Parkinson's Symptoms

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Parkinson's Symptoms
Parkinson's Symptoms
Video: Parkinson's Symptoms
Video: Movement signs and symptoms of Parkinson's disease | NCLEX-RN | Khan Academy 2023, February
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Parkinson's disease: symptoms

Parkinson's disease begins insidiously, as the decrease in the dopamine concentration in the brain is a process that takes years or decades and only leads to noticeable impairments over time. The demise of dopaminergic brain nerve cells often begins years before the first early symptoms of the disease appear.

The impairments become stronger and therefore more clearly recognizable over time. The causes of Parkinson's disease are still unknown.

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  • Which early symptoms can occur?
  • What are the main symptoms of Parkinson's disease?
  • What other symptoms can I experience?

In general, a distinction is made between the possible symptoms of Parkinson's disease so-called motor symptoms, that is, symptoms relating to movement, and non-motor symptoms, which can range from pain, impaired bladder function to psychological and cognitive disorders and even dementia.

Which early symptoms can occur?

Various more or less characteristic complaints can be the first signs or early symptoms of the disease. However, they are often not initially associated with Parkinson's disease and are therefore not treated accordingly. The early symptoms include, for example:

  • general reduction in performance,
  • Sleep disorders,
  • Lack of pleasure and interest,
  • depressive mood, easy irritability,
  • rