What is the Connection Between Parkinson's and Dystonia?

Parkinson’s and dystonia are neurological disorders that adversely affect one’s ability to control his or her movements. Presenting together, there is no known, established cause for the development of Parkinson’s and dystonia. There is no cure for either condition, so treatment is generally centered on symptom management. Oftentimes, medications, physical therapy and, in some cases, surgery are utilized to slow disease progression and allow for some semblance of normalcy during the early stages of Parkinson’s disease.

Dystonia is considered a muscle disorder originating in the brain that compromises one’s ability to control his or her muscular movements. Painful in its manifestation, the spasms associated with this progressive condition may present singly or in several parts of the body simultaneously. Affecting more than 250,000 people in the United States alone, dystonia does not discriminate and may affect anyone of any age. The most common presentations of this progressive disorder serve to accentuate the debilitating effects of Parkinson’s disease.

Similar to dystonia, there is no known, single cause for the development of Parkinson’s disease. Adversely affecting one’s ability to control his or her physical movements, this progressive condition presents gradually as impaired mobility, facial expression, and speech. Though there is no known cause for the disorder's development, it has been suggested that various environmental and genetic factors may contribute to symptom manifestation. Not only may consistent exposure to environmental toxins, such as pesticides, lead to a loss of muscular function, but chemical imbalances, such as those that occur with dopamine depletion and nerve damage, may also play a pivotal role in disease development.

Due to the gradual onset of symptom development, there is no definitive test designed to diagnose Parkinson’s and dystonia. Most diagnoses are made through a thorough assessment of one’s complete medical history and the administration of a variety of neurological examinations. Established criteria may also be utilized to determine if one’s symptoms meet the patterned progression of Parkinson’s and dystonia. Criteria often includes whether the individual exhibits at least two of the tell-tale signs of disease, determining on which side of the body symptoms manifest, and whether or not one’s condition improves with the administration of medication.

Individuals with dystonia and Parkinson’s often develop psychological issues, including depression, problems controlling their bodily functions, and impaired digestive function, which may contribute to regular constipation. During the latter stages of the disease, complications may impair one’s ability to chew and swallow, which can increase his or her risk for choking. Oftentimes, the medications administered to slow the progression of Parkinson’s and dystonia may lead to the development of insomnia, hallucinations, and a permanence of involuntary movements, such as twitching.

The early onset of symptoms often includes the development of mild tremors that affect one’s hands. Though symptom manifestation generally varies in presentation and degree depending on the individual, common signs include muscle rigidity, impaired speech, and an inability to perform automatic movements, such as blinking. Many individuals develop mild presentations of impaired mobility, such as shuffling when they walk, and may have moments where they lose their balance. As the disease progresses, individuals eventually lose their ability to speak, remain mobile, and control their movements. During the later stages of disease progression, one’s cognition becomes severely compromised and he or she is unable to move voluntarily.

In the absence of a cure, medications and physical therapy are frequently utilized to aid with symptom management. The use of medications, such as MAO-B inhibitors and anticholinergics, may be utilized to increase and regulate dopamine levels and manage the physical presentations of Parkinson’s and dystonia that often present during the initial stages of disease development, such as tremors. Additional medications, including levodopa, may be administered to further aid with alleviating Parkinson’s and dystonia symptoms. Unfortunately, as the disorder progresses, medications eventually lose their effectiveness in the presence of more pronounced symptoms.

Physical therapy may also be recommended to help slow the progression of initial Parkinson’s and dystonia symptoms. Regular exercise can be effective in promoting mobility and muscle function. Additional therapies may be recommended to aid with the latter manifestations of impairment, such as those which may affect one's speech and cognition.

For some individuals, surgery may be an option to slow disease progression. During a procedure known as deep brain stimulation, an electrode is positioned within the brain to reduce the prominence and frequency of involuntary movement. As with any invasive medical procedure, there are risks associated with deep brain stimulation and these should be discussed with a qualified health care provider prior to pursuing this treatment option.