Q: My grandfather has been diagnosed with Parkinson’s disease. Could you please tell me what causes it? Can it be caused by stress or shock? I ask because my mother is being blamed for my grandfather getting the disease after a fight they had early last year. Could this be true?

A: There’s no way in which your mother could have caused your grandfather’s Parkinson’s disease. Whoever said that she caused it has no insight into the problem. Sometimes stress might make one aware of the symptoms for the first time, but Parkinson’s simply cannot be the result of fighting with someone.

Parkinson’s disease occurs when certain nerve cells, or neurons, die or become impaired. Normally, these neurons produce dopamine. Loss of dopamine causes the nerve cells to fire out of control, leaving patients unable to direct or control their movement in a normal manner.

It’s not exactly known why these changes occur. In some instances, genetics may play a role; in others, not. Environmental factors could also play a role.

Possible causes of parkinsonism include drugs like metoclopramide, reserpine and antipsychotic drugs (all of them are reversible causes of parkinsonism), arterial disease of the brain, certain toxins like manganese dust and carbon disulphide, severe carbon monoxide poisoning, after encephalitis (von Economo encephalitis in 1918-1924; rare today) and in rare diseases like Wilson’s disease, Shy-Drager syndrome and Steel-Richardson-Olszewski syndrome.

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