Parkinson's Disease

Parkinson’s disease is a brain disorder that is diagnosed in an estimated 60,000 Americans each year. It occurs when nerve cells, or neurons, in certain parts of the brain die or become impaired and can no longer produce dopamine, the chemical that enables the body to coordinate muscles and movement. Symptoms begin to appear when approximately 80 percent of the cells that produce dopamine are damaged.

More than 1 million people with the disease typically show signs of tremors in the hands, arms, legs, jaw and face, as well slowness of movement, stiffness and problems with balance. Both men and women can be affected by Parkinson’s disease, which also crosses all social, ethnic, economic and geographic boundaries.

Although a small number of patients may be diagnosed under the age of 50, most cases of Parkinson’s disease are identified in people over 65. Blood tests and X-rays cannot be used to diagnose the disease. Rather, blood tests and brain scans, such as magnetic resonance imaging, may be done to rule out other conditions with similar symptoms. The diagnosis may then be confirmed after a thorough examination. There is no cure for Parkinson’s disease, but symptoms can be managed through medications, surgery or a combination of both.

One of the more commonly prescribed medications for Parkinson’s disease is levodopa. This medicine can reduce symptoms of slowness, stiffness and tremor. Levodopa works in the brain where it is converted into dopamine. It is always taken in conjunction with an enzyme inhibitor called carbidopa because blood enzymes would break down most of the levodopa before it could reach the brain.

Substitutes for levodopa, called dopamine agonists, have been developed that do not have to be taken with an enzyme inhibitor. However, these medications tend to cause other side effects.  Medications that do not stimulate dopamine production also can be taken to manage symptoms of Parkinson’s disease. Medications should be managed under close physician supervision because each person reacts differently to different drugs.

Deep brain stimulation offers a surgical alternative to medications to treat symptoms of Parkinson’s disease. This procedure involves surgically implanting a battery-operated medical device called a neurostimulator. Similar to a heart pacemaker, it delivers electrical stimulation to specific areas of the brain that control movement and blocks abnormal nerve signals that cause symptoms. The neurostimulator is about the size of stopwatch and usually is implanted under the skin near the collarbone. It is attached by an extension wire passed under the skin of the shoulder, neck and head to an electrode, or lead, which is implanted into the brain through a small opening in the skull. 

The deep brain stimulation system provides continuous symptom control and can be adjusted as needed. It does not damage healthy brain tissue and can be reversed if necessary. Medications may still be required, but at reduced levels for most patients.

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Location Clues for Headaches

When your head hurts, you only want the pain to GO AWAY. See the head locations indicated for possible causes and treatments. If headaches persist, talk with a doctor.

Eye Area

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Cluster Headache

Symptoms: frequently develops during sleep and also have tearing in the eye, nasal congestion, face flushed. May last for several hours.

Causes: alcoholic beverages, excessive smoking

Treatment: oxygen; ergotamine; sumatriptan, intranasal anesthetic

Eye Strain

Symptoms: bilateral pain in the front of the head

Causes: muscle imbalance, uncorrected vision, astigmatism

Treatment: corrected vision

Frontal Area

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Fasting Headache

Symptoms: mild to moderately intense pain, diffused (not pulsing)

Causes: insufficient food or hydration

Treatment: eating (may take up to 72 hours for pain to subside)

One Side of Head

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Migraine With or Without Aura

Symptoms with aura: warning signs such as visual disturbance or arm or leg numbness; after warning, severe pain

Symptoms without aura: no warning signs; severe, one-sided throbbing pain, may be accompanied by nausea, vomiting, cold hands, sensitivity to light and sound

Causes: may be hereditary, food-induced, hormonal, excessive hunger, change in altitude, weather, lights, excessive smoking, stress

Treatment: medication may be effective for migraines with aura; when pain begins, use ice packs, products with caffeine, ergotamine, prescribed medications or steroids; please see a doctor if you have migraines

Nasal Area

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Sinus Headache

Symptoms: gnawing pain that often increases throughout the day

Causes: infection, nasal polyps or other blockage such as a deviated septum

Treatment: aspirin; acetaminophen; NSAIDs; antibiotics

General / All Over

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Fever Headache

Symptoms: pain that accompanies fever

Causes: infection swelling of the blood vessels in the head

Treatment: aspirin; acetaminophen; NSAIDs; antibiotics

Hangover Headache

Symptoms: throbbing pain and nausea

Causes: alcohol (dilates and irritates blood vessels in the brain and surrounding tissue)

Treatment: liquids (including broth); fructose such as honey or tomato juice)

Hunger Headache

Symptoms: pain before mealtime

Causes: skipping or delayed meals, low blood sugar, muscle tension

Treatment: regular, nourishing meals with adequate protein and complex carbohydrates

Hypertension Headache

Symptoms: generalized or ‘hairband’ area pain that is most severe in the morning, diminishing during the day

Causes: severe hypertension

Treatment: managing blood pressure levels, such as with medication



National Headache Foundation