Parkinsonism & Parkinson’s Disease

Parkinson’s symptoms can resemble those of other neuromuscular disorders, and there is no specific test to identify Parkinson’s disease. Houston Methodist neurologists collate decades of experience in neuromuscular disease research and care to provide accurate, personalized diagnoses.

Our first step is to discuss your symptoms in depth. The first signs of Parkinson’s disease may be vague, such as a slight tremor in one hand, not swinging the arms while walking or lost ability to show facial expressions. Over time, symptoms will worsen and may progress to include:

• Cognitive deficit
• Decreased ability to perform automatic movements such as blinking 
• Depression
• Difficulty writing
• Dragging the feet
• Fecal or urinary incontinence
• Impaired speech and swallowing
• Muscle stiffness or rigidity
• Posture and balance problems
• Severe tremors in both hands
• Sexual dysfunction
• Slow movement (bradykinesia)
• Sudden drops in blood pressure (orthostatic hypotension)
• Taking shorter steps 
• Trouble sleeping

Once we have a clear picture of your symptoms, we will conduct a neurological and physical examination to rule out any underlying conditions and provide an appropriate diagnosis.

Though there is no cure for Parkinson's disease, Houston Methodist's integrated neurology team is on the leading edge of treatment innovations. We will create a comprehensive best treatment plan to reduce your symptoms and improve your quality of life. 

Medications
A range of medications can help manage Parkinson’s symptoms:

• A combination of carbidopa and levodopa can introduce more dopamine to the brain
• Dopamine agonists (such as pramipexole) mimic the effects of dopamine in the brain
• MAO-B inhibitors prevent the breakdown of dopamine
• Catechol O-methyltransferase inhibitors prolong the effect of levodopa therapy
• Oral medication, such as Botox®
• Intrathecal administration of baclofen

Behavior Modifications
Getting regular exercise and incorporating rest time into your day can help relieve mild to moderate parkinsonism symptoms. Participating in physical therapy can help reduce muscle stiffness, rigidity and balance problems.

Surgery
Houston Methodist offers deep brain stimulation (DBS), a procedure in which a neurosurgeon implants electrodes into the brain, which are then connected to a generator that is surgically placed in the patient’s chest. The DBS device sends electrical pulses to the brain that are proven to reduce stiffness, tremors and dyskinesia (involuntary movements). DBS enables many patients to respond to medication up to a decade longer.

Advancements in MRI-guided surgery allows us to perform this procedure with even greater precision. We are leading clinical research to determine whether DBS offers the added benefit of reducing the risk of fall-related injuries in patients with Parkinson’s disease.