At a glance
What it is
Progressive loss of dopamine-producing neurons in the midbrain, causing difficulty initiating and controlling movement.
Typical signs
Resting tremor (pill-rolling), rigidity, bradykinesia (slowness), postural instability, balance and gait difficulties.
How we treat it
Dopamine-replacement therapy (levodopa) is first-line. Deep brain stimulation (DBS) for advanced disease when medication loses efficacy.
What Parkinson's disease is
Parkinson's disease is progressive neurodegeneration of dopamine-producing neurons in the substantia nigra. Dopamine loss leads to slow, stiff, tremulous movement. Most cases present after age 60, though early-onset cases occur. Cause is unknown in most patients.
What we see in clinic
10M
People worldwide with Parkinson's
4–6 years
Average motor control duration on levodopa before DBS needed
80%
Show improvement in tremor and rigidity after DBS
Key facts
How it is treated
Medical management is first-line. Surgery considered when medication complications emerge.
Dopamine replacement
First-line for all patients
- Levodopa — converted to dopamine in brain
- Dopamine agonists (pramipexole, ropinirole)
- MAO-B inhibitors to slow dopamine breakdown
Adjunctive medication
When first-line drugs lose potency
- COMT inhibitors to prolong levodopa effect
- Amantadine for dyskinesia reduction
- Anticholinergics for tremor
Deep brain stimulation (DBS)
Advanced disease, medication complications
- Electrodes in subthalamic nucleus (STN) or globus pallidus interna (GPi)
- Continuous electrical pulses normalise circuit activity
- Allows levodopa dose reduction, minimising dyskinesia
Rehabilitation
All stages
- Physical therapy for gait and postural stability
- Speech therapy for voice and swallowing
- Occupational therapy for daily activities
Parkinson's surgery at our center
Related reading
Motor disorders
Conditions affecting movement control, such as cerebral palsy, spasticity and dystonia, treated with physiotherapy, Botox or functional neurosurgery.
Stroke
A medical emergency where blood flow to part of the brain stops, and every minute counts. We handle recovery and preventing another stroke.
Book a consultation
The secretary schedules first appointments during clinic hours; please have prior imaging, operative notes and a current medication list available at the time of the call.
This page provides general information about parkinson's disease and is not a substitute for individual medical assessment. If your symptoms are severe or worsening, contact a clinician promptly.