Yes. Parkinson's disease is progressive, and the rate differs so much between people that an average is close to useless for an individual. Treatment remains effective for many years, and what changes over time is less the response to medication than the smoothness and duration of that response.
Yes. Parkinson's disease is progressive, and the rate differs so much between people that an average is close to useless for an individual. Treatment remains effective for many years, and what changes over time is less the response to medication than the smoothness and duration of that response.
The early motor features - tremor, slowness, rigidity, reduced arm swing - are usually the part treatment handles best and for longest. What accumulates is a wider set of problems that respond less well: balance difficulty and falls, freezing of gait, speech becoming quiet, swallowing, constipation, bladder urgency, low blood pressure on standing, disturbed sleep, and changes in mood, attention and memory. Many people find these non-motor features affect daily life more than the tremor that first brought them in, which is why review covers them explicitly.
Levodopa keeps working, and that is worth stating plainly because people fear it will stop. What alters is the pattern of benefit. In the early years a dose covers the interval comfortably. Later the same dose helps for a shorter period, so symptoms return before the next one is due, and involuntary movements can appear at peak effect. Those are motor complications of long-term treatment interacting with disease progression, not evidence that the drug has failed, and they are managed by adjusting timing and formulation.
Age at onset and the presenting pattern both carry some prognostic weight: younger onset and a tremor-predominant picture are generally associated with slower progression, while a presentation dominated by postural instability and gait difficulty tends to move faster. Coexisting cognitive change is significant. No treatment has been shown to halt the underlying process, but regular vigorous exercise has the most consistent evidence of any intervention for maintaining function, and it is worth treating as part of the plan rather than as general advice.
This practice diagnoses and follows Parkinson's disease, adjusts medication, and manages the non-motor features for adults 18 and older. It performs no surgery and implants no devices, so deep brain stimulation and focused ultrasound are assessed at a centre that provides them. There is no infusion suite here, so infused or intestinal-gel therapies are arranged elsewhere. MRI and CT are performed at an imaging centre and the report is reviewed with you here. Physiotherapy and speech therapy are arranged locally.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Parkinson's disease; National Institute of Neurological Disorders and Stroke; American Academy of Neurology.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.