Glossary of Parkinson’s terminology
Some of the most common terminology used in Parkinson's is explained.
Apomine® (apomorphine hydrochloride)
A dopamine agonist which is quick acting and has a short duration of effect. It is given by injection or continuous pump.
Atypical Parkinsonism
Conditions which resemble Parkinson’s but have some variations in symptoms, response to medications and prognosis.
Basal Ganglia
A set of structures deep within the brain, that consists of the striatum, globus pallidus, subthalamic nucleus and substantia nigra. Dopamine is produced in the cells of the substantia nigra. It is this area that provides a definite diagnosis of Parkinson’s post mortem. The basal ganglia has important implications in movement, cognitive and emotional functions.
Bradykinesia
Slowness in initiating and executing movement.
Bradyphrenia
Slowness of thought process.
Deep Brain Stimulation
A reversible surgical procedure used in the management of Parkinson’s. It involves placing electrodes into a chosen target site of the brain. This site choice depends on the aspect of Parkinson’s to be treated – for example tremor or dyskinesia.
Dopamine
A chemical produced by the substantia nigra in the basal ganglia. It is responsible for transmission of signals between nerve cells that control movement. A lack of dopamine is the primary factor in Parkinson’s. The reason for this depletion of dopamine remains unknown.
Duodopa® (levodopa and carbidopa)
A gel formulation of Sinemet® which is infused via a permanent tube into the small intestine. This is an alternative mode of treatment in later stage Parkinson’s.
Dyskinesia
Involuntary movements (nodding, jerking, twisting) resulting from medium to long-term use of levodopa.
Dystonia
Abnormal and sustained posturing which can affect any part of the body, more commonly seen in the feet, toes and neck. Predominantly occurring in the ‘off’ state.
Freezing
The temporary inability to move. Freezing may only last a few seconds. It can occur in confined spaces or when changing direction.
Idiopathic
A term meaning ‘cause unknown’.
Kinson® (levodopa and carbidopa)
A dopamine replacement therapy medication.
Kripton® (bromocriptine mesylate)
A dopamine agonist medication.
Levodopa (L-dopa)
A chemical precursor of dopamine which can be taken orally. It is converted to dopamine and crosses the blood brain barrier.
Lewy Bodies
Round microscopic structures found in brain cells at post-mortem. Often regarded as a definitive sign of Idiopathic Parkinson’s.
Liquid Sinemet® (levodopa and carbidopa)
A liquid preparation of Sinemet® which is made daily and taken in an hourly to two-hourly regime. Often prescribed in complex cases of Parkinson’s.
Madopar® (levodopa and benserazide)
A dopamine replacement therapy medication available in rapid, normal and controlled release preparations.
Monoamine Oxidase Inhibitors (MAOIs) (Selegiline®, Eldepryl®)
Drugs which block the breakdown of dopamine in the brain. Drug interactions are possible with this group of medications.
Motor Fluctuations
A variance in response to levodopa therapy which may develop after a few years of treatment. This can be ‘wearing off’, or ‘on/off’ phenomena.
Neupro® (rotigotine)
A dopamine agonist administered via a transdermal patch. It is changed daily and should be refrigerated.
‘On-Off’ Phenomena
Motor fluctuations resulting from medium to long term use of levodopa. This can be abrupt and unpredictable.
Parkinsonism
Conditions which resemble Parkinson’s by the presence of muscle rigidity, tremor, and bradykinesia These are also known as atypical Parkinsonism or pseudo-Parkinsonism.
Parkinson’s Plus
A group of conditions that make up other forms of progressive Parkinsonism. These include Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP).
Parlodel® (bromocriptine)
A dopamine agonist medication.
Permax® (pergolide mesylate)
A dopamine agonist medication.
Resting Tremor
A tremor which occurs when the affected limb or body part is at rest. It oscillates at a frequency of four to five Hz per second. Can be exacerbated with stress.
Restless Legs Syndrome
An unrelated sensory disorder which commonly occurs in Parkinson’s. It is characterised by the urge to move the legs either during sleep or awake at rest.
Rigidity
Muscle rigidity is felt on passive movement and may present as ‘cogwheel’ (when tremor is present) or ‘lead-pipe’ (in the absence of tremor).
Selgene® (selegiline hydrochloride)
Refer to monoamine oxidase inhibitors.
Sifrol® (pramipexole)
A dopamine agonist medication.
Sinemet® (levodopa and carbidopa)
A dopamine replacement therapy medication available in normal and controlled release. Liquid Sinemet® can be prepared from this medication.
Stalevo® (Catecholamine O-methyl Transferase (COMT) Inhibitors)
Contains an enzyme which prevents further breakdown and extends the duration of the effectiveness of levodopa. It is a combination therapy of levodopa, carbidopa and entacapone.
Substantia Nigra
The deepest structure within the basal ganglia is located around the top of the spine in the brain stem. Dopamine is produced in the substantia nigra and sends signals from the substantia nigra up to the striatum. A loss of dopamine producing cells within the substantia nigra is the primary cause of Parkinson’s symptoms.
Symmetrel® (amantadine)
An anti-viral medication which is thought to increase dopamine release in the brain and therefore may be used in the treatment of Parkinson’s.
Tasmar® (tolcapone)
This original COMT inhibitor is no longer widely used due to the risk of hepatic failure.
Tremor
An involuntary rhythmic movement which usually occurs when the affected body part is not in use (at rest) and may be described as ‘pill-rolling’. It may affect any part of the body but predominantly occurs in the upper or lower limbs or jaw and is initially seen on one side of the body. Internal tremor may be felt but is not visible. Not all cases of Parkinson’s will experience tremor.
Wearing Off
A variance in response to levodopa therapy which may develop after a few years of treatment. This can be ‘wearing off’ or ‘on/off’ phenomena. Also referred to as motor fluctuations. In addition to motor fluctuations, sensory and autonomic symptoms may fluctuate in response to the levodopa levels and availability. These include sweating, anxiety and pain.
Support for you
- Call the Fight Parkinson’s Information Line on 1800 644 189
- Email: info@fightparkinsons.org.au