When Tremors Begin…

As people age, it’s normal to experience occasionally stiff muscles or slowing reflexes. But, for 1 million Americans, those symptoms are the first harbingers of Parkinson’s disease.

Shahid Rehman, M.D.

Parkinson’s disease is a chronic and progressive neurodegenerative disorder that can strike men and women of any ethnicity, according to Shahid Rehman, M.D., neurologist for NorthBay Healthcare. It affects the nerve cells in the brain that control movement and coordination, ultimately leaving the patient unable to command their movements normally.

As a neurologist, Dr. Rehman cares not only for patients with Parkinson’s disease, but also other disorders of the nervous system, such as headaches, epilepsy, stroke, multiple sclerosis, movement disorders and dementias, including Alzheimer’s disease.“Parkinson’s has four core features, and two need to be present for a diagnosis,” Dr. Rehman says. “The features are resting tremors in the hands, arms, legs or jaw; rigidity in the muscles; slowed movements; and postural instability.”

The type and severity of symptoms vary with each patient, and with the stage of the disease. Early symptoms—stiff and rigid muscles and slowed movement—may develop gradually and may not even be entirely noticed at first. Eventually, patients may experience such a degree of stiffness and rigidity that it becomes difficult to get in or out of a chair or a bed, or to dress themselves. They may also have a shuffling gait, serious balance issues and weakness in one or both limbs. “Falls are a serious risk factor,” he notes.

Further along in the disease’s progression, some patients may experience digestive or urinary problems, such as constipation or incontinence, have cognitive changes and sleep disturbance or have difficulty swallowing.

“Making an early diagnosis is important,” Dr. Rehman says. “Then we are able to start treatment that can minimize symptoms and improve the patient’s quality of life.” Treatment typically includes medications, and possibly surgery.

The disease is most commonly diagnosed when a patient is in their early 70s, but it is not uncommon to see symptoms in people in their 40s, he adds.

Most patients are referred to NorthBay neurologists after first visiting with their primary care physician.

A diagnosis is made using neuroimaging studies and blood tests, to rule out any other diseases that may mimic the symptoms of Parkinson’s, such as spinal cord disorders. “While Parkinson’s is a degenerative disease, its symptoms can be managed, which is good news for those patients who may be concerned about what their future holds,” Dr. Rehman says.

Reduce Fall Risk for People with PD

Seople with Parkinson’s disease have problems with their balance and coordination, which can increase their risk of falling. The fall risk can be reduced with the help of physical therapy or exercising through pool therapy, says Dr. Rehman. Family and friends can also make the home a safer place by following these tips:

  • Remove all lose wires, cords and throw rugs around the house. Minimize clutter and make sure rugs are secure.
  • Install grab bars and nonskid tape in the shower stall or bathtub.
  • Make sure all halls, stairways and entrances are well-lit. A nightlight in the bathroom and a lamp close by the bed will also help if you have to get up in the night.
  • Clean up spills in the bath, kitchen and garage quickly.
  • Assure that stairs are clear of clutter and that the handrail is secure.

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