Parkinson's Disease
Signs & Symptoms
Symptoms of the disease affect different people in different ways, ie.
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.
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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:
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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 begin 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
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