Ongoing treatment may be a number of drugs used to treat Parkinson’s disease in its various stages.
*Generally, the initial treatment of Parkinson’s disease begins with:
-Dopamine agonists (bromocriptine, pergolide, pramipexole, ropinirole);
-Levodopa and carbidopa;
-Peripheral inhibitor of catechol-0-methyltransferase (COMT) inhibitors, entacapone, tolcapone;
-Anticholinergic agents (benztropina, trihexifenidil)
-Selegiline – inhibitor of monoamine oxidase type B;
-Amantadine.

*Surgery
Surgery may be considered when medication can no longer control symptoms of Parkinson’s disease or when side effects are quite severe and affect daily activities of the patient.

Surgery is not a solution for those with Parkinson’s disease. Usually, after that, the medication is still necessary, but surgery may reduce the number and doses of drugs necessary to control symptoms. All this leads to reducing adverse effects caused by drugs and also to collect and control the Parkinson disease symptoms.

Drug treatment is usually in the treatment of Parkinson’s disease. The aim of medication is to compensate for the lack neurotransmitter – dopamine, which causes symptoms of the disease. Treatment is started, usually when symptoms lead to handicap person. Treatment may vary depending on symptoms, patient age, and depending on its response to drugs. Medicines can relieve symptoms, but a number of adverse effects. It takes time for the doctor to establish an effective combination of drugs, which take effect on each person. Today, levodopa is considered the most effective in controlling symptoms of Parkinson’s disease for many years was the preferred drug for the treatment of newly diagnosed Parkinson persons. However, due to its use for a long time and higher doses appeared a number of motor complications, which were difficult to treat.

A person in an advanced stage of disease is limited in terms of freedom of movement and conducting daily activities. Symptoms of Parkinson’s disease may change from day to day and adverse effects of drugs used in the treatment may limit its effectiveness. Your doctor will need to alter treatment based on changes that occur in disease symptoms. A speech therapist may recommend speech and breathing exercises that can help patients who have monotonous speech, imprecise, whispered, specify those affected by Parkinson’s, especially in the final stages.
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There must be a modification in terms of nutrition, about what and how they eat. For example, they can eat standing up and eating little, and food has to be as easy to chew as possible. However the patient may exempt any food problems. Keeping your chin high, swallowing often and avoiding sweets may be reduced salivation. Muscular blocking can be solved by making deliberate movements. Moving to a fixed point on earth, making a first step in long march style can help overcome episodes of muscle stiffness.

As the disease progresses, symptoms become increasingly annoying. Most patients develop a tremor from easy to moderate. Movements are slow and limited due to muscle stiffness and slowing or loss of automatic reflexes (bradykinesia).

Treatment at this stage is weighed according to the severity of symptoms and adverse effects of drugs. The symptoms will change as the disease  passes through various developmental stages. The doctor will monitor the evolution of individual patient treatment and will change depending on the appearance of new symptoms. Levodopa is the most popular drug used to treat Parkinson’s disease. Still, it may have some adverse effects at high doses or after a long treatment. Your doctor may prescribe dopamine agonists, pramipexole or ropinirole such as to prepare the start of levodopa treatment. Recent studies have shown that these drugs can delay the occurrence of adverse effects of levodopa. Also, the doctor may prescribe dopamine agonists with levodopa in the same time.

At first, patients with Parkinson’s disease may not need treatment if symptoms are mild. Prescribing doctor may postpone treatment until the time symptoms are distressing and interfere with daily activities. Additional treatment methods such as exercise, physiotherapy and occupational therapy can help in all stages of Parkinson’s disease, especially in maintaining the tone, mobility and independence. If medication is needed, there are several options. Although levodopa is still considered the best medicine for Parkinson’s, its side effects (which include involuntary movements and other motor complications) may cause problems in the late stages of disease. Recent studies suggest that initial treatment with dopamine agonists pramipexole and ropinirole such as the need may delay starting treatment with levodopa and may thus delay the occurrence of side effects of it. Other nondopaminergice drugs that can be used in the early evolution of the disease are amantadine, mono-amine oxidize inhibitors (such as selegin) and anticholinergics (such as trihexifenidil).
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The doctor together with the entire team that oversees the patient suffering from Parkinson’s can advise you on this in terms of emotional support and medical education specific to the disease. They are important at all stages of disease evolution. There is no treatment to stop the destruction of nerve cells that causes the disease. However, some medications can improve symptoms. Surgery may be also useful in treating the symptoms, but for a small number of people. Treatment is different for each person and may change as the disease evolves. Age, occupation, family and living conditions may influence decisions on starting treatment, its type and when to change medications. If health status changes and treatment should be adjusted to achieve a balance between quality of life, side effects of disease and treatment cost.

There are a number of measures to be taken by the person affected by Parkinson’s at home to make it easier to cope with symptoms. Patient should be advised to use their energy for activities strictly necessary and to design the house so that it is very easy to move any things you need to be at hand. All this will help you be an independent. Regular exercise, a balanced diet is important in the treatment. Exercise can help maintain tone, coordination and strength, but also in maintaining weight and reducing the potential for constipation. In terms of people with Parkinson’s diet is very important that they ask all the information on physician diet because protein intake may interfere with drug absorption and can change their effectiveness.

Patient description should answer the following questions:
- Tremor occurred suddenly or gradually?
- Led to his improvement or worsening?
- As part of the body was affected?
It is advisable to call emergency services if symptoms such as sudden weakness, paralysis, loss of balance, impaired speech or vision problems. These may be signs of a heart attack. Symptoms of Parkinson’s disease usually develop slowly during several months.

