Parkinson’s Disease

Symptoms can differ greatly from person to person. The most common signs and symptoms of Parkinson’s disease include:

• Tremor (shaking) when you’re at rest, usually starting in the hands, arms or legs
• Stiff or rigid muscles, often in the arms, legs or neck
• Slowed movements (bradykinesia)
• Problems with balance and walking

Parkinson’s can also cause symptoms that aren’t related to movement, like changes in sleep, mood, memory, blood pressure and bowel or bladder function.

Because Parkinson’s disease is a progressive condition, symptoms typically develop gradually and change or get worse over time. Our team is prepared to help you find the right diagnosis and treatment to achieve the best quality of life at every stage.

Currently, there’s no single test that can clearly identify Parkinson’s disease. The symptoms can also appear similar to other conditions or typical signs of aging. That’s why it’s essential to see a specialist who has the experience needed to make an accurate diagnosis, especially at early stages of the disease.

Because we see patients with all kinds of movement disorders, our neurologists can more easily differentiate Parkinson’s from other disorders.

To make a diagnosis, your doctor will ask questions about your symptoms and past health. They will also do a neurological exam to check how well your nerves are working. In some cases, they will order tests (like bloodwork or imaging) to rule out other conditions.

Experts typically evaluate Parkinson’s disease in 5 stages based on how far the disease has advanced.

• Stage 1: There may be some symptoms, like tremor, but they’re generally mild and may only affect one side of the body. Day-to-day life typically isn’t disrupted.
• Stage 2: Symptoms worsen and start to affect both sides of the body, which can impact balance and walking. Certain tasks may be more challenging, but overall, daily living isn’t significantly disrupted.
• Stage 3: Symptoms become more obvious, including difficulty with walking, standing and other movements. Everyday tasks are more difficult, but independent living is still possible.
• Stage 4: Symptoms are severe and disabling, with significant movement-related challenges. Assistance from a caregiver is needed to perform routine tasks.
• Stage 5: Symptoms are the most severe and may include a complete inability to stand, walk, eat or swallow. A caregiver is needed at all times.

Parkinson’s disease affects every person differently. In most cases, it takes many months or years for symptoms to progress from one stage to another.

Our team provides personalized care to maximize comfort and function at every stage, from the earliest signs of disease to the most advanced.

Atypical parkinsonism is a group of conditions that have similar symptoms to Parkinson’s disease, but don’t respond well to the same medications. People with atypical parkinsonism may also experience other symptoms that aren’t commonly seen with Parkinson’s disease.

Types of atypical parkinsonism include:

• Corticobasal degeneration (CBD)
• Dementia with Lewy bodies (DLB)
• Multiple system atrophy (MSA)
• Progressive supranuclear palsy (PSP)

For the best symptom management, it’s important to see a movement disorder specialist who can accurately diagnose your condition.

Deep brain stimulation (DBS) is a surgical treatment for a variety of conditions, including Parkinson’s disease and related movement disorders.

If medications are not effective in managing your symptoms, or if you experience serious side effects, DBS may be recommended. DBS is most often used to treat movement-related symptoms like tremor, stiffness and trouble walking.

During DBS, a neurosurgeon places electrodes on the brain that connect to a device implanted in the chest. The device sends signals back to the electrodes that modify the brain activity that causes tremors and other Parkinson’s symptoms.

DBS may be used in combination with medication and other therapies. It’s not an appropriate treatment for everyone with Parkinson’s disease. Our experts provide a comprehensive evaluation to determine if DBS will be a safe and effective treatment.

Focused ultrasound is an innovative, incision-free treatment for hand tremor caused by Parkinson’s disease or essential tremor.

Guided by magnetic resonance imaging (MRI), focused ultrasound waves precisely target the area of your brain that controls your tremor. In most cases, relief from tremor symptoms is noticeable immediately after the procedure.

We connect eligible patients to focused ultrasound treatment at Atrium Health Wake Forest Baptist in Winston-Salem, NC. If you’re interested in learning more, talk to your doctor. You can also find information about the treatment process, eligibility, side effects and more on this focused ultrasound treatment page.

As Parkinson’s disease progresses, the symptoms can make it difficult to go about your everyday life. Rehabilitation and therapy services are designed to help you manage these challenges.

In partnership with Atrium Health Carolinas Rehabilitation, we offer a variety of rehabilitative services for Parkinson’s disease, including:

• Physical therapy: A trained professional will guide you through exercises to reduce pain and improve mobility, strength and balance. All of our physical therapists who work with Parkinson’s disease patients have advanced certifications and provide highly specialized care.
• Occupational therapy: Working with an occupational therapist can help with everyday tasks like self-care and home chores.
• Speech therapy: Our speech-language pathologists can help you improve your ability swallow, speak and communicate effectively.

Learn more about neurodegenerative disorders rehabilitation.

Returning patients: Call 704-468-0101 or schedule through MyAtriumHealth.

New patients: Appointments for new patients are by referral only. If you’re interested in seeing one of our specialists, talk to your doctor. Referring physicians can fax a referral to 704-468-0022. To learn more about our program, call 704-468-0101.