Symptoms of Parkinson's Disease

Symptoms of Parkinson's disease - Parkinson's disease is considered to be one of the major disorders that wreak havoc on the motor system. There are four primary physical symptoms that characterize this incurable disease. These symptoms, referred to as the "TRAP" symptoms include Tremors, Rigidity; Akinesia, and Postural reflex.

As Parkinson's disease progresses and each of these symptoms worsens, the sufferer may find that their ability to walk, speak and do other very simple things is affected.

Symptoms of Parkinson's Disease

Symptom Description
Tremors A tremor is both an involuntary and rhythmic movement that occurs most commonly in the fingers, hands, arms, legs and face (often in the lips) and is known as a resting tremor because it is the most noticeable when the person is not actively moving that part of his or her body. Tremors are the most common first symptoms of Parkinson's disease being found in approximately seventy percent of sufferers although up to twenty-five percent of sufferers do not experience tremors at all.
Rigidity Rigidity is all about muscle tone and is often felt as a form of stiffness or tightness. In Parkinson's disease having rigidity of the muscles, which is often seen in lower back pain or shoulder pain is called "cogwheel rigidity."
Akinesia Akinesia (lack of movement) often goes hand in hand with bradykinesia (slowness of movement) when it comes to Parkinson's disease. Sometimes even the simplest of everyday tasks, such as buttoning a blouse, brushing or flossing teeth, combing hair, pouring a glass of milk, or tossing a salad become more difficult to do because of slower movements that cannot be helped.
Postural Reflex Impairment Postural reflex impairment does not show itself initially when a person first begins experiencing the symptoms of Parkinson's disease. Rather it occurs much later in the progression, sometimes many years, and has to do with the patient's ability to keep their balance and also be coordinated. People at this stage should have someone with them at all times as the tendency to fall is very great.

Some of the physical symptoms of Parkinson's disease that show themselves early in the development of Parkinsons disease include:

  • Changes in handwriting style (often becoming smaller and sloppier)
  • A weakening of the face and throat muscles which can lead to choking, coughing, drooling and problems speaking and swallowing
  • Cramps in both joints and muscles; an inability to swing one's arm on one side as one walks about
  • Isolated, uncomfortable shoulder pain
  • Difficulty turning over in bed, getting out of bed or getting up from a chair or couch
  • Constipation and problems starting or controlling the flow of urine
  • A tendency to "freeze", in other words a moment when one is unable to move (this occurs most often while walking)
  • An excess of dandruff or the tendency for skin to get oily

Top Three Conditions Mistaken for Symptoms of Parkinson's Disease

Parkinson's disease, especially in its early stages when symptoms are mild, is not easy to diagnose. The non-specific, and easily overlooked nature of the signs of Parkinson's disease make it difficult to spot, and unlike many illnesses, there is no one laboratory test or radiological exam that will provide a definitive diagnosis of Parkinsons disease.

Patients exhibiting Parkinson's-like symptoms of Parkinson's disease may undergo blood and urine tests, or CT or MRI scans to exclude other conditions, but none of these will provide a diagnosis of Parkinsons disease.

The best way to test for Parkinson's disease is to conduct a systemic neurological examination that includes tests to gauge a patient's reflexes, muscle strength, coordination, balance, gait, and overall movement. Even so, according to information presented on The Michael J. Fox Foundation for Parkinsons Research, up to 25 percent of Parkinsons disease diagnoses are incorrect.

So, why is there confusion about diagnosing Parkinson's disease? The simple answer is that symptoms of Parkinsons disease are not clear cut, and therefore, it is easy to mistake them for other conditions, or to classify them as parkinsonian when they are not.

Symptoms of Parkinson's disease - top three conditions mistaken for Parkinson's disease:

  1. Multiple system atrophy (Shy-Drager Syndrome): a rapidly progressing disease that first features autonomic nervous system insufficiencies (dizziness, lack of bladder control, impotence, etc), and then takes on Parkinson's disease-type symptoms such as rigidity, tremor, bradykinesia, postural instability, and difficulty walking.

