Parkinson's Disease Treatment

How is Parkinson's Disease Diagnosed?

A neurologist diagnoses Parkinson's disease by reviewing the patient's medical history and symptoms and performing a detailed neurological examination. The doctor assesses movement, muscle stiffness, balance, reflexes and walking pattern.

There is no single test to confirm Parkinson's disease. However, blood tests and imaging tests such as MRI or DaT scan may be recommended to rule out other neurological conditions.

How is Parkinson's Disease Treated Based on Severity?

The table shows the recommended course of treatment for Parkinson's disease based on the severity:

Stages of Parkinson's Disease and Their Treatment

The Hoehn and Yahr scale divides Parkinson's disease into five stages, depending on how severe the symptoms are. Depending on a patient's disease progression, a doctor suggests the following treatment:

Other Treatments for Parkinson's Disease

For moderate to advanced Parkinson's disease, doctors may recommend infusion therapies, rehabilitation or surgery when oral medicines are no longer effective. Infusion therapies such as foslevodopa and apomorphine provide continuous medication delivery to reduce ‘on' and ‘off' periods.

Physiotherapy, occupational therapy and speech therapy help improve mobility and daily functioning, while Deep Brain Stimulation (DBS), MR-guided Focused Ultrasound (MRgFUS), or, in selected cases, Gamma Knife® stereotactic radiosurgery may be considered for suitable patients.

Oral Medications for Parkinson's Disease

Oral medicines are the main treatment for Parkinson's disease and are usually prescribed at different stages as the disease progresses. These include:

• Pramipexole: It is a dopamine agonist that helps with movement symptoms and can delay the need for higher doses of levodopa.

• Ropinirole: It can be taken by itself or with levodopa to help manage Parkinson's symptoms.

• Rasagiline: It is an MAO-B inhibitor that helps keep dopamine active in the brain and may improve symptom control.

• Safinamide: This is often given with levodopa to help reduce "off" episodes in people with advanced Parkinson's.

• Entacapone: This is a COMT inhibitor that helps levodopa work longer and reduces wearing-off symptoms.

• Carbidopa-Levodopa: It is the most effective medicine for improving tremors, stiffness, and slow movement.

• Opicapone: This is a COMT inhibitor taken once a day with levodopa to help control symptoms.

• Amantadine: It can help reduce involuntary movements and give some relief from Parkinson's symptoms.

• Trihexyphenidyl: It may be prescribed primarily for tremor in selected younger patients.

• Istradefylline: It is added to levodopa treatment to help reduce off-time.

Ayurvedic and Alternative Treatments for Parkinson's Disease

People with Parkinson's disease can consider Ayurvedic or other complementary therapies to help manage symptoms and support their well-being. Some of these treatment options for Parkinson's disease include:

• Herbal Formulations: Help boost your energy, reduce fatigue, and support clear thinking.

• Panchakarma Therapy: Helps with muscle stiffness, promotes relaxation, and improves circulation. Treatments such as Abhyanga, a type of oil massage, are often included.

• Pranayama and Yoga: Breathing exercises like Anulom Vilom and Bhramari, along with yoga, may help reduce stress and improve balance and mobility.

Home Care for Managing Parkinson's Disease

Simple home care tips can support medical treatment and help people with Parkinson's disease. Some helpful home care tips to manage this disease include:

• Take your Parkinson's medication just as your doctor has prescribed.

• Do not smoke and avoid alcohol.

• Wear supportive shoes and recommended walking aids.

• Go to your physiotherapy, occupational therapy, and speech therapy sessions regularly.

• Maintain consistent sleep and daily routines.

• Ask your family for support when you need it.

Latest Treatments for Parkinson's Disease

Recent progress in treating Parkinson's disease focuses on keeping symptom control steady and reducing 'off' periods. Advanced Deep Brain Stimulation (DBS) now uses smart, closed-loop systems that sense real-time brain signals and automatically adjust electrical stimulation.

Non-surgical delivery methods, such as continuous 24-hour skin infusions (e.g., foslevodopa/foscarbidopa [Vyalev]) and medicine, like carbidopa-levodopa intestinal gel infusion and continuous apomorphine infusion, keep medication levels steady all day.

Meanwhile, research into gene and stem cell therapies, along with new protective drugs, aims to slow disease progression.

How Long Does Parkinson's Disease Treatment Take?

Parkinson's disease is a lifelong condition, so treatment is usually continued throughout life. This table shows the approximate amount of time needed for each treatment:

Treatment Side Effects for Parkinson's Disease

Most treatments for Parkinson's disease are safe when your doctor prescribes and monitors them carefully. Still, some medicines and procedures can cause side effects, such as:

• Nausea

• Vomiting

• Dizziness

• Low blood pressure when standing up, also called orthostatic hypotension

• Sleepiness or sudden sleep episodes

• Hallucinations

• Psychosis

• Agitation

• Feeling faint upon standing

• Heartburn

• Confusion, particularly in older adults

• Dry mouth

• Constipation

• Involuntary movements (dyskinesias)

Lifestyle Changes for Parkinson's Disease

Maintaining a healthy lifestyle can help you move better, lower your risk of problems, and improve your quality of life during Parkinson's disease treatment. Try incorporating the following habits:

• Exercise regularly with advice from a professional.

• Eat a balanced diet that includes plenty of fibre.

• Keep both your body and mind active.

• Work towards keeping a healthy weight.

• Make sure you drink enough water to stay hydrated.

• Practice balance and posture exercises.

• Do not smoke.

• Avoid alcohol.

• Aim to get enough sleep each night.

• Attend regular follow-up appointments.

Triggers That Can Worsen Parkinson's Disease

There are a few factors that can make Parkinson's disease symptoms worse for a short time or make treatment less effective. These include:

• Ongoing stress or feeling anxious

• Not getting enough sleep

• Dehydration

• Constipation

• Infections such as urinary tract or chest infections

• Physical inactivity

• Certain medicines that block dopamine

• Poor nutrition

• Sudden changes in medication without medical advice

Treatment Cost for Parkinson's Disease

The cost of treating Parkinson's disease in India varies depending on the disease stage, type of treatment, location, hospital, and duration of care. A visit to a neurologist usually costs between ₹1,000 and ₹2,000. Physiotherapy sessions typically cost ₹500 to ₹1,000 per session. Monthly medicine costs range from about ₹2,000 to ₹5,000.

For advanced treatments like Speech/Occupational Therapy, the price is between ₹500 and ₹1,500 per session. For Deep Brain Stimulation (DBS) surgery, the cost is usually between ₹8 lakh and ₹25 lakh, depending on the hospital, the surgeon's experience, and the type of device used.

Does Health Insurance Cover Parkinson's Disease Treatment in India?

Yes. Parkinson's disease is covered under health insurance, either under comprehensive or critical illness policies. Generally, standard health insurance plans cover hospital stays, diagnostic tests, therapies and ongoing care needed to manage the condition, depending on the policy. Besides, deep brain stimulation is covered under modern treatments by most insurers. However, the exact coverage varies from one policy to another.

Most insurers cover Parkinson's disease under critical illness insurance plans, which require a survival period of 30 days and a waiting period of up to 90 days. Such plans pay a lump sum payout upon diagnosis, which can be used to pay for treatment or to cover unemployment costs. To ensure receiving financial protection at the required time, thoroughly review the terms and conditions of your mediclaim policy.