • Physical therapy to help you regain muscle strength and teach you ways to move safely
  • Occupational therapy to help you learn to adapt to your symptoms and do tasks safely
  • Speech therapy to help you if you have problems with swallowing or speaking
• You may have brain surgery called deep brain stimulation to help control the advanced symptoms of Parkinson’s disease. Deep brain stimulation is a surgical procedure in which a very thin wire (electrode) is placed into the part of the brain causing Parkinson’s symptoms. The wire runs under the skin to a very small machine (neurostimulator) placed under the skin in your upper chest. The neurostimulator sends small electrical signals to the electrode to block nerve signals that cause PD symptoms. Surgery is not a cure and is usually only considered if medicines do not help.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Shaking (tremor)
  • Rigidity (looking and feeling stiff and unable to start moving)
  • Slowed-down movements
  • Loss of balance or coordination
  • Drooling
  • Trouble swallowing
  • Trouble thinking clearly or remembering
  • Abdominal cramps or pain
  • Side effects from your medicine, such as nausea, dizziness, and mental changes, such as hallucinations
  • Depression
  • Loss of bladder control
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. Talk with your provider about how long your stay may be.