Parkinson's Disease Signs & Symptoms

Conditions & Diseases: Brain & Nervous System

Parkinson's Disease

Signs & Symptoms

Symptoms of the disease affect different people in different ways i.e., rate of progression of different symptoms varies in different people. For example, tremors are a major symptom in some patients but can be nonexistent or minor in others.

Generally, the symptoms begin on one side of the body and progressively affect both the sides. Often, the symptoms are severe when compared to the other side.

Initial symptoms are subtle and gradual with affected people feeling mild tremors or they experience slight difficulty in getting out of a chair. The patient speaks softly and his/her handwriting is slow and cramped. The patient may lose track of a word or thought or feel tired, irritable, and depressed for no reason. The face may also lack expression and animation (known as “masked face”).

As the disease progresses a person develops parkinsonian gait, which comprises of a tendency to lean forward, take small quick steps as if to move forwards (called festination) and reduced swinging of arms. The four primary symptoms of the disease are:

Tremors:
The typical tremors due to Parkinson's Disease is rhythmic with back and forth motion at a rate of 4-6 beats per second affecting about 70 percent people. Generally, tremors begins in a hand involving a thumb and forefinger appearing as a “pill rolling” tremor when the hand is at rest or patient is under stress. Sometimes, a foot or jaw may be affected first. Tremors that occur when a person is awake and sitting or standing still is called “resting tremor”. These tremors disappear during sleep or improve with intentional movement (8) & (11).

Rigidity:
It is important to understand that movement is possible only when a muscle becomes active and an opposing muscle relaxes. “In PD, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed.” The rigidity leads to ratchet-like or short, jerky movements known as “cogwheel” rigidity (8).

Bradykinesia:
Bradykinesia is a slowing down and loss of spontaneous and automatic movement. A person cannot perform normal routine activities such as washing and dressing at a rapid pace and may take several hours.

Postural Instability:
Postural instability or impaired balance and coordination results in developing a forward or backward lean ultimately leading to a fall. Generally, affected people develop a stooped posture wherein the head is bowed and shoulders are drooped (8).

In addition to the primary symptoms mentioned above, the following secondary symptoms also appear:

Loss of facial expression or “masking”
Soft, whispery voice (hypophonia)
Micrographia (i.e., small, cramped handwriting)
Difficulty in swallowing food (dysphagia)
Drooling
Dementia or confusion
Sleep disturbances
Constipation and Urinary problems
Depression
Fear or anxiety
Memory difficulties and slowed thinking with slow response to questions (bradyphrenia)
Sexual dysfunction
Aching of muscles and joints due to rigidity
Fatigue and loss of energy
Compulsive behavior
Excessive salivation (hypersalivation)
Excessive sweating (hyperhidrosis)
Scaling, dry skin on the face and scalp (seborrhea) (8), (11) & (12)

Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com