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Conditions Related to Parkinson's

No two people have the same Parkinson’s disease (PD).

No two people have the same Parkinson’s disease (PD). With diverse symptoms and varied speeds of progression, PD does not affect every person the same way.

However, people with Parkinson’s are at greater risk of developing related conditions. These are risks only. Their knowledge aids in practicing prevention and allow for a better life. 

People with Parkinson’s have a higher risk of developing:

Melanoma

Melanoma is an invasive form of skin cancer that has been found to develop more often in people with Parkinson’s. Early detection of melanoma means a better chance of stopping cancer from progressing to lymph nodes. Other risk factors are: male gender, Caucasian race, constant exposure to ultraviolet (UV) light and family history of melanoma. 

The following preventative measures can help reduce chances of developing melanoma: 

  • Use the melanoma ABCDE's to monitor irregularities in moles and beauty marks: 
    Asymmetrical
    Borders are uneven or irregular
    Colors such as many shades of brown within the same mole, or even red or blue
    Diameter bigger than the eraser on a pencil
    Evolution – grows over time, changes color or shape
  • Wear sunscreen and UV protective clothing daily.
  • Schedule a yearly screening with a dermatologist.

Neurogenic Orthostatic Hypotension (nOH)

Orthostatic hypotension (OH) is a persistent drop in blood pressure that occurs within three minutes of standing. Certain medications, dehydration and conditions such as heart disease increase this risk.

Damage caused by nervous system disorders, such as PD, can result in the nervous system not being able to make or release norepinephrine — a chemical that constricts blood vessels and raises blood pressure. This causes dizziness or lightheadedness. When OH happens in people with PD, it is called neurogenic OH (nOH). It affects approximately 10 to 65 percent of people with PD.

Doctors define it as a blood pressure drop of 20 millimeters of mercury (20 mm Hg) in systolic blood pressure (the top number in a blood pressure reading), or a drop of 10 millimeters in diastolic blood pressure

This symptom is common in mid- and late-stage Parkinson’s. Learn more at nOHmatters.com.  

OH symptoms include:

  • Lightheadedness
  • Dizziness
  • Weakness
  • Difficulty thinking
  • Headache
  • Feeling faint

Strategies to manage nOH:

  • Speak with your doctor about reducing or eliminating certain medications (such as anti-hypertensives and some dopaminergic medications).
  • Drink more fluids to keep hydrated. 
  • Consume more salt and caffeine. 
  • Wear thigh-high support stockings. Compression garments such as antigravity stockings can be effective in preventing OH.
  • Do isometric exercises before getting up that contract the leg or feet muscles. 
  • Monitor your blood pressure.
  • Sleep with your head elevated between 10 and 30 degrees.
  • Take care when changing the position of the body (e.g., standing up).
  • Be aware of behaviors and circumstances that can make nOH worse:
    • Exposure to heat
    • Fever
    • Prolonged standing
    • Vigorous exercise
    • Drinking alcohol
    • Straining while going to the bathroom
    • Meals high in carbohydrates

Ask your doctor about medications that can treat nOH.

Pseudobulbar Affect (PBA)

Pseudobulbar affect (PBA) is characterized by frequent, uncontrollable outbursts of crying or laughing. Outbursts can be intense and often do not match the situation or the person’s feelings

Episodes are brief and may occur several times per day. It occurs when PD affects the brain areas controlling expression of emotion, disrupting brain signaling and triggering the involuntary episodes. It is often mistaken for depression or bipolar disorder.

PBA used to be referred to as “emotional incontinence” or “pathological laughing and crying.” These terms are not commonly used today because researchers better understand the brain and PBA symptoms. Pseudobulbar affect can also occur in people with brain injuries. According to PBA Info, up to 24 percent of people with PD have symptoms that may suggest PBA. 

The following lifestyle strategies can help manage pseudobulbar affect:

  • Keep a diary tracking what triggers PBA episodes and share it with your doctor. 
  • If you feel an episode approaching, try to focus on something unrelated and adjust your posture.
  • During an episode take slow deep breaths until you are in control. Relax your forehead, shoulders, and body.

Page reviewed by Dr. Ryan Barmore, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

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