    Some neurological specialists have speculated Shy-Drager Syndrome may be a form of Parkinsons disease rather than a separate condition, but for now, it remains its own entity.

  2. Supranuclear palsy: results in rapid paralysis of eye movements, rigidity, difficulty speaking, and subtle mental shifts.

    Supranuclear palsy is a disorder of a different part of the brain than Parkinson's disease, and patients with this condition do not respond to standard antiparkinsonian drugs such as levodopa. The speed at which the disease progresses also sets it apart from Parkinson's disease.

  3. Benign Essential Tremor (familial tremor): a gradually progressing condition that shows as tremors in the hands and arms on both sides of a patient's body, and occasionally the head.

    Unlike with Parkinson's familial tremor does not affect the legs, and the two illnesses respond to different drugs.

Beyond those three, there are several other conditions that are often confused with the symptoms of Parkinson's disease, including Multiple Sclerosis, Amyotrophic Lateral Sclerosis (Lou Gehrig's disease), Normal Pressure Hydrocephalus, Striato-Nigral Degeneration, Pseudobulbar Palsy, Wilson's disease, Hallervorden Spatz disease, Olivopontocerebellar Degeneration, Huntington's disease, Dystonia, and brain tumors.

With such a variety of illnesses sharing many of the same symptoms and characteristics, it's not surprising symptoms of Parkinson's disease are often misdiagnosed. People who have mild symptoms, or who would like a second opinion, should certainly ask their doctor about having the diagnosis confirmed by another physician.

With early diagnosis being the key to maintaining longer-term independence and a high quality of life, it is important to have an accurate diagnosis so that appropriate treatment therapies can begin immediately.

Testing for Symptoms of Parkinson's Disease - What You Should Expect

The usually gradual and non-specific nature of the presentation of Parkinson's disease can make it difficult to diagnose, especially in the early stages of the disease when you're experiencing a few symptoms of Parkinson's disease. People who suffer from Parkinson's may go to their physician after noticing symptoms such as tremors or trembling, a sense of unbalance, difficulty walking, stiffness, trouble talking, or slowness of movement.

Both men and women can be affected by Parkinsons disease, and although there are cases of young-onset Parkinson's, the disease most often tends to affect people over the age of 50. So how do you know if you have Parkinson's disease? What tests are available and what should you expect?

Parkinson's disease is not always simple for physicians to diagnose; in fact, it is thought that up to a quarter of Parkinson's diagnoses are incorrect. Unlike many illnesses, there is no one laboratory test or radiological exam that will provide a definitive diagnosis of Parkinson's disease. Patients exhibiting symptoms of Parkinson's disease may undergo blood and urine tests, or CT or MRI scans to exclude other conditions, but none of these will provide a diagnosis of Parkinson's disease.

Other nuclear tests may be useful for helping to diagnose Parkinson's, but at the present time are generally used more for research purposes rather than as a diagnostic tool.

The most common way to test for Parkinson's disease is thorough physical and systemic neurological examination. This may include tests to gauge the patient's reflexes, muscle strength, coordination, balance, gait, and smoothness of movement.

Clinically, the appearance of Parkinson's disease is noted by the presence of four "cardinal" signs or key symptoms of Parkinsons disease including tremors or trembling at rest; akinesia and bradykinesia; rigidity; and postural instability. (note for a better understanding of these terms refer to the top of this page and for other terms used in describing symptoms of Parkinson's disease click here and go to the end of the page: terms used in describing symptoms of Parkinson's disease.)

A physician may make a diagnosis of Parkinson's disease if two of the following three conditions are present: akinesia and bradykinesia; rigidity; or tremors at rest, especially, if the two are noticed in conjunction with some of the secondary signs of Parkinson's, such as greasy skin, increased sweating, impaired olfactory senses, constipation or increased urination, dizziness when standing, numbness, pain, burning sensations, fatigue, restlessness, difficulty sleeping, or depression.

Physicians may also look for a family history of Parkinson's disease when trying to test for the illness. Although there are cases where a known genetic mutation causes Parkinsons in a family, there are more common cases of a family history of Parkinson's without a known link.

