Early Onset Parkinson's Disease

Parkinson’s disease is a disabling neurological condition with many different symptoms. It mostly affects middle age to older people, but can show up in younger people. Early onset Parkinson’s disease can show up just like the usual onset. Younger people may notice a hand tremor, or have trouble walking. The symptoms can mimic other neurological conditions and diagnosis in younger people can be tricky.

At this time, there is no definitive testing for Parkinson’s disease. Doctors can diagnose Parkinson’s by symptom criteria after ruling out other health conditions that may be the cause of symptoms. If you have any of the symptoms below, see your doctor and ask for a referral to a neurologist. The information contained here is not for diagnosing Parkinson’s and is for information on the disorder. This article will help you understand Parkinson’s disease, and what it may look like in someone that doesn’t seem old enough to be suffering from it.

What Is Early Onset Parkinson's Disease?

When Parkinson’s symptoms appear between the ages of 21 and 40 years, it is considered “early onset.”

Early onset Parkinson’s disease is the same as Parkinson’s disease and a degenerative neurological disease that manifests in a small group of neurons in the substantia nigra. These neurons produce dopamine (neurotransmitter) that signals muscle response in the smooth muscles. It can also affects some “non-motor” functions of the body.

In Parkinson’s disease, these neurons that produce dopamine die off and this lowers the dopamine levels. Body movements begin to become slower, walking becomes uncoordinated, balance is affected, and hand tremors set in. The cause of these cells dying is still unknown.

Early Onset Parkinson's Disease Symptoms

The symptoms at onset are most often the same as the onset in later years, but it can be challenging for a young person that has to deal with work, children, and social situations.

Parkinson’s in younger adults tends to be milder and progresses slower. This may be due to better health and the cells are less aged. There usually aren’t any issue with dementia and cognitionin younger people with Parkinson’s. The tremor and involuntary movements that go with the disease are often the most severe issue for younger people.

  • Hand tremor at rest
  • Slowed movements
  • Rigid muscles
  • Balance issues
  • Depression
  • Skin issues
  • Low blood pressure
  • Bowel and bladder issues
  • Sweating
  • Trouble sleeping
  • Cognitive issuesbecause it can affect the way you feel, think, and behave or affect your memory
  • It can rarely lead to impulse control disorder like binge eating, excessive shopping or hyper-sexuality   

Only a few symptoms need to be present to diagnose Parkinson’s and not all younger people have all of the symptoms. It is important if you have any of the above symptoms to see your doctor as soon as possible. It may be necessary to rule out other health conditions that can cause neurological symptoms.

Early Onset Parkinson's Disease Risk Factors

The risk factors for early onset Parkinson’s disease are the same as Parkinson’s that comes on later in life. The one big risk factor for Parkinson’s disease is age and male gender. Other factors include:

  • Smoking
  • Drinking too much caffeine
  • Exposure to chemicals/pesticides
  • Head injury
  • Genetics/Family history

Treatments for Early Onset Parkinson's Disease

The treatments for any case of Parkinson’s disease are the same. Here are the treatments:

1.       Levodopa- Carbidopa

Levodopa is one of the first lines of treatments for Parkinson’s disease. The levodopa goes into the brain where it is changed into dopamine. The carbidopa which is combined with Levodopa prevents the levodopa from being changed too soon outside the brain. Carbidopa also helps with some of the side-effects including nausea, dizziness, and low blood pressure. Levodopa effects may wear off with long-term use and cause other side-effects like involuntary movements. This drug is available for oral use and by infusion.

2.       Dopamine Agonist Medications

Dopamine agonists act like dopamine inside your brain. They tend to be less effective but the effects last longer. They are often given with levodopa to make it work better. Side-effects includeincreased sexuality, addictive behavior, hallucinations, and lethargy.

3.       MAO-B Inhibitors

These stop your brain from breaking down dopamine. They inhibit a chemical in the brain called monoamine oxidase B that reduces the amount of dopamine you have available. Side-effects include inability to sleep and nausea. This medication should not be used with carbidopa-levodopa as this combination can cause hallucinations. They also cannot be taken with anti-depressant medications.

4.       Catechol-O-methyltransferase (COMT) Inhibitors

These can increase the effectiveness of levodopa and makes it work longer. Side-effects includeinvoluntary movement, diarrhea, nausea, and low blood pressure.

5.       Anticholinergics

These are rarely used anymore and help reduce the Parkinson’s tremor. The side-effects with these medications often cannot be tolerated and include trouble urinating, dry mouth, confused thinking, memory issues, and constipation.

6.       Amantadine

This medication can relieve symptoms for short periods of time if the disease is mild. It can be used in combination with carbidopa-levodopa later in the disease to relieve involuntary movements caused by other medications. Side-effects include swelling of the ankles, hallucinations, and purple color of the skin.

7.       Deep Brain Stimulation

Doctors can implant electrical stimulators in your brain that can target the areas that help stimulate muscle control. The system can be adjusted to help manage symptoms. Risks of this procedure include stroke, hemorrhage, and infection. This is usually only used in people who do not respond to medication or have a more severe case.

Early Onset Parkinson's Disease Complications and Prognosis

Parkinson’s disease is not a fatal condition, but certain complications can lead to poor health and death. The prognosis depends on how old you are, if you are healthy, and how severe your condition is. Complications include:

  • Blood clots in the legs
  • Aspiration pneumonia
  • Blood clots in the lungs

The above complications are usually what shorten the lifespan of someone with Parkinson’s. 

 
 
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