Parkinson’s Disease

The specialists at Indiana University Health Neuroscience have particular expertise in Parkinson’s disease, providing comprehensive evaluation and exceptional treatment. Parkinson’s is a movement disorder that progresses slowly, and includes symptoms such as poor dexterity, tremor, soft speech, and difficulty with walking, movement and coordination. It affects men and women and is characterized by a combination of four major symptoms: shaking with limbs at rest, slowness of movement, rigidity of the limbs or trunk, and poor balance.

Designated as a Center for Care by the National Parkinson's Foundation, we provide the highest level of care for patients with this disorder. People from across the country seek our advanced treatments and specialized expertise. Teams of Indiana University Health neurologists and neurosurgeons work together to provide individualized care. Using sophisticated diagnostic testing, the most innovative treatments and various education and support services, we help people who have Parkinson’s best manage their condition so they can enjoy life to their fullest ability.

Jump ahead on this page

1. Symptoms  
2. Causes 6. Treatment
3. Risk Factors 7. Parkinson's Disease Clinic
4. Complications 8. Managing At Home
5. Diagnosis  


Symptoms of Parkinson’s disease may be mild at first. For instance, a person may have a slight tremor or a feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, usually starting on one side first, and can include:

  • Decreased eye blinking
  • Drooling or difficulty swallowing
  • Problems with balance and walking
  • Decreased facial expression (like wearing a mask)
  • Muscle aches and pains
  • Movement problems, including difficulty starting to walk or getting out of a chair, difficulty continuing to move, slowed movements or difficulty with writing or eating
  • Rigid or stiff muscles
  • Shaking, called tremors
    • Usually occurs in the limbs at rest, or when the arm or leg is held out
    • Eventually may be seen in the head, lips, tongue, and feet
    • May be worse when tired, excited or stressed
  • Finger-thumb rubbing (pill-rolling tremor) may be present
  • Slowed, quieter speech and monotone voice
  • Stooped posture
  • Low blood pressure when getting up, sweating, drooling, lack of body temperature control

A person who has Parkinson’s may also exhibit psychological symptoms such as anxiety and tension, confusion or dementia, depression, fainting, hallucinations and memory loss.

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Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson’s disease occurs when the nerve cells in the brain that make dopamine slowly die. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to loss of normal muscle function, with symptoms worsening over time.

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Risk Factors

Parkinson’s disease most often develops after age 50. One of the most common nervous system disorders of the elderly, it affects one in 100 people over age 60, with the average age of onset being 60. Sometimes it occurs in younger adults, with 5-10 percent of patients being age 40 or younger. In some cases, Parkinson’s runs in families. When a young person is affected, it is usually due to a form of the disease that is hereditary.

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People who have Parkinson’s may suffer from many problems related to the disorder, including:

  • Difficulty performing daily activities
  • Trouble with swallowing or eating
  • Disability (differs from person to person)
  • Injuries from falls
  • Pneumonia from breathing in saliva
  • Side effects from medications

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Our experienced doctors are experts at diagnosing Parkinson’s disease. To confirm the disorder, they rely on patient history and a complete physical and neurological exam. Neurodiagnostic and laboratory testing may also be used to diagnose the disease.

The sooner a person with Parkinson’s receives the correct diagnosis, the better. Treatment is more likely to lead to good symptom control if care begins early. That is why prompt, accurate diagnosis is important. Because IU Health Neuroscience doctors have vast experience treating movement disorders, they have the clinical knowledge to properly identify signs and symptoms, and many people seek their highly specialized expertise when frustrated with lack of diagnosis or adequate treatment elsewhere.

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There is no known cure for Parkinson’s disease. The goal of treatment is to control symptoms through medication, or in some cases, surgery. IU Health Neuroscience offers the full range of the most innovative treatments and our highly skilled doctors determine the best course of therapy for each person.


Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wear off, and symptoms can return. If this happens, your doctor may need to adjust the type of medication, the dose, the amount of time between doses or how the medicine is taken.

Botulism Injections

Our specialists use botulism toxin injections to give patients effective, temporary relief from severe muscle spasms and contractions. Too much botulism toxin can be fatal, but in small doses, it is very safe. When it is injected directly into a person's muscle, the botulism toxin blocks neurotransmitter messages, and helps reduce and eliminate muscle spasms. Each treatment provides relief for about three to four months.


For some people with Parkinson’s, surgery may be an option. These surgeries do not cure the disorder, but can help ease symptoms. IU Health neurosurgeons perform two procedures: deep brain stimulation which brings electrical stimulus to areas of the brain that control movement, and ablative surgery which destroys brain tissues that cause Parkinson’s disease symptoms.

Deep brain stimulation (DBS)

In deep brain stimulation, doctors place electrodes deep in the brain, which are connected to a pacemaker-like device implanted under the skin near the collarbone. The device sends regular electrical impulses to target areas of the brain to correct excessive or misguided signals. IU Health Neuroscience has performed DBS for more than 15 years and has Indiana’s largest, most comprehensive DBS program.

Ablative surgery

In ablative surgery, our neurosurgeons use electrical charges to damage a tiny section of the brain. Using sophisticated, 3D brain mapping and MRI, our experienced neurosurgeons can identify the exact area of the brain that is causing abnormal movements. Then, with exact precision, they apply a small charge directly to the brain via electrodes. The charge interrupts electrical currents within that section of the brain. Once that part of the brain cannot send messages, abnormal movements are more controlled.

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Parkinson's Disease Clinic

IU Health Neuroscience offers a dedicated clinic for people who have Parkinson’s disease, staffed by neurologists, neurosurgeons, researchers and nurses specializing in movement disorders. People can learn about the latest treatment options in the news, participate in clinical trials and join a Parkinson’s support group.

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Managing At Home

Certain lifestyle changes can help make living with Parkinson’s disease easier:

Healthy Eating And Exercise

A nutritionally balanced diet with plenty of fruits, vegetables, whole grains and fluids is key. Changes in what you eat or drink may be necessary if there are swallowing problems. Exercise is beneficial, but the activity level might need to be adjusted to meet changing energy levels. It is crucial to take regular rest periods and avoid stress.

Walking With Care

Parkinson's disease can disturb your sense of balance, making it difficult to walk. It is important to move slowly, stand up straight, strike the floor with your heel first and look directly in front of you (not down) while walking. Railings or banisters are usually placed in commonly used areas of the house.

Avoiding Falls

In the later stages of the disease, people may fall more easily. In fact, you might be thrown off balance by just a small push or bump. Try not to pivot your body over your feet while turning (make a U-turn instead). Keep your center of gravity over your feet, and avoid leaning or reaching. Do not carry things while walking, and avoid walking backward. Other changes may be needed around the home to prevent falls and make the bathroom safe.

Daily Living Activities

Everyday activities, such as dressing, eating, bathing, writing and speaking, can be difficult for people with Parkinson’s disease. A physical, occupational or speech therapist can show you techniques that make daily life easier. Special eating utensils, wheelchairs, bed lifts, shower chairs, walkers and wall bars can also improve quality of life.

From diagnosis through treatment, IU Health Neuroscience provides the most experienced doctors and the most innovative treatment options for sophisticated Parkinson’s disease care.

Learn more about Parkinson's disease.

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