Monthly Archives: October 2011

Parkinson’s Disease Health Center


Parkinson’s Disease Health Center

Select An Article All Subchapter Articles:Treatment OverviewHome TreatmentMedicationsSurgeryOther TreatmentParkinson’s and DietParkinson’s and Exercise

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Exercise and Parkinson’s Disease



Because Parkinson’s disease affects your ability to move, exercise helps to keep muscles strong and improve flexibility and mobility. Exercise will not stop Parkinson’s disease from progressing; but, it will improve your balance and it can prevent joint stiffening.

You should check with your doctor before beginning any exercise program. Your doctor may make recommendations about:

  • The types of exercise best suited to you and those which you should avoid
  • The intensity of the workout (how hard you should be working)
  • The duration of your workout and any physical limitations
  • Referrals to other professionals, such as a physical therapist who can help you create your own personal exercise program

The type of exercise that works best for you depends on your symptoms, fitness level, and overall health. Generally, exercises that stretch the limbs through the full range of motion are encouraged.

Here are some tips to keep in mind when exercising.

  • Always warm-up before beginning your exercise routine and cool down at the end.
  • If you plan to workout for 30 minutes, start with 10-minute sessions and work your way up.
  • Exercise your facial muscles, jaw, and voice when possible: Sing or read aloud, exaggerating your lip movements. Make faces in the mirror. Chew food vigorously.
  • Try water exercise, such as water aerobics or swimming laps. These are often easier on the joints and require less balance.
  • Work out in a safe environment; avoid slippery floors, poor lighting, throw rugs, and other potential dangers.
  • If you have difficulty balancing, exercise within reach of a grab bar or rail. If you have trouble standing or getting up, try exercising in bed rather than on the floor or an exercise mat.
  • If at any time you feel sick or you begin to hurt, stop.
  • Select a hobby or activity you enjoy and stick with it. Some suggestions include: gardening; walking; swimming; water aerobics; yoga; tai chi.

Brain & Nervous System Health Center


Brain & Nervous System Health Center


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New Guidelines for Treating Essential Tremor

American Neurological Association Recommends Best Treatments for the Movement Disorder
By Cari Nierenberg
WebMD Health News


graphic of human head

Oct. 19, 2011 — New treatment recommendations for a movement disorder called essential tremor were introduced this week by the American Neurological Association. The latest advice describes the most effective drugs and surgeries to help ease the trembling hands, head, or voice seen in this condition.

A panel of nine experts reviewed more than 250 recent studies in revising the treatment guidelines. They were published online in the journal Neurology and were last updated in 2005.

Essential tremor (ET) is the most common type of tremor and affects about 10 million Americans. A person with this disorder has periods of uncontrollable shaking. This shakiness might be seen in the hands, or as a nodding head or a quivering voice. 

Essential tremor occurs when muscles are used, such as when holding a glass in your hand. The tremors seen in Parkinson’s disease occur when muscles relax, such as when holding your hands in your lap or resting your arms at your sides.

Mild cases of ET might not need any treatment, although people might feel embarrassed about seeming shaky.

Drug Recommendations

When trembling interferes with a person’s life, doctors are most likely to prescribe the drugs propranolol (Inderal, InnoPran), a beta-blocker medication used sometimes to treat high blood pressure, or primidone (Mysoline), which is sometimes used to control seizures.

Although the scientific evidence suggests these two drugs are the most effective treatments for tremor, 30% to 50% of patients might not improve or can’t tolerate either one of them. So “these first-line medications for ET clearly fail to meet the needs of many patients,” write the guideline authors.

If these treatments don’t reduce the tremors, the guidelines suggest some other helpful alternatives. These include: two seizure drugs, gabapentin (Fanatrex, Gabarone, Horizant, Neurontin) or topiramate (Topamax, Topiragen); two other high blood pressure medications, atenolol (Senormin,Tenormin) or sotalol (Betapace, Sorine); or the anxiety drug alprazolam (Niravam, Xanax).

“More and better research is needed since not all people with essential tremor benefit from these drugs,” says guidelines researcher Theresa A. Zesiewicz, MD, in a news release. Zesiewicz is a neurologist at the University of South Florida Health in Tampa.

When people are not benefiting from medication, the guidelines call for doctors to consider surgical therapy as an option. Deep brain stimulation of the part of brain called the thalamus can be performed for severe tremors. The procedure involves implanting an electrical device in the brain.

A second surgical procedure, called unilateral thalamotomy, can also be performed on the thalamus area of the brain. This procedure has been shown to reduce tremors.

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James Valvano posted in Hd family.James Valvano12:43pm Oct 27

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