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Young Onset Parkinson's Disease (YOPD)
Sunday, 15 August 2004
Sunday, 15 August 2004

What

Parkinson’s disease (PD) is typically thought to be a disorder of the elderly, with an average age of approximately 58 years in the U.S. and elsewhere. Some of the first symptoms, however, may arise earlier in life; some cases of PD having clearly developed up to three decades earlier. When people develop PD in their twenties or thirties, this is generally referred to as Young-Onset Parkinson’s disease, or YOPD. While the disease is defined by its age of onset, YOPD appears to be identical to PD beginning at an older age. Both diseases are caused by the progressive impairment or deterioration of nerve cells in an area of the brain known as the substantia nigra. When functioning normally, these neurons produce a vital brain chemical known as dopamine. Dopamine serves as a chemical messenger in a communication pathway that coordinates smooth and balanced muscle movement. A lack of dopamine results in abnormal nerve functioning, causing a loss in the ability to control body movements.

Who

Approximately one million Americans have Parkinson's disease, including three out of every 100 people over the age of 60. Over 50,000 Americans are diagnosed with Parkinson's disease each year. The average age at which it is diagnosed is 60. For YOPD however, about 10%-20% of those diagnosed with Parkinson's disease are under age 50, and about half of those are diagnosed before age 40. Men are slightly more likely to develop the disease than women.

Signs and Symptoms

YOPD shares many of the symptoms associated with Parkinson’s disease. These often include, but are not limited to, muscle rigidity, tremors, slowed movements (bradykinesia), and changes in walking pattern.

Possible Causes

While scientists and physicians attribute Parkinson’s disease to a combination of environmental factors and genetic causes, genetic causes may be more influential in YOPD. However, we do not understood much in regard to the mode of inheritance, or the exact genes that may play a role in development of Parkinson’s disease. In some cases, the onset of Parkinson’s disease is clearly linked to environmental exposures, such as: • Environmental toxins - manganese, carbon monoxide, carbon disulfide and some other pesticides • Medications - antipsychotics used to treat severe paranoia and schizophrenia can cause a person to experience symptoms that resemble Parkinson's disease (Parkinsonism) • Street drugs - MPTP, a synthetic heroin, can cause severe Parkinson's disease-like symptoms • Blood vessel disorders - Although rare, stroke and atherosclerosis (hardening of the arteries) can cause symptoms similar to Parkinson's disease There is also a rare degenerative condition that produces symptoms similar to Parkinson's disease known as Shy-Drager syndrome.

Diagnosis

Making the diagnosis of YOPD (or PD) is somewhat difficult since there are no specific blood or laboratory tests available to diagnose the disease. Some imaging tests, such as a CT scan (computed tomography) or MRI (magnetic resonance imaging), may be used to rule out other disorders that cause similar symptoms. In addition to these tests, the physician may need to observe the patient over time to recognize signs of tremor and rigidity. A comprehensive history of the patient's symptoms, activity, medications, other medical problems, and exposures to toxic chemicals (see Possible Causes) may help in the proper diagnosis. The physical examination should include assessment of the patient's reflexes, coordination, muscle strength, and mental function. Because the diagnosis is based on the history and physical examination of the patient, it is important that the doctor be experienced in evaluating and diagnosing patients with Parkinson's disease. If Parkinson's disease is suspected, a specialist may be consulted or a referral may be given, preferably to a neurologist who specializes in movement disorders.

Treatment

Treatment for YOPD differs slightly from older onset Parkinson's disease. People with early onset have less of a tendency to develop problems with thinking and reasoning than when the disorder begins in older years. In general, younger people have a smoother, longer-term course of the illness, with the rate of progression significantly slower. Associated problems, such as memory loss, confusion and balance difficulties, are also less frequent in young people with the disease. On the other hand, people with young-onset Parkinson's disease often have more movement problems due to the most commonly prescribed medication, levodopa, than older people with the disease. For this reason, young-onset patients are usually treated with alternatives to levodopa. Young-onset patients are also better candidates for many of the experimental surgical procedures and medical innovations that are being developed to treat and reduce the symptoms of Parkinson's disease.

Prognosis

Although research is ongoing, to date there is no known cure or way to prevent Parkinson's disease. There is very real hope that the causes, whether genetic or environmental, will be identified and the precise effects of these causes on brain function will be understood. These remarkable achievements give real hope for the future. Still, even though there is no cure for Parkinson's disease, by identifying individual symptoms and determining a proper course of treatment, most people with the disease can live enjoyable, fulfilling lives.

Connect with other parents

In the spirit of community and support, Madisons Foundation offers the unique service of connecting parents of children with rare diseases. If you would like to be connected to other parents of children with this disease, please fill out this brief form.

Weblinks

National Parkinson’s Organization
Website with sections on research, information, support groups, further links.

Michigan Parkinson’s Foundation
Nice website with general information about the disease, support group, newsletter, advocacy and links to other websites.

Mighigan Parkinson’s Foundation
Website linking to treatment information.

Young Onset Parkinson’s Association
National association with information, chat room and newsletter for those with Young Onset type of Parkinson’s .

WebMD
Medically oriented information on Parkinson’s with pictures of the brain, research links and links to other neurological issues.

Google Search for Young Onset Parkinson's Disease (YOPD)

References and Sources

Schrag A, Ben-Shlomo Y, Brown R, Marsden CD, Quinn N. “Young-onset Parkinson's disease revisited--clinical features, natural history, and mortality.” Department of Clinical Neurology, Institute of Neurology, University College, London, UK.