Parkinson's disease. Symptoms

Symptoms of Parkinson

Symptoms of Parkinson's disease

First symptoms

Early symptoms of Parkinson's disease are subtle and occur gradually.
Affected people may feel:

  •     tremors
  •     difficulty rising from a chair
  •     may find that they speak too softly
  •     that his writing is slow and looks cramped or small
  •     may lose track of a word or a thought
  •     may feel tired, irritable, or depressed for no apparent reason.

This very early period may last a long time before symptoms appear more classic and obvious.

Friends or family can be the first to notice changes in someone with early Parkinson's disease. You can see the face of the person lacks expression and animation (known as "lack of expression in the face") or that the person does not move an arm or leg normally. They also may notice that the person seems stiff, unsteady, or unusually slow.

As the disease progresses

The tremor that affects most Parkinson's patients may begin to interfere with daily activities. Patients may not be able to hold utensils steady or may find that the shaking makes reading a newspaper difficult. Tremor is usually the symptom that causes people to seek medical help.

People with PD often develop a so-called parkinsonian gait that includes a tendency to lean forward, take small quick steps as if hurrying forward (called festination), and reduced swinging of the arms. They may also have difficulty in initiating movement (start hesitation), and may stop suddenly when walking (frostbite).

Parkinson's disease does not affect everyone the same way, and the rate of progression differs among patients. Tremor is the major symptom for some patients, while for others, there is no or very minor.

The disease symptoms often begin on one side of the body. However, as it evolves, the disease eventually affects both sides. Even after the disease involves both sides of the body, symptoms are often less severe on one side than the other.

Primary symptoms of Parkinson's disease

Tremor. The tremor associated with the disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back and forth at a rate of 4-6 beats per second. May involve the thumb and forefinger and look like a tremor as "pill rolling." The tremor often begins in one hand, but sometimes affect one foot or the jaw. It is most obvious when the hand is at rest or when the person is under stress. For example, the tremor may become more pronounced a few seconds after the hands are rested on a table. Tremor usually disappears during sleep or improves with intentional movement.

Stiffness. Rigidity, or resistance to movement, affects most people with Parkinson's disease. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. Parkinson's disease, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient's arm, which move only in ratchet-like or short, jerky movements known as stiffness "cogwheel".

Bradykinesia. Bradykinesia, or the delay and loss of spontaneous and automatic movement, is particularly frustrating because it can make simple tasks somewhat difficult. The person can not rapidly perform routine movements. Activities once performed quickly and easily, such as washing and dressing, may take several hours.

Postural instability. Postural instability or impaired balance, causes patients to fall easily. Affected individuals may develop a stooped posture in which the head is bowed and shoulders slumped.

Other symptoms of Parkinson's disease

Some are minor, others are not. Many can be treated with medication or physical therapy. No one can predict which symptoms will affect an individual patient and the severity of symptoms varies from person to person.

Depression. This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Fortunately, depression can usually be treated successfully with antidepressant medications.

Emotional changes. Some people with PD become fearful and insecure. Perhaps they fear being unable to cope with new situations. You may not want to travel, go to parties or socializing with friends. Some lose their motivation and become more dependent on their families. Others may become irritable or uncharacteristically pessimistic.

Difficulty swallowing and chewing. Muscles used in swallowing may work less efficiently in later stages of the disease. In these cases, food and saliva may collect in the mouth and back of the throat, which could result in choking or drooling. These problems can also be difficult to obtain adequate nutrition. Speech therapists and speech therapists, occupational therapists and dieticians can often help with these problems.

Changes in speech. About half of patients with the disease have problems with speech. They may speak too softly or in a monotone, hesitate before speaking, slur or repeat their words, or speak too fast. A speech therapist may be able to help patients reduce some of these problems.

Urinary problems or constipation. In some patients, may cause problems with bladder and bowel due to malfunction of the autonomic nervous system, responsible for the regulation of smooth muscle activity. Some people may become incontinent, while others have trouble urinating. In others, constipation may occur because the intestinal tract operates more slowly. Constipation can also be caused by inactivity, eating a poor diet or drinking too little fluid. Medications used to treat the disease also contribute to constipation. It can be a persistent problem, and in rare cases, serious enough to require hospitalization.

Skin problems. Parkinson's disease, is common for the facial skin to become very oily, particularly on the forehead and sides of the nose. The scalp may become oily too, resulting in dandruff. In other cases, the skin can become very dry. These problems are also the result of an improperly functioning autonomic nervous system. They can be useful standard treatments for skin problems.

Excessive sweating, another common symptom, is usually controllable with medications used for the disease.

Trouble sleeping. Sleep problems common in PD include difficulty staying asleep at night, restless sleep, nightmares and emotional dreams, and drowsiness or sudden onset of sleep during the day. Patients with PD should never take sleeping pills over the counter without consulting their doctors.

Dementia or other cognitive problems. Some but not all people with PD may develop memory problems and slow thinking. In some cases, cognitive problems are severe, leading to a condition called Parkinson's dementia late in the course of the disease. This dementia may affect memory, social opinion, language, reasoning, or other mental skills. There is currently no way to stop this insanity, but studies have shown that a drug called rivastigmine may slightly reduce the symptoms. The drug donepezil also can reduce behavioral symptoms in some people with dementia associated with Parkinson's.

Orthostatic hypotension. Orthostatic hypotension is a sudden drop in blood pressure that occurs when a person stands up from a lying position. May cause lightheadedness, dizziness and in extreme cases, loss of balance or fainting. Studies have suggested that Parkinson's disease, this problem is caused by a loss of nerve endings in the sympathetic nervous system that control heart rate and other automatic body functions. Medications used to treat Parkinson's disease may also contribute to this symptom.

Muscle cramps and dystonia. The rigidity and lack of normal movement associated with Parkinson's disease often causes muscle cramps, especially in the legs and toes. Massage, stretching, and applying heat may help with these cramps. The disease may also be associated with dystonia, sustained muscle contractions that cause forced or twisted positions. Dystonia in PD is often caused by fluctuations in the level of dopamine in the body. Can usually be relieved or reduced by adjusting the individual drugs.

Pain. Many people with Parkinson's disease have aching muscles and joints due to the rigidity and abnormal postures often associated with the disease. Treatment with levodopa and other dopaminergic drugs often alleviates these pains to some extent. Certain exercises can also help. People with Parkinson's may also have pain due to nerve root compression or muscle spasms associated with dystonia. In rare cases, people with PD may develop unexplained burning, stabbing sensations. This type of pain, called "central pain," originates in the brain. To treat this type of pain can be used dopaminergic drugs, opioids, antidepressants and other medications.

Fatigue and loss of energy. The unusual demands of living with Parkinson's disease often lead to problems with fatigue, especially late in the day. Fatigue may be associated with depression or sleep disorders, but also can result from muscle stress or from overdoing activity when the person feels good. Fatigue can also result from akinesia, problems in initiating or making a move. Exercise, good sleep habits, staying mentally active, and not forcing too many activities in a short time can help relieve fatigue.

Sexual dysfunction. Parkinson's disease often causes erectile dysfunction due to its effects on nerve signals from the brain or because of poor blood circulation. PD-related depression or use of antidepressants can cause decreased sexual desire and other problems. Often these problems are treatable.

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