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Parkinson's Disease

How fast does PD progress?



My father was diagnoses with PD 5 years ago and has gone from no visible symptoms to not being able to walk because he can`t keep his balance. Alot of his meds have a side effect that includes balance problems, visual problems, dizziness, and drowsiness. It seems that his progression was awfully fast. Is this a normal course for this disease?


Parkinson's disease (PD) is a neurodegenerative disease that has a large variability in its presentation and progression. Patient's with idiopathic PD typically have slow progression of symptoms over several years or a few decades. However, there appears to be some patients with PD who are most bothered by trouble walking and balance problems. Unfortunately, the walking and balance trouble may respond minimally to medications typically used to treat PD, and thus lead to a more rapid rate of decline. This decline is often exacerbated by decreased ambulation activity level. It is often beneficial for a patient bothered by these issues to obtain an outpatient course of physical therapy focusing on gait and balance.

There are also several syndromes that have symptoms similar to PD, but also have other features not commonly associated with PD early in the disease. These syndromes also tend to progress at a much faster pace and lead to a more debilitating level much sooner. The cardinal features of PD include:

There are many other non-motor symptoms people with PD may also experience and are much less specific. These include:

Depending on the patient, certain features may be more bothersome. Some of the medications used to help motor symptoms of PD can have side effects or worsen some of the non motor symptoms of PD, especially constipation or lightheadedness.

It is very important for patients to monitor their blood pressure for any change when they experience lightheadedness or dizziness, and report this to their doctor. To minimize potential side effects of medications, patients need to stay well hydrated (64 ounces of fluids a day) and add dietary fiber supplements. There are other conservative measures and medications that can be discussed with a patients physician if these side effects occur.

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Response by:

Punit  Agrawal, DO Punit Agrawal, DO
Assistant Professor of Neurology
College of Medicine
The Ohio State University

Karen M Thomas, DO Karen M Thomas, DO
College of Medicine
The Ohio State University