Concerned if you have Parkinson Disease? Dr Tay Kay Yaw, Senior Consultant from the Department of Neurology at National Neuroscience Institute, gives detailed answers to your questions.
Tremors in the arms or legs, stiffness, slowness of movement and walking are common symptoms of Parkinson disease, a neurological disorder that usually strikes people over the age of 50. This brain disorder is caused by the degeneration of neurons which produce the neurotransmitter dopamine. A deficiency in dopamine affects the body’s ability to regulate movement.
Dr Tay Kay Yaw, Senior Consultant from the Department of Neurology at National Neuroscience Institute, gives detailed answers to your questions.
Question by jollybean
dear Dr Tay, my mum who is 71 years old, has been diagnosed 6mths ago with Parkinson disease, just wondering does this disease cause giddiness? She has been having chronic giddiness for the past few years, especially the last few months, which was pretty bad, it happens almost daily and affecting her daily activities. Also, she is diabetic and has a left inner ear patch done in '06, and stable aneuryism. We are hoping to find the cause of her giddiness. Thank you.
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
This is an interesting question. I have a few patients who complain of chronic giddiness and diagnosed as having Parkinson disease.
First of all, just make sure that her features of Parkinsonism is not due to drugs that are used to treat giddiness—drugs such as stemetil, maxolon, stugeron can cause Parkinsonlike features.
Secondly, some of the drugs used to treat Parkinson disease can cause low blood pressure especially on standing that can be perceived as giddiness.
Thirdly, I understand that your mum has left inner ear patch done, could the chronic giddiness secondary to ENT causes then?
Lastly, after ruling out all the above conditions, some patients continue to complain of giddiness which can be a non-motor feature of Parkinson disease.
Question by mosmos
Are there are natural food products that contain dopamine that can be eaten to prevent Parkinson disease?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
There are some foods which have been hyped to increase dopamine in the brain such as almonds, avocados, bananas, dairy products, lima beans, pumpkin seeds, and sesame seeds. Sincerely speaking, as to my knowledge, none of these have been proven to prevent PD and it is important to consume food in moderation.
Question by chewtlk7
Dear Dr Tay, I'm a 62 yr old female. I exercise regularly and considered agile for my age. In the last couple of months, I have experienced on a few occasions (while I was lying down to bed, and one time in the plane) the need to shake my arm and leg - generally on the right side. Is this indicative of an onset of Parkinson? I have no other symptoms.
Is there any food group to strengthen the production of dopamine? yrs sincerely
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
My answer for your question is that it is unlikely due to Parkinson disease. However, your symptoms may be suggestive of restless leg syndrome which can be describe as an urge to move especially in the evenings/ night while you are resting. This can be associated with iron deficiency.
Have a consult with your GP to elicit more into your problem.
The food that is hyped to induce dopamine production is stated above, however there is no evidence that it can prevent PD.
Question by limsiewyoke
I am a 50 years old female. I have slight tremor on my right arm for more than 10 years. My doctor has previously prescribed me Inderal which I had taken for 2 months but without any improvement. As the doctor feels that it is not of serious concern, I stopped any further treatment. To-date I still have my tremors though at times a little worse. I also have stiffness in my joints which I attribute to my age. I am on Statin since Oct 2005 and I take coffee every day though usually not more than 1 to 2 cups. Does long term taking of statin and coffee have any possible side effects?
Tammy
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Usually Parkinson disease is a progressive disorder and from your history of 10 years, Parkinson’s disease as a diagnosis is less likely. I think your doctor must have diagnosed you as having Essential Tremor. The tremor in Parkinson disease and essential tremor is slightly different in which tremor in Parkinson disease usually occur at rest and tremor in essential tremor usually occur on sustaining posture or during action.
I think it is perfectly fine to take statin and coffee in the point of view of Parkinson disease, there is no evidence implicating any of the above to development of Parkinson Disease.
Question by hlatun20
Hi, for PD can patient become some difficulty or unable to pass urination.
