Parkinson’s Disease: All you need to know about the symptoms and treatment

Millions of lives are affected by Parkinson’s disease globally—often unnoticed by those not directly affected. Dr Gajanan Ashok Panandikar, consultant neurologist at Healthway Hospital, Old Goa, elucidates that recognising the symptoms early and offering the right support can make a profound difference to those with the disease.

Dr Gajanan Ashok Panandikar, Consultant Neurologist at Healthway Hospital, Old Goa

Parkinson’s disease—a progressive degenerative disorder of the nervous system—is characterised by the loss of specific neurons in the brain that produce dopamine. This loss results in a deficiency of dopamine, which is a critical chemical messenger that governs movement. This, in turn, leads to the physical symptoms that can be visible – shaky hands (tremors), stiff muscles, moving more slowly and feeling unsteady on your feet. Goa, of late, has seen a rise in reported cases of Parkinson’s disease, partly because people are living longer and doctors can diagnose it better and earlier. While the disease is typically seen among individuals over the age of 60, it is important to note that roughly 10 percent of patients experience an early onset before the age of 50.

Diagnosis entails a clinical process based on a detailed evaluation of signs and symptoms and looking closely at how a person moves. While specialised tools like DAT (Dopamine Transporter) scan often helps with early detection, they are currently available only in big cities. However, the disease can also be accurately identified through expert clinical examination and assessment in the majority of cases.

While there is no complete cure for Parkinson’s yet, several management strategies help dealing with the symptoms. Traditionally people start with oral medications, but for those with more severe symptoms, there are newer options like Deep Brain Stimulation (DBS) or injectable apomorphine that can help bring back a person’s quality of life. DBS, also known as brain pacemakers, involves a surgery where electrodes are placed in the brain to send electrical signals to certain areas with a pacemaker.. This helps in effectively managing movement issues and tremors in advanced cases when medications aren’t enough.

It is, however, critical to note that Parkinson’s extends beyond physical movement, often bringing significant emotional and cognitive hurdles. Nearly 40 percent of patients may face anxiety or panic attacks with a high chance of depression and, occasionally, psychosis. As the disease progresses, cognitive shifts such as forgetfulness and word-finding difficulties may also arise. Unfortunately, these symptoms are often misdiagnosed as psychiatric issues. This in turn leads patients to frequently face social stigma fuelled by a lack of public awareness. To combat isolation, the Parkinson’s Society of Goa provides essential physiotherapy, speech therapy and counselling to help patients maintain their independence.

Ultimately, effective management requires a multidisciplinary approach that goes beyond just medication. Success depends on a combination of regular exercise—such as yoga, swimming and cycling—a nutritious diet and a safe, fall-resistant home environment. Patients must remain diligent with their medication schedules and maintain close communication with their neurologist. Therefore, while the challenges are real, the momentum in global research and community support provides a hopeful path toward better outcomes, early intervention and a more inclusive society for all those affected by the condition.

Box 1: Recognising the Signs of Parkinson’s

The symptoms of Parkinson’s extend beyond physical movement, often affecting emotional health and daily functions.

• Motor Symptoms: Persistent shaking (tremors), rigid muscles, slow movement and compromised balance or coordination.
• Physical Challenges: Difficulty with speech,chronic constipation or urinary urgency.
• Mental & Emotional Health: Increased anxiety, depression, mood fluctuations or occasional episodes of psychosis.
• Sensory & Sleep: A diminished sense of smell and frequent sleep disruptions.
• Cognitive Function: Potential for memory lapses or difficulty finding words as the condition progresses.

Box 2: Proactive Management & Safety Strategies

Living well with Parkinson’s requires a combination of physical activity, nutritional support and environmental safety.

• Movement & Therapy: Maintain mobility through aerobic exercise and stretching. Activities like yoga, swimming and cycling are excellent for both physical and mental clarity.
• Dietary Support: Consume a high-fibre, calcium-rich diet. Ensure consistent hydration to manage blood pressure and prevent fainting or falls.
• Home Safety: Create a ‘fall-proof’ environment by clearing floor clutter and removing loose rugs.
• Specialised Care: Engage in ongoing speech and swallowing therapy to maintain communication and eating safety.
• Medication Discipline: Never alter your dosage or discontinue Parkinson’s medication without direct supervision from your doctor.

This article is authored by Dr Gajanan Ashok Panandikar, consultant neurologist at Healthway Hospital, Old Goa