Treatment of Parkinson’s disease by neurologist Ihor Stanislavovych Shkinder in Dnipro.

Patients present with difficulties in movement, tremors, muscle stiffness, or changes in behavior and mood. The physician performs a thorough clinical evaluation, analyzing the patient’s complaints and medical history, and, when necessary, orders additional tests to clarify the cause of the symptoms.

As a result, the patient receives a clear and consistent plan of action: what needs to be done now, which examinations to undergo, and how to monitor changes in their condition over time. Special attention is paid to precisely identifying the causes of the disturbances and adjusting therapy with consideration of possible side effects and coexisting conditions, which helps improve quality of life even in complex cases.

When to See a Doctor

If you notice changes in movement, muscle stiffness, or other symptoms that make daily life difficult, a consultation with a neurologist may be helpful. The doctor can help identify the causes of your complaints, assess how they are progressing, and, if necessary, order further tests. You should make an appointment with a neurologist if, with Parkinson’s disease, you notice:

• Persistent trembling in the hands, legs, or head
• Muscle stiffness that makes movement difficult
• Slowness in performing everyday activities
• Problems with balance or frequent falls
• Speech difficulties, changes in voice, or reduced facial expression
• Occasional mood changes or memory decline
• Symptoms that recur or worsen over time
• Movements that interfere with work or normal rest
• No effect from previous attempts to improve the condition
• New difficulties in everyday tasks
• Worsening symptoms without a clear cause
• Sleep disturbances and restlessness at night

Even if the symptoms do not seem serious, a comprehensive assessment can help determine what steps are needed next. You should not delay seeing a neurologist if your condition worsens or new complaints appear — this is an important part of monitoring your health and choosing the right treatment approach.

Emergency conditions, or when you need to see a doctor urgently

• A sudden and severe worsening of movement or the appearance of weakness on one side of the body
• Rapidly increasing muscle stiffness or severe tremor that interferes with speaking and moving
• A combination of speech problems, difficulty swallowing, and balance problems
• A sudden deterioration in consciousness, severe confusion, or disorientation
• The onset of a severe headache unlike your usual headaches

If you have these symptoms, do not wait for a scheduled appointment — urgent medical care is needed. Our clinic offers house-call doctor visits for an emergency assessment and arrangement of further care.

Causes and Risk Factors in Parkinson’s Disease

In this section, we will discuss the possible causes of Parkinson’s disease and the factors that may affect the risk of developing it or its progression. Understanding these points can help determine what should be checked and what to pay attention to when assessing the condition with a doctor.

Main causes / mechanisms (briefly)

• Impaired function of nerve cells responsible for movement control
• Degenerative processes in the brain that gradually worsen signal transmission
• Genetic predisposition that affects the likelihood of developing the disease
• Exposure to external toxins and harmful substances that may damage the nervous system
• Chronic imbalance of chemicals in the brain, especially dopamine

Risk factors

• Age over 50 — risk increases with age
• Family history or cases of the disease in close relatives
• Sex — men are more likely to experience the disease
• Exposure to certain toxins and chemicals in the workplace
• Head injuries and serious neurological damage in the medical history
• Chronic stress and worsening overall health
• Possible influence of lifestyle and diet

Reversible causes that should be ruled out

• Medications that can cause Parkinson’s disease–like symptoms
• Metabolic disorders, such as vitamin deficiencies or hormonal imbalance
• Effects of infections that temporarily affect nervous system function

Each case requires a comprehensive assessment and examination to understand the causes of the symptoms and choose the right treatment. If Parkinson’s disease is suspected, it is important to consult a doctor for a detailed examination and to rule out reversible conditions.

Diagnostics

Diagnostics for Parkinson’s disease is aimed at a thorough review of the patient’s complaints and condition in order to determine the causes of the symptoms and create a plan for further steps. This approach helps clarify what is happening in the body and choose appropriate examination and treatment methods.

