Parkinson's disease (PD, also known as idiopathic or primary parkinsonism, hypokinetic rigid syndrome/HRS, or paralysis agitans) is a degenerative disorder of the central nervous system. The motor symptoms of Parkinson's disease result from the death of dopaminegenerating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. Research is ongoing.
Early in the course of the disease, the most obvious symptoms are movement-related. These include shaking, rigidity, slowness of movement and difficulty with walking and gait. These are not always obvious however. Later, thinking and behavioral problems may arise, with dementia commonly occurring in the advanced stages of the disease, whereas depression is the most common psychiatric symptom. Other symptoms include sensory, sleep and emotional problems.
The condition is progressive and requires due consideration not only in regard to its impact on flight safety at the time of certification but also its likely future evolution during the period of certification.
The impairment caused by the disease fluctuates so that the status at the time of examination may not reflect the more serious intermittent impairment that may occur.
Medication does reduce symptoms but does not alter the course of the disease. Many of the preparations given for Parkinson’s disease have side effects that are not acceptable for certification.