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Generally PD patients have urinary issues, more commonly on frequency rather than inability to void. Make sure there is no prostatic hypertrophy in a male and if Parkinson symptoms occur in a patient who cannot void (with no known cause found), we are usually worried about another parkinsonism syndrome called multiple system atrophy.
Question by kitty
Hi Dr Tay, What are the basic tests for PD?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
PD is diagnosed clinically based on the UK Parkinson Disease Brain Bank Criteria. No investigation is needed provided there is no atypical feature. In the western research centres, they use a specialized scan called the DAT scan to detect dopaminergic deficit. However the DAT scan is not available here.
Other tests that we sometimes do in our clinic are Wilson disease screen especially in the young and also thyroid function test.
Question by esim
Hi Dr Tay,
If there is only one common symptom like slowness of movement and walking out of the rest mentioned of tremors, stiffness, is this consider as high risk of dementia possibility? The slowness of movement and walking also comes with tiredness, as in easily tired and having ache after a short walk distance or this is just normal for people over 65?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
If I get your question correctly, is fatigue after walking for a short distance and slowness of movement normal in aging?
It could be possible but generally you need to be sure that they are not excessive and therefore pathological.
Question by srrozc
Dear Doc,
My grandfather had been suffering from PD for almost 3 years already. Recently he came over from Jakarta to see a local specialist and after taking the prescribed medication, he started having hallucinations and was mentally hyperactive at night., which was worrying. My family decided to seek for a second opinion, with another specialist, with regards to the dosage and type of medication. The 2nd specialist reduced the dosage and the side effects were greatly reduced. Although my family felt relieved when they saw the “improvement” (reduced side effects of the medication), my concern is, with reduction in dosage, will it still be effective and beneficial for my grandfather’s condition in the long run?
Currently his medication includes Madopar, Sifrol 0.125, Bioquinone and Resolor. Please advise. Regards, Ong
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Do not worry about the dose, treat the patient and not the medication. As long as the medication is enough to cause your grandfather to have a good quality of life, there will be just fine.
Here I need to stress that the medication we give in Parkinson disease does not stop the neurodegeneration process that is happening. What we are doing is just replacing the dopaminergic deficit that is the result of the neurodegeneration.
So in the future, as the neurodegeneration goes on, your granddad will require more frequent dosing of levodopa to control his motor symptoms and if that causes hallucination, then he has to be put on an antipsychotics or cholinesterase inhibitors which suppresses the hallucinations thus allowing the levodopa to be increased in order to control motor symptoms. Another thing to mention is that your doctor needs to rule out all other medical condition such as infections which can cause hallucinations.
Question by octane
Cuurently are there any cure for Parkinson disease? Other than taking dopamine medicine, does regular exercise helps in preventing Parkinson disease?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Unfortunately there is no cure for PD currently. Exercise has many beneficial effects in PD patients. Some animal studies have shown that there may be possible protective effects of exercise on PD model of animals. Studies in cognition also showed that people who exercise regularly have a lower incidence of cognitive problems.
Question by jaden chia
I am just curious, what Causes Parkinson Disease?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Unfortunately, this is unknown at the present moment. We do know however there is accumulation of a protein called Lewy Bodies in the brain. How this comes about remains elusive till now. There are some suggestions of genetics as the cause of PD or in interaction with environmental factors.
Question by starvisual
Is there any exercise (physically or mentally) to prevent or delay having Parkinson disease?
Answered by Dr Tay Kay Yaw Consultant Department of Neurology National Neuroscience Institute
Exercise that requires you to achieve cardiovascular fitness is generally encouraged. The definition of cardiovascular fitness can easily be found on the internet as it will depend on your age. For mental stimulation I have always encouraged my patients to continue and soldier on as usual and try not to think of PD as a limiting disease to them. Think of it as just a little faster aging than normal and do whatever you want to do although in advanced cases this may need supervision. Use your brain regularly to think of solutions- if you do not use it you will lose the mental capacity of the brain.
Ref: T12
