Although Parkinson’s Disease (PD), a progressive neurological disorder, is associated with tremors in most cases, not everyone experiences tremors, say neurologists. This is one of the common myths about Parkinson’s Disease. Though it is mostly seen among the elderly, doctors state that it is sometimes seen among younger adults too.
At a recent event organised in Bengaluru by the National Institute of Mental Health and Neurosciences (NIMHANS) and the Parkinson’s Society of Karnataka to mark World Parkinson’s Day (April 11) and Parkinson’s Awareness Month (April), neurologists and movement disorder specialists busted common misconceptions about PD.
1. Not everyone with PD has tremors
Disputing this myth is Dr Pramod Kumar Pal, professor & head of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS). He says that though resting tremors on one side of the body is the main manifestation of PD, someone with PD might also experience non-motor symptoms.
“The main manifestation of PD is tremor on one hand or one leg on one side of the body. There is also stiffness, slowness and difficulty in walking. The shaking or the tremor is present over a lifetime of PD, over 10, 20, 15 years, in approximately 80 percent of the people. The rest 20 percent may not have obvious tremor so PD can also manifest as only slowness, stiffness and difficulty in walking. Absence of tremors, does not mean it is not PD. There are people who may not have tremors but have PD,” says Dr Pal.
2. PD is not strictly a movement-related disorder
Dr Ravi Yadav, professor, department of neurology, NIMHANS says “There are several conditions that are associated with PD which are not movement-related. This includes constipation, sleep issues, dry skin, dandruff, anxiety and depression. Some people also experience loss of smell, some report memory and cognitive function issues. These are all known as non-motor symptoms.”
Dr Yadav says that most of these non-motor symptoms are easily treatable and it is important to let your physician know as soon as you start experiencing these symptoms. “They will be able to treat it properly, adjust the medication according to the symptoms. Non-motor symptoms are also an integral part of PD and people should be made aware of it,” Dr Yadav adds.
3. If I have PD, my children need not get it
“A common concern for most relatives of people with PD is that it might be hereditary,” says Dr Vikram Holla, Assistant Professor of Neurology at NIMHANS, who specialises in movement disorders.
Dr Holla added that PD is transferred genetically only in around 5 -15 % of the cases. “In a majority of the cases, the reason for the disease is not genetic. So, chances of your children developing the condition are low,” he said.
4. PD is caused by destruction of brain cells, not linked to lifestyle
Dr Pooja Mailankody, additional professor of neurology at NIMHANS says, “PD is not caused due to bad lifestyle or mental stress. In PD, the brain cells get destroyed over time. While the exact cause for the reduction in the number of these brain cells is not known, it is known that PD is not caused by stress and a bad lifestyle.
5. PD does not affect only the elderly
Neurologists say that though most people with PD are the elderly, it can also affect people in their 20s and 30s.
“We used to believe that onset of PD, the motor symptoms at least, happens when you’re around 60 years of age. Now we know that in Asian countries and particularly in India, onset of PD can happen even at the age of 50. Presently, we also know that there are conditions known as young-onset PD that can affect people between the ages of 20 to 50 years. It causes tremors and stiffness. Juvenile PD affects people who are younger than 20,” said Dr Pal. He added that juvenile PD could be a more advanced form of PD where the person may experience psychosis and other mental health issues, says Dr Pal. The earlier it starts, the more likely it is caused by genetic factors, Dr Pal adds.
6. Not just medication, but exercises can help in PD treatment
Dr Mailankody says that in PD, there are several other things that can make a big difference – exercise is one such activity. “It can slow down the progression of the disease. Yoga, exercise and other such activities can greatly improve the quality of life of someone suffering from PD. Maintaining a well-balanced diet can also help,” says Dr Mailankody.
Click here for diet tips for people with PD.
7. Levodopa, the drug used to treat PD, is not harmful
“In PD, the level of dopamine, a neurotransmitter in the brain, starts reducing. The symptoms seen in people with PD are induced due to this. Levodopa is part of the dopamine-replacement therapy and will reduce some of the symptoms. It is not harmful,” says Dr Nitish Kamble, additional professor of neurology, NIMHANS.
But studies have also shown that dyskinesia (involuntary jerks) induced by levodopa is a common complication. However, it is currently the most effective drug to treat PD. The complication could be linked to how the drug is administered and the disease progression rather than long-term usage of the drug.