From an 1817 essay to modern therapy
London physician James Parkinson described six cases in his 1817 Essay on the Shaking Palsy; decades later French neurologist Jean-Martin Charcot attached his name to the condition. In the late 1950s Sweden's Arvid Carlsson showed that dopamine controls movement (earning a 2000 Nobel Prize), and in 1960 Oleh Hornykiewicz found it depleted in patients' brains. George Cotzias's high-dose levodopa regimen in 1967 was hailed as a miracle, Alim-Louis Benabid pioneered deep brain stimulation (DBS) in 1987, and in 1997 clumps of the protein alpha-synuclein were identified as a hallmark of the disease. Michael J. Fox's 1998 announcement brought it unprecedented public attention.
Symptoms and diagnosis
The defining feature is bradykinesia—movements that become slow and small—together with resting tremor or rigidity. Tremor often starts in one hand at rest, like rolling a pill; handwriting shrinks, the face loses expression, and steps shorten. Years before motor symptoms, many people lose their sense of smell, act out dreams (REM sleep behavior disorder), or develop chronic constipation and depression. No blood test confirms it; a neurologist diagnoses it by exam and response to medication, sometimes with a DaTscan. Later on, cognitive decline can appear.
Treatment and living well
Levodopa, which the brain converts to dopamine, remains the most effective drug; dopamine agonists and MAO-B inhibitors are alternatives. After several years, doses may wear off sooner and cause involuntary movements, when DBS or continuous infusion therapies can help. Nothing yet stops the disease, but strong evidence shows that regular aerobic exercise, tai chi, boxing programs, and dance improve symptoms and quality of life. About 1 million Americans live with Parkinson's, and the number is climbing with an aging population.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Does a shaky hand mean Parkinson's?
- Not usually—essential tremor, which shakes during movement, is more common. Parkinson's tremor typically appears at rest.
- Is it inherited?
- Mostly not; only about 5–10% of cases run in families.
Sources reviewed: 2026-10-26
References
- Parkinson, J. (1817). An Essay on the Shaking Palsy. London: Sherwood, Neely and Jones.
- Bloem, B. R., Okun, M. S., & Klein, C. (2021). Parkinson's disease. The Lancet, 397(10291), 2284–2303.
- Postuma, R. B., et al. (2015). MDS clinical diagnostic criteria for Parkinson's disease. Movement Disorders, 30(12), 1591–1601.