Medical specialists recommend

The following health professionals can diagnose and treat Parkinson’s disease:
- GP;
- Doctor of internal medicine;
- Neurologist.
Other specialists that may be involved in tracking patient suffering from Parkinson’s are:
- Speech doctor;
- Physiotherapist;
- Occupational therapy specialist.

1. Early diagnosis
At the moment there is no screening test for Parkinson’s disease. Diagnosis of Parkinson’s disease is based on medical history and a thorough neurological exam.
2. Investigations
There are no laboratory tests to diagnose Parkinson’s disease. If the patient’s symptoms and results of a doctor during the consultation are not entirely typical of Parkinson’s disease you can do some tests to diagnose other conditions with similar symptoms. For example, blood tests can be done to see if somehow it is not a thyroid or liver disease. An MRI examination can be done to exclude a myocardial infarction or a tumor of the central nervous system.

Another imaging test called PET (positron emission tomography) can detect low levels of dopamine in the brain and can also be diagnosed as Parkinson’s disease. However, this investigation is not a usual because it is very expensive and not available in many hospitals, is still in experimental phase..

*Risk factors
Risk factors in this disease are difficult to identify because the disease is not known. Advanced age is the only known risk factor for Parkinson’s disease (not included early-onset Parkinson’s disease). Most debut after 50 years, although disease can occur in people between 30 and 50 years and even, in rare cases, the youth.
A very small number of people who have been diagnosed with this disease have a close relative suffering from Parkinson’s disease symptoms. It seems that a family history of Parkinson’s disease significantly increases the risk of disease from a family member. With family cases early onset Parkinson’s disease can be an important risk factor in illness and other family members, but it is a rare form.
Some studies have shown that prolonged exposure to certain environmental factors, such as pesticides, chemicals, using water from wells can increase the risk of disease, but until now this has not been demonstrated. There are many conditions that can develop Parkinsonism (a group of symptoms that include tremor, muscle rigidity, slower movements and balance disorders).

It is advisable to avoid sleeping during the day and make the exercise day and before bed to drink a glass of warm milk or tea without caffeine.

Parkinson’s disease can cause a variety of other symptoms.

These may include:
- Reduced dexterity and coordination. Handwriting changes and writing are becoming less common (micro-graphic). Reduced athletic abilities and daily activities such as dressing or meal becomes more difficult;
- Muscle cramps and joint damage;
- An oily skin and the appearance or increase dandruff;
- Digestive and urinary problems. Constipation is common. Is difficult to control urination and frequent urination may occur and compelling. Drugs used to treat the disease may help or worsen symptoms;
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- Problems in the control of involuntary or automatic body functions such as: increased sweating, decreased blood pressure when people stand in orthostatic position (orthostatic hypotension) and sexual dysfunction. But these symptoms can be given and the treatment used in Parkinson’s disease;
- Sudden onset and brief inability to move. Often affect the person walking;
- Sleep problems can occur, mood and thinking at those affected by this disease.

Sleepiness or insomnia can occur at these patients due to anxiety, depression, or physical fatigue. People affected by the disease may not have a normal sleep since and can not easily change position in bed.

Up to one in three people suffering from Parkinson’s disease may develop dementia and confusion, similar to those of Alzheimer’s disease (all primary degenerative dementia, characterized by the appearance of a slowly evolving dementia), the final phase of the disease. Depression can contribute to memory loss and causing confusion.

*Diseases with similar symptoms

Parkinson’s disease can be difficult to diagnose because many diseases have symptoms that are common in Parkinson’s disease (tremor, muscle rigidity, slower movements, and balance disorders).

Parkinson’s disease can affect a person’s ability to control body movements. Certain nerve cells in the brain occur normally, a chemical called dopamine. Dopamine is a neurotransmitter or chemical mediator, through which nerve cells control body movements. In Parkinson’s disease, these nerve cells that produce dopamine, are destroyed leading to low levels of it. When this happens, problems may arise in body movement.
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Parkinson’s disease gives a range of symptoms and complications. This article only covers the general treatment of disease rather than individual symptoms.
Treatment can control Parkinson disease symptoms in the early evolution of the disease and is started as soon as symptoms affecting daily activity and ability to work sick person. For example, a right-handed person that installs tremor on the left side may not feel embarrassed by the appearance of this symptom and cannot feel the need for treatment until symptoms are worse. A person that cannot fulfill their assignments because of the sign may want to start treatment much faster than a person who works or not or if the daily activities are not affected by of any of the symptoms.

-Causes

Ongoing studies are seeking to determine if there is a genetic cause of Parkinson’s disease. Only a small percentage of those with Parkinson’s disease have a parent, brother or sister with the disease. However, the transmission of genes (the basic unit of heredity composed of deoxyribonucleic acid) appears to be abnormal because of early-onset Parkinson’s disease within families where the disease is found at much younger ages.Low levels of dopamine (mediators) involved in movement control give the symptoms of this disease. The lack of this neurotransmitter occurs when nerve cells in a certain part of the brain (black substance), which produce dopamine deteriorate or are destroyed. The exact cause of the damage to nerve cells is unknown.

The type and severity of symptoms varies from one patient to another and according to disease stage. Symptoms that may occur in a patient in the early stages may not develop until in late stages of the disease to other patients or may not appear at all.