Michael J. Fox Has Parkinson Disease

Michael J. Fox is due to say goodbye to the television program Spin City on the May 24 show. We are therefore rerunning an article we wrote a while back about Mr. Fox and Parkinson disease to put this matter in a medical perspective.

-- Medical Editor, MedicineNet.com

The 37-year-old Canadian actor Michael J. Fox has Parkinson disease, a progressive degenerative disease of the part of the brain called the substantia nigra that controls movement. Although Parkinson disease occurs mostly in older people, it sometimes does strike people in their forties or, as with Mr. Fox, even younger people.

Mr. Fox was first diagnosed when he noticed a "twitch" in his left little finger while he was working on the set of the 1991 film Doc Hollywood, he told People magazine. Parkinson disease has several classic signs and symptoms including tremors, stiffness of the limbs, a mask-like face, gait disturbance (difficulty walking), depression and, late in the disease, dementia.

The tremor is characteristically a resting tremor that especially involves the hands and fingers. It is described as a "pill rolling" tremor, a name that harks back to the similarity between the tremor's movement and that required to "roll a pill" in pharmacies past. In the early stages of Parkinson disease, the tremor stops when the person does something active, such as walking. Mr. Fox said that he paced during an interview to quell his tremor.

After the diagnosis in 1991, Fox's disease progressed over the next few years affecting his entire left side with tremors and stiffness.

Michael J. Fox said he is in the "late mild" stage of the disease. For clinical purposes, Parkinson disease is arbitrarily divided into mild, medium, and severe stages.

Stiffness of the limbs and difficulty starting movements are characteristic. In the early stages of the disease, this may show up as trouble running, etc. As the disease worsens, the patient may have a difficult time initiating activities such as walking or dressing. Mr. Fox said that sometimes he is so stiff he cannot pick up and operate his TV remote control.

Along with a limited capacity to moving the arms and legs, a patient with Parkinson disease also experiences a decreased ability to move the muscles of the face. As a result, the facial expression tends to be unchanging and is said to be "mask-like."

Another feature of Parkinson disease is difficulty stopping an action once it has been started. For instance, patients may have trouble stopping once they do start walking. Affected individuals may walk faster and faster until they fall or hit something in their path.

Up to 50% of patients develop depression and 20% suffer memory loss. Additionally, some people with Parkinson disease may have hallucinations, seeing and hearing things that are not real.

While there are no medications that can stop Parkinson disease from progressing, many good medical treatments are available for its symptoms. Fox takes the drug Sinemet (levodopa-carbidopa). It controls some of the milder symptoms, including, "the constant rigidity of his hips, tremors in one or both hands, and a 'tapping' feeling in his feet." Mr. Fox reportedly has also had brain surgery (on the thalamus) to try to relieve his tremors.

Among Mr. Fox's reasons for going public about his condition is his desire to raise public awareness of Parkinson disease and funds for it.

For more on this disorder, please see the Diseases and Treatments Forum on Parkinson Disease.