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Diseases & conditions
Brain & nerves

Parkinson's disease

Parkinson's disease is a long-term brain condition in which the nerve cells that control movement slowly stop working. It usually starts after age 60 and gets worse slowly over many years. It is not contagious and is not a normal part of ageing. There is no cure yet, but medicines and exercise can control the symptoms well for many years.

Symptoms

  • Shaking (tremor) of a hand or arm at rest, often on one side first
  • Slow movement and small, shuffling steps
  • Stiff muscles
  • Poor balance and falls
  • Small handwriting and a soft voice
  • Less facial expression
  • Constipation, poor sleep, low mood and loss of smell
  • When to see a doctor

    Get medical help quickly if you notice any of these:

    • A new tremor, slowness or stiffness, especially on one side
    • Frequent falls
    • Choking or coughing when eating or drinking
    • Confusion, seeing things that are not there, or severe low mood
    • Symptoms getting much worse, or medicine wearing off quickly

    In an emergency, go to the nearest hospital or clinic straight away.

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    Causes

    • Loss of brain cells that make dopamine, a chemical needed for smooth movement
    • The exact cause is usually unknown
    • Older age is the main risk
    • Family history in a few people
    • Some medicines (for example some antipsychotics or anti-sickness medicines) can cause similar symptoms

    Prevention

    • There is no sure way to prevent it
    • Regular physical activity throughout life may lower the risk
    • Avoid long-term contact with farm pesticides without protection
    • Do not use medicines that can cause similar symptoms without a doctor

    Treatment

    • Medicines such as levodopa with carbidopa, prescribed and adjusted by a doctor
    • Take doses on time and do not stop them suddenly
    • Daily exercise, walking and physiotherapy to keep movement and balance
    • Speech therapy for voice and swallowing problems
    • Make the home safe to prevent falls
    • Treatment of constipation, sleep problems and low mood

    Common questions

    Is every tremor Parkinson's disease?

    No. Many tremors have other causes, such as essential tremor, anxiety, an overactive thyroid, too much tea or some medicines. A doctor can examine you and tell the difference.

    Does Parkinson's disease affect memory?

    Some people develop memory or thinking problems, usually many years after diagnosis. Staying active and social, and treating low mood and poor sleep, can help. Tell your doctor about any changes.

    General information onlyThis guide does not replace an examination by a doctor. Do not start or stop a medicine without a doctor's advice.