Approach to diagnosis

• Collecting a detailed medical history, including a description of symptoms and how they have progressed
• Physical and neurological examination to assess motor function
• Ordering basic laboratory tests when indicated to exclude reversible causes
• Performing additional studies if necessary, such as neuroimaging or specialized tests
• Analyzing the results in the context of the medical history and examinations
• Developing a preliminary diagnostic and treatment plan
• Discussing next steps and follow-up with the patient

Typical tests when indicated

May include:

• Magnetic resonance imaging (MRI) of the brain to assess the condition of the brain
• Ultrasound examination of the vessels of the neck and head
• Electrophysiological tests if needed
• Blood tests to exclude metabolic disorders
• Assessment of sleep and cognitive function based on individual indications

What to bring to the appointment

• Discharge summaries and results of previous examinations and tests
• A list of medications currently being taken
• Notes or a symptom diary from the past few weeks
• Information about any other existing medical conditions
• Questions or notes you would like to discuss with the doctor

Diagnosing Parkinson’s disease requires a comprehensive, step-by-step approach, which helps create a clear plan for further action and choose the optimal treatment strategy.

Treatment

Treatment for Parkinson’s disease is aimed at relieving symptoms and maintaining the patient’s quality of life. The treatment plan is selected individually, taking into account the current condition and the person’s specific characteristics, and, when indicated, requires a doctor’s evaluation.

Treatment goals

• Reduce the severity of the main symptoms and improve motor function
• Slow the progression of impairment and preserve independence
• Improve quality of life and daily functioning
• Prevent complications and support overall health

Main treatment approaches

• May include medication therapy to correct the chemical balance in the brain
• Rehabilitation and exercises to maintain motor skills and coordination
• Non-drug methods aimed at improving sleep and reducing depression
• Diet and lifestyle adjustments based on individual needs
• If necessary, additional interventions may be prescribed as indicated

What the doctor does

• Selects and adjusts treatment based on the patient’s response and associated conditions
• Evaluates treatment effectiveness and monitors possible side effects
• Explains the criteria for improvement and the course of treatment in clear, understandable language
• Coordinates care with other specialists if there are related health issues
• Recommends necessary examinations and follow-up as indicated

What to expect: plan and monitoring

• The treatment plan is created individually and may change depending on how the condition progresses
• Treatment effectiveness is assessed regularly, with adjustments made if needed
• The doctor schedules follow-up visits for monitoring and planned treatment adjustments
• Approximate timelines for changes depend on the specifics of the disease and the response to treatment

For more information about treatment options or to develop an individualized plan, please book a consultation with Dr. Igor Stanislavovich Shkinder.

Prevention

Prevention in Parkinson’s disease helps reduce the risk of developing the condition and slow the progression of symptoms. The prevention plan is selected individually, taking into account health characteristics and the doctor’s recommendations.

Main measures of primary prevention

• Blood pressure and blood sugar control
• Maintaining an active lifestyle and regular physical activity
• Quitting smoking and limiting alcohol consumption
• A balanced diet with adequate vitamins and minerals
• Avoiding exposure to toxins and harmful substances whenever possible

Screening and secondary prevention / regular monitoring

• Regular neurological examinations when indicated
• Monitoring changes in motor and cognitive function
• Assessing comorbidities and adjusting treatment as recommended by a doctor
• Monitoring sleep and emotional state when necessary

Practical tips

• Discuss the optimal level of physical activity for you with your doctor
• Monitor the quality and quantity of your sleep, and report any disturbances to your doctor
• Follow the prescribed treatment regimen and do not change it without consulting a specialist
• Keep a symptom diary for more accurate monitoring of your condition
• Visit your doctor regularly to adjust the prevention plan in a timely manner

Prevention in Parkinson’s disease requires a systematic approach and ongoing follow-up with a doctor to choose the most suitable measures.

Important to know

Treatment for Parkinson’s disease requires a comprehensive approach and regular monitoring. It is important not only to relieve symptoms, but also to understand the causes and factors affecting the condition. Early evaluation helps choose the most appropriate treatment strategy and reduces the risk of complications or accelerated progression. Symptoms may change over time, so treatment plans often need to be adjusted and ongoing medical supervision is essential. Many external and internal factors, such as stress, physical activity level, sleep quality, and coexisting conditions, influence the course of the disease. Self-medication can make diagnosis more difficult, cause side effects, and delay access to qualified care.

• The goal of treatment is to identify and address the causes, not just mask the symptoms
• Early consultation helps improve symptom control and reduce risks
• The treatment plan may change, so regular monitoring and adjustment are required
• Stress, physical strain, and sleep affect the development and severity of symptoms
• Coexisting conditions must be taken into account when selecting therapy
• Self-medication can alter symptoms and make further diagnosis more difficult
• Our clinic focuses on accurate diagnosis and appropriate treatment with all nuances taken into account

For more detailed information about Parkinson’s disease and modern treatment approaches, we recommend visiting our general page on the topic.

Self-help before the appointment: what you can and cannot do

Before an appointment for Parkinson’s disease, it is important to follow safe measures so as not to worsen your condition or distort the clinical picture. If there are any serious changes or a deterioration in your condition, seek medical help immediately from Dr. Igor Stanislavovich Shkinder.

What you can do before the appointment

• Write down when and how the first symptoms appeared, as well as the circumstances in which they started
• Keep a symptom diary, noting the intensity and time of day
• Bring to the appointment a list of all medications you are currently taking and their dosages, if you know them
• Reduce physical exertion and make sure you get enough rest so as not to overburden your body
• Measure your blood pressure and pulse if you know how to do so and it is safe
• Drink enough water to avoid dehydration
• Note any changes in mood, sleep, and cognitive function
• If possible, record any triggers that make the symptoms worse

What you should not do before the appointment

• Do not stop taking prescribed medications without consulting your doctor
• Do not experiment with new medications or remedies without medical advice
• Do not use unproven folk methods or “treatments”
• Do not try to interpret test results or scans on your own
• Do not postpone a doctor’s visit if symptoms worsen or new problems appear
• Do not increase physical activity without a specialist’s recommendation
• Do not change your sleep or diet routine on your own if it may affect your condition
• Do not ignore changes that cause concern or make everyday life difficult

If there are signs of an emergency or a sudden worsening, seek immediate help from Dr. Igor Stanislavovich Shkinder.

How I can help as a doctor with Parkinson’s disease

During a Parkinson’s disease consultation, I can help you understand your symptoms and current condition, determine the next treatment and monitoring plan, and provide guidance on what to do next. A medical approach includes a comprehensive review of all aspects of your health in order to choose the most appropriate management strategy. During the appointment, we will discuss all questions together and create a clear plan for your next steps.

During a Parkinson’s disease consultation, I can help you with the following:

• Review symptoms and medical history to identify possible causes or contributing factors
• Assess the severity of symptoms and potential risks to your condition
• Review current prescriptions and medication tolerance if treatment has already started
• Create a plan for next steps: indicated tests, treatment, and monitoring of progress
• Take into account comorbidities and medications that may influence treatment selection
• Provide recommendations on daily routine and lifestyle based on your situation
• Discuss criteria for treatment effectiveness and timing of follow-up visits for monitoring
• Perform an initial assessment and differential evaluation of the causes of symptoms
• Adjust treatment if the desired effect is not achieved or if side effects occur

I pay close attention to monitoring the patient’s condition and, when necessary, adjust the treatment plan to reduce the risk of complications and improve quality of life. In complex situations or when there is uncertainty, a second opinion and review of test results may be recommended.

What questions can you ask a doctor about Parkinson’s disease?

At an appointment for Parkinson’s disease, you can discuss the following situations and symptoms with Igor Stanislavovich Shkinder:

• Tremor (shaking) in the hands or other parts of the body
• Muscle stiffness and difficulty moving
• Slowness in performing everyday activities
• Balance problems and frequent falls
• Changes in mood, memory, and attention
• Recurrent symptoms that do not go away or become worse
• No effect from previous treatment or the need for adjustment
• The need for a second opinion on an already established diagnosis

In the event of sudden deterioration, a sharp decline in motor function, speech impairment, or loss of consciousness, emergency care is needed—do not wait for a scheduled appointment.

Questions you can discuss during the consultation

• What is happening to me, and what could it be?
• Why might this problem have appeared now?
• How can I tell whether this is related to Parkinson’s disease or another condition?
• What examinations are needed in my case specifically?
• Which tests and studies are truly necessary, and which can be skipped?
• How should I prepare for the tests and for the doctor’s appointment?
• What treatment options are available, and how do they differ?
• Can the symptoms be completely eliminated, or is this a chronic condition?
• Why is the prescribed treatment not bringing relief, and what should be done next?
• Can some medications or procedures be avoided?
• How long does treatment usually last, and how often are follow-up visits needed?
• What signs indicate that the condition is improving or worsening?
• What should I do if my condition suddenly worsens or an exacerbation occurs?

This doctor diagnoses and treats various manifestations of Parkinson’s disease and selects therapy taking into account coexisting conditions and individual characteristics. It is important to remember that in acute situations and serious changes, quick access to emergency care is necessary. If the situation goes beyond outpatient management, you will be referred to appropriate specialists or to a hospital for further care.

How the consultation works

A Parkinson’s disease consultation is a detailed review of your symptoms, an assessment of your condition, and the creation of a plan for next steps. The scope of any necessary examinations is determined individually, depending on the symptoms and indications. It is not always possible to make a final diagnosis in a single visit, but the doctor will be able to provide an initial assessment and outline the steps needed to clarify the condition.

1. Clarifying complaints and the purpose of the visit: the doctor asks what exactly is bothering you, when the symptoms began, and what you expect from the consultation.
2. Collecting medical history and risk factors related to the nervous system and overall health.
3. Reviewing previous examinations and treatment: you are advised to bring documents, scan images, and a list of medications you are taking.
4. Performing an examination and specialized tests if indicated, to understand the nature of the disturbances and their severity.
5. Formulating preliminary conclusions — what is most likely and which causes need to be ruled out.
6. Creating a plan for further examinations, which may include MRI, blood tests, and other studies if indicated.
7. Discussing general principles of treatment and management, without medication details, taking individual characteristics into account.
8. Organizing follow-up and next steps: when a repeat appointment is recommended, how to monitor changes, and when to seek care sooner if symptoms worsen.

If this is your first visit, special attention will be given to a precise description of symptoms and identifying the causes of their appearance. If treatment has not produced the expected effect, we will review the reasons for the lack of improvement and adjust the approach if necessary.

This approach will help you feel more confident and understand what is happening with your health, while helping the doctor choose the most appropriate care plan.

Preparing for the Appointment

Preparing for a neurology appointment for Parkinson’s disease will help make the diagnosis faster and allow for a treatment plan to be chosen more effectively. Proper preparation helps the doctor get complete information about your condition.

• Bring a list of all current medications, including names and dosages, if you know them
• Bring results of previous examinations to the appointment: MRI scans, blood tests, neuropsychological tests
• Write down your main complaints: when the symptoms began, what makes the condition worse or better
• Do not stop taking prescribed medications without consulting your doctor
• Come with prepared questions or notes about your condition
• If your doctor recommended coming on an empty stomach, do not eat or drink for 8–12 hours before the appointment (unless told otherwise)
• Avoid using makeup or cream on your head before the examination (if this is important for the assessment)
• Come without contact lenses if an eye examination is planned, or check in advance
• Record any changes in your overall condition and accompanying symptoms
• If you have any questions about preparation, clarify the details when scheduling the appointment

If you have questions about taking medications or specific preparation requirements, do not change your treatment on your own; it is better to discuss this with your doctor in advance.

About the Doctor

Igor Stanislavovich Shkinder is a neurologist of the highest category with over 20 years of experience. He regularly works with patients who need help with Parkinson’s disease, including those who are:

• seeking treatment for the first time,
• experiencing recurring symptoms, or
• not feeling any benefit from previous treatment.

In his practice, the doctor pays special attention to a detailed review of complaints and in-depth clinical analysis to identify the causes of the disorders. He also takes into account any accompanying conditions and adjusts treatment with possible side effects in mind.

During the consultation, you will receive a clear explanation of the situation and a step-by-step plan for further action.

Why Patients Choose Dr. Igor Stanislavovich Shkinder

When treating Parkinson’s disease, Dr. Igor Stanislavovich Shkinder provides patients with a systematic and transparent approach to diagnosis and treatment. The doctor takes into account all the specifics of your condition and previous therapy, which helps build a consistent treatment plan tailored to the particular case. Another important aspect of Igor Stanislavovich’s work is tracking changes over time — continuous monitoring and timely treatment adjustments ensure close attention to any changes and patient safety.

• A clear treatment plan with a precise explanation of the sequence of steps and follow-up timelines
• Tests and examinations only when clinically indicated, without unnecessary or unjustified procedures, to save time
• Consideration of comorbid diagnoses and medications to reduce the risk of side effects and drug interactions
• Monitoring of disease progression and timely adjustment of therapy when effectiveness is insufficient
• Review of previously performed examinations, including complex cases, to gain an accurate understanding of the situation
• Explanation of the plan and possible risks in simple, accessible language, without excessive medical terminology
• Emphasis on preventing flare-ups and complications in order to minimize the negative manifestations of the disease
• Experience in managing patients with chronic and combined forms of Parkinson’s disease

This approach allows patients to feel involved in the treatment process and understand the logic behind the decisions being made. When necessary, the doctor collaborates with other specialists to make treatment as comprehensive and safe as possible.

Case Studies

Initial consultation for tremor and stiffness

A middle-aged patient presented with complaints of newly developed tremor in the hands and difficulty moving. An important step was ruling out other causes of the symptoms, including neurological and systemic diseases. During the consultation, a detailed medical history was taken and a physical examination was performed, with additional tests ordered as indicated. Over time, improvement in motor function and a reduction in the severity of tremor were noted. The physician recommended regular follow-up and an individualized supportive treatment program.

Treatment adjustment due to lack of effect

An elderly patient had already been receiving treatment, but the symptoms persisted and even worsened. Attention focused on reviewing previous prescriptions, assessing drug tolerance, and identifying possible adverse reactions. After revising the therapy, an adjusted plan was developed taking comorbid conditions into account. Follow-up showed a reduction in unpleasant symptoms and stabilization of the condition, and treatment continues to be monitored and adjusted as needed.

Chronic course with comorbid problems

An elderly man with a long-standing illness presented with a further decline in cognitive function and mood disturbances. The clinical review included assessment of all symptoms and the interaction of comorbid conditions. The physician developed a comprehensive plan including both medication and non-pharmacological measures. As a result, stabilization of cognitive and emotional status was observed. Ongoing follow-up continues with therapy adjustments as needed.

Symptom flare-up and prevention plan

A middle-aged female patient was admitted with worsening motor difficulties and sleep disturbances. The physician emphasized the need to rule out acute complications and performed a comprehensive assessment of her condition. A treatment plan was developed with an emphasis on preventing further flare-ups and improving quality of life. After one month, a reduction in symptom severity and improved sleep were noted. The patient remains under regular follow-up and receives recommendations to maintain her condition.

Second opinion and reassessment of a previous diagnosis

A young patient sought confirmation or clarification of a diagnosis that had been made earlier. The physician carefully reviewed the provided records, performed additional testing, and thoroughly analyzed the symptoms. As a result, a revised clinical picture was formulated and a more precise management strategy was proposed. Regular follow-up is recommended to monitor progress and adjust therapy in a timely manner.

How long does the consultation last?

A consultation usually takes 30–60 minutes. Please уточняйте the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your symptoms and questions, and if possible, bring the results of any examinations.

What should I bring to the appointment?

Please bring any test results, scans, discharge summaries, and a list of medications you are taking, including dosages.

Do I need to come fasting?

Usually not, unless the doctor has given different instructions. Preparation details are provided when booking.

How many visits are usually required?

The number of visits depends on your condition and the complexity of the case. Usually, follow-up and monitoring are needed.

When can I expect the first results from treatment?

The appearance of changes is assessed individually and depends on the chosen treatment approach.

What should I do if my condition worsens before the appointment?

If your symptoms worsen, contact a doctor. In acute conditions, emergency care is needed.

Can treatment be combined with my current medications?

Discuss all medications with your doctor. Do not change or stop any prescribed drugs on your own.

Can I have an online consultation?

Yes, remote consultations are available. Please уточняйте the format when booking.

Can I come with tests and examinations already done?

Yes, bring all available results for a full assessment of your situation.

Do I need to come back for follow-up, and how often?

Follow-up visits are scheduled depending on the progress and the chosen treatment plan.

Can I get a second opinion from the doctor?

Yes, the doctor can provide an independent review of previous diagnoses and prescriptions.

What should I do if symptoms return after improvement?

Inform the doctor, as this is important for adjusting the treatment approach and monitoring your condition.

How is Parkinson’s disease diagnosed?

Diagnosis includes reviewing your medical history, a physical examination, and any necessary tests, planned individually.

Can I come without prior examinations?

Yes, the doctor will assess what needs to be checked based on your complaints and medical history.

How often is condition monitoring done?

The frequency of monitoring is determined by the doctor and depends on the specifics of the disease and treatment.

What examinations are usually prescribed?

Tests are selected individually. They often include MRI, blood tests, and functional assessments.

What is important to tell the doctor at the first appointment?

Tell the doctor about all your symptoms, how they developed, any treatment you have had, and any underlying conditions.