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Clinical Services at Rush Treatments for Parkinsons Disease
Program Description

Parkinson's disease is a chronic, progressive disease. Although there is currently no cure, symptoms can be managed through medications and surgical interventions. Patients at Rush may receive some of the following state-of-the-art treatments:

  • Symptomatic therapies: These work to improve the symptoms of the degenerative process by amplifying dopamine, the major product of these cells, without directly affecting cell degeneration. The following medications are commonly used to manage the symptoms of the disease:

    • Levodopa (usually taken as the combination drug carbidopa-levodopa, known as Sinemet) is the mainstay of symptomatic therapy for Parkinson's disease. While it dramatically improves the symptoms of Parkinson's disease, long-term use may have its pitfalls, including unpredictability in motor function at different times of day, an increase in involuntary movements and a number of side effects. Clinicians at Rush are highly skilled in carefully adjusting levodopa and judiciously using other agents in combination with levodopa to provide people with Parkinson's many years of benefit.
    • Dopamine agonists may be used as the sole agent for the treatment of Parkinson's disease, but more often are used in combination with levodopa. Available dopamine agonists include pramipexole and ropinirole, which can be prescribed multiple times daily or in new long-acting, once-daily formulations.
    • Catechol O-methyltransferase (COMT) inhibitors entacapone and tolcapone enhance the effectiveness of levodopa by enhancing delivery of levodopa to the brain, and, in the case of tolcapone, decreasing the breakdown of dopamine.
    • Other medications used in the treatment of Parkinson's disease include selegiline, rasagiline, trihexyphenidyl, benztropine and amantadine.
       
  • Surgical intervention: Deep brain stimulation (DBS) is a surgical procedure in which a surgeon inserts an electrical wire into specific brain regions, and high-frequency stimulation is applied through a battery that is placed underneath the skin of the chest wall. Patients whose disease is not adequately managed by medication are often good candidates for DBS. With DBS, expertise matters. Rush's strong movement disorders surgery program has a highly experienced, multidisciplinary team that includes a neurosurgeon, neurologist, physician assistant, nurse practitioner, neuropsychologist, speech therapist and social worker.
     
  • Protective therapies: These aim to delay the degenerative process in the brain. While there are currently no proven drug treatments for halting, slowing or reversing the degenerative process of Parkinson's disease, patients have access to clinical trials that are testing the effectiveness of protective therapies, which may include some of the following:

    • Vitamins
    • Nutritional supplements
    • Agents that alter blood chemical levels-Drugs that decrease stress on dopamine neurons
    • Gene therapy
       
  • Other investigational therapies: New therapies are constantly being developed to improve the treatment of Parkinson's disease. Our patients have access to new investigational therapies through our research and clinical trials programs.

Comprehensive care

We take a holistic approach to patient care by addressing both the motor and nonmotor aspects of movement disorders. Members of our team can connect patients with other specialists at Rush who can address some of the following common nonmotor symptoms of the disease:

  • Mood disorders (e.g., depression, anxiety)
  • Cognitive impairment (e.g., slowness of thought, difficulty with planning or multitasking, memory trouble, dementia)
  • Neuropsychiatric issues (e.g., hallucinations, apathy, behavioral changes)
  • Sleep disruption (e.g., acting out one's dreams, fragmented sleep)
  • Autonomic disturbance (e.g., urinary dysfunction, constipation, blood pressure changes and dizziness)

Second Opinion and Consultation Services

The majority of patients seen at the Rush Parkinson's Disease and Movement Disorder Center are referred by their primary care doctors or other neurologists for primary diagnosis of unknown movement disorders, second opinion and complex management of these diseases.

  • One-time consultations: The 60-minute consultation includes the following:

    • Detailed history of the movement disorder-focused examination
    • Discussion of relevant issues regarding diagnosis and treatment
       
  • Annual or infrequent visits: After the one-time consultation, patients go back to their primary physician, who uses our recommendations and conducts all further aspects of evaluation and treatment. Patients return to our clinic on an annual basis for reassessment so that additional recommendations may be made to the referring physician.
     
  • Newly diagnosed patients: The first medication or treatment intervention decision for movement disorders is of utmost importance. Newly diagnosed patients who are not on any treatment for Parkinson's disease (also known as de novo patients) are seen quickly in our clinic and are offered special appointments. We have many options for de novo patients, including clinical trials and studies investigating ways to slow down the progression of the disease.
     
  • Continuing care: Patients who choose Rush Parkinson's Disease and Movement Disorders Center as their primary care generally come in every three to four months for 15- to 20-minute visits for evaluation and to discuss changes and concerns. More frequent visits may be necessary for complex problems. All changes in treatments are coordinated by our movement disorders clinicians.

Contact us

For diagnosis or continuing care: For an appointment, call (312) 563-2030.

For newly diagnosed patients not on any medication: Call (312) 563-2030 and tell the receptionist you are not on any treatment and a special appointment will be offered.

For physicians: All physicians (family doctors, internists, neurologists) requesting a movement disorder consultation may submit a signed, written consultation request on the doctor's prescription pad and fax it to (312) 563-2024.

 







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