Symptoms of Parkinson's disease - Does your Family Health History Play a Part in Parkinsons disease?

About 15 percent of cases of Parkinson's disease occur in people who have a family history of the condition, while the remaining 85 percent of cases are considered sporadic, with no known history of the disease in the family, and the inheritance pattern, if it exists, remains unknown.

When family history comes into play, it is usually a result of mutations of the LRRK2, PARK2, PARK7, PINK1, or SNCA genes. Modifications to other genes may also increase or decrease the risk of developing Parkinsons disease. Genetic testing may help shed light on an individual's propensity for developing Parkinson's disease when a mutation is a factor.

Parkinson's disease may appear more than once in the same family without the condition actually being inherited. Because the causes of Parkinson's remain unclear, it is possible that environmental contributors may also play a role instead of or in addition to genetics.

Women and men who have Parkinsons disease may worry about passing on the disease to their children, but statistically, having a parent with Parkinson's only raises a person's risk of developing the disease at some point in his or her lifetime to about six percent.

Additionally, women of child-bearing age with Parkinson's disease can safely have children without immediately "passing on" the disease, although they should speak to their doctor about the possible effects of medications on the fetus in utero and afterward when the baby may be breastfeeding.

Prospective parents may also want to discuss the potential ramifications of raising a child while living with Parkinsons and its progressive, long-term debilitation.

Dealing with Depression after a Parkinson's Diagnosis

Parkinson's disease is often thought of as a physical disease: in advanced cases, it is easy to see the symptoms of Parkinson's disease mainly tremors, tics, stiffness and mobility problems that characterize the disease. Yet there is a strong link between mental health and Parkinson's disease, too, with dementia often settling in later stages of the disease.

A more prominent mental health issue associated with Parkinson's is depression. Parkinsons literature suggests as many as half of people with Parkinson's disease may also suffer from depression as they deal with the symptoms of Parkinson's disease and the life changes that take place.

Depression is a serious condition that can interfere with everyday functioning, and in severe cases, can even lead to isolation, self-mutilation or suicide. While it can be triggered by stressful events, prolonged environmental or social circumstances, or even from medication, depression results from abnormal brain function of which the cause is not certain.

In addition to the classic depression signs of moodiness, unsociability, decreased hygiene or care for personal appearance, isolation or low self-esteem, Parkinson's patients may exhibit different signs of depression than those people who do not have the disease. Differences in the symptom profile for people with Parkinson's as opposed to those who do not may include:

  • Higher rates of anxiety
  • Sadness without guilt or self-blame
  • Frequent occurrences of suicidal thoughts but with fewer actual suicides

The good news is that depression, for both healthy individuals and those with Parkinson's is treatable. Seeking and undergoing treatment for depression will allow people to feel better about themselves and their circumstances, and in the case of those dealing with Parkinson's and all the symptoms of Parkinson's disease, will allow them to focus more on overcoming the symptoms of their disease and living a more normal life.

Treatment should be a collaborative effort between the Parkinson's physician and a qualified mental health professional, preferably a psychiatrist who can prescribe appropriate medication. By encouraging communication between neurologist and psychiatrist, potential medication interference can be avoided and best possible mental and physical health achieved more quickly.

Even when treated, depression does not disappear overnight, and it may take time to discover the right balance of medication and emotional therapy to help patients recover, even if they are very ill. No matter the stage of Parkinson's a person might be experiencing, there is a treatment for depression that can be incorporated into his or her overall health treatment plan without compromising the efficacy of either program.

People with Parkinson's, especially if they suffer from depression, may feel overwhelmed by the enormity of their health issues as they try to deal with all the symptoms of Parkinson's disease. It may be helpful to learn more about the disease and the advances that allow most people with Parkinson's to live long and productive lives.

It may also be comforting to consult with other people who have the disease and who have learned to live with it. Worldwide, there are national, regional and local associations dedicated to Parkinson's disease research, education and helping people cope with it. This kind of real-life support from people who know what it is like to live with Parkinson's can be an invaluable addition to the support network provided by family and friends.



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