Parkinson's Disease

Parkinson's disease is a chronic, progressive movement disorder that affects your body's ability to control movement. Parkinson's disease is a result of damage to brain cells that produce dopamine. Dopamine relays messages to the parts of the brain that control movement.

Parkinson's disease symptoms include the following:

• Trembling of limbs, hands and face (tremor)
• Stiffness of limbs and the body's core (rigidity)
• Slow movements
• Poor balance and coordination
• Excessive drooling (sialorrhea)

Early Signs of Parkinson's Disease

Early signs of Parkinson's disease can be difficult to notice. However, if you experience the following early signs, speak with your primary care doctor.

The sooner you are diagnosed with Parkinson's disease, the sooner you can begin treatment to help prevent deterioration.

• Loss of sense of smell
• Chronic constipation
• Physically acting out your dreams at night (or, REM sleep behavior disorder)

Parkinson's Disease Diagnosis

At our Chicago location, the movement disorders care team uses the following process to diagnose Parkinson's disease. The evaluation is recorded so that multiple movement disorder specialists can review.

• Detailed health and family history, including discussion of prior treatments (for a second opinion)
• Neurologic exam, including an evaluation of thinking and memory (cognitive assessment), movement, sensation, gait and balance
• Motor assessment that includes performing motor tasks, such as tapping your index fingers to your thumbs repetitively
• Videotaped testing review in which our providers carefully review a videotaped session of you performing the above tests. They look for whether you display certain movements that are characteristic of Parkinson's disease. The team then discusses their opinions to reach a consensus on the diagnosis.

Parkinson's Disease Treatment at Rush

Movement disorder experts at Rush approach Parkinson's disease treatment holistically. They work with you and your loved ones to make sure to preserve your quality of life in a variety of ways:

Managing Your Medications

• The first medication or treatment decision for Parkinson's disease is crucial. Different medications can alter your brain's chemicals in a variety of ways. Many clinical trials of potential new Parkinson's disease treatments are only available if you have not started any medications.
• If you are newly diagnosed but not yet on any medication, Rush has special appointments to get into our center quickly. It's important to get an initial assessment or second opinion from movement disorder experts.
• Once you are on medication, our providers work with you to continue to refine them as your needs change.

Addressing Parkinson's Disease Symptoms

• Our providers connect you to experts in exercise, physical therapy and occupational therapy for Parkinson's disease; these therapies can help improve gait, balance, tremor, flexibility, grip strength, motor coordination and your ability to perform daily activities.
• We connect you to speech therapists who specialize in Lee Silverman Voice Treatment (LSVT). LSVT can help you speak more loudly and clearly.
• We have psychiatrists and neuropsychologists who specialize in Parkinson's disease to help you cope with depression and other mental health issues.
• We have experts to help with autonomic dysfunction (problems with involuntary actions of the body); these include urinary problems (e.g., incontinence), dizziness or blood pressure changes.
• Providers at Rush University Medical Center work closely with gastroenterologists and dietitians there to address gastrointestinal issues, such as constipation and bloating, that are common in people with Parkinson's disease. 

Surgical and Nonsurgical Parkinson's Disease Procedures

• Botulinum toxin (Botox) injections: We offer Botox to treat excessive drooling (sialorrhea). Injecting botulinum toxin directly into the salivary gland tells the gland to stop producing saliva. Reducing the amount of saliva that builds up in your mouth can help prevent potentially embarrassing leaks and improve your quality of life. The effects are typically seen after a few weeks and last around three months, with few side effects.
• Deep brain stimulation (DBS): DBS is a surgical procedure that can help address symptoms that are affecting your quality of life. Rush offers multiple types of DBS, including responsive DBS. If you are not a candidate for DBS, you may be eligible for focused ultrasound. Your providers will talk through all the options you have to address your symptoms.
• Focused ultrasound: Focused ultrasound is a nonsurgical procedure that can help you manage essential tremor or parkinsonian tremor. It uses sound waves to treat the specific spot in your brain that controls tremor.

Rush Excellence in Parkinson's Disease Care

• Parkinson's Center of Excellence: Our Chicago location for movement disorders services is a Parkinson's Foundation Center of Excellence. These centers must meet rigorous standards to earn this designation. For one, a program must have multiple specialists with expertise in Parkinson's disease, including movement disorders neurologists, mental health professionals (e.g., neuropsychologists) and physical and occupational therapy.
• Parkinson's diagnosis expertise: Our providers treat more than 6,000 movement disorders patients a year. This gives them extensive experience confirming or providing a Parkinson's diagnosis vs. another movement disorder with similar symptoms. It also helps them recommend medication options more likely to work for you.
• Asleep DBS and focused ultrasound: Rush is one of the first systems in the region to offer asleep deep brain stimulation (DBS) and the nonsurgical focused ultrasound for parkinsonian tremor. We also offer more targeted DBS options with responsive and directional DBS.
• Parkinson's disease dementia: Our team has expertise diagnosing and treating Parkinson's disease dementia as well as Lewy body dementia — and distinguishing between them. Rush University Medical Center is the only designated Research Center of Excellence for Lewy body dementia in Illinois.
• Exercise therapy: Regular exercise can help with many of the symptoms of Parkinson's disease. That's why Rush offers multiple exercise options specifically for patients with Parkinson's, including karate and dance therapy in Chicago and boxing in Aurora.
• Parkinson's Disease GI issues: Parkinson’s disease often causes gastrointestinal (GI) issues that can dramatically decrease your quality of life. Rush University Medical Center offers a Parkinson’s Disease GI clinic to address these concerns, such as constipation, bloating and aphasia. Neurologists, gastroenterologists and dietitians work together to help you get the tests and treatment you need to address these issues.
• Ongoing education and support, including for caregivers: It can be difficult to live with Parkinson's — and to care for someone who has it. That's why we offer ongoing education through newsletters and patient-focused seminars. And we have support groups for patients and caregivers with Parkinson's (in Oak Park and Aurora).
• Parkinson's research and clinical trials: Our team continually offers research clinical trials to better understand and treat Parkinson's. Your provider will talk with you about any trials for which you may be eligible.