Parkinson’s Disease’s Five Stages

Once your neurologist has made a positive diagnosis of Parkinson’s disease, he or she will consider treatments for the disease based on the apparent stage of Parkinson’s present. The five stages of Parkinson’s disease offered by the Hoehn and Yahr scale are distinguished by the degree of disability and the severity of the symptoms.

Stage I Unilateral disease

In Stage I Parkinson’s disease, the symptoms and movement disorders are restricted to one side of the body. It’s a relatively early stage of the disease, and for most people, it may last for years. One of the most promising treatments in Stage I of Parkinson’s is neuroprotective treatment – assorted strategies that may shield the nervous system from further damage. Among the drugs that have been explored for their neuroprotective benefits are vitamin E, which has so far proved ineffective, and a selective MAO-B inhibitor called Rasigiline, which has shown promise in preliminary tests.

Stage II Bilateral Disease

In Stage II Parkinson’s disease, the symptoms will have spread to both sides of the body. Even if the ‘crossover’ is very trivial – an intermittent tremor on the opposite side of the body, for instance – the disease is considered to have progressed to Stage II. A newer therapy that is being used in Stages I and II is the early prescription of dopamine agonists which have traditionally been employed in the later stages of the disease. Researchers theorize that the difficulties that arise from treatment with Levodopa in latter stage Parkinson’s may not be present if the treatment is started early in the disease’s life – that in fact, levodopa may actually grants some protection to the neurological system.

Stage III

Stage III Parkinson’s disease is characterized by progressing symptoms, and the onset of postural instability and falling. Stage III Parkinson’s disease is the stage when treatment with L-dopa or other dopamine agonists is traditionally begun. L-dopa is commonly, in recent years, given with a supplementary drug that helps the body use it more efficiently.

Stage IV

Stage IV Parkinson’s disease is typified by an increase in balance problems (postural instability) and more falling. In some patients, particularly those who have young-onset Parkinson’s disease and are otherwise in good health, surgery to alleviate some of the symptoms may be considered.

Stage V

Parkinson’s patients are typically wheelchair bound at Stage V and unable to walk without assistance. Available treatments include L-dopa, with a COMT inhibitor to give longer lasting results. There are also several types of brain surgery which may be helpful. Those include a pallidotomy – a procedure that kills off a small group of cells in the brain to stop the tremors and rigidity associated with Parkinson’s disease, and DBS – Deep Brain Stimulation, in which electrodes are implanted in the brain to deliver a consistent low level of electronic pulses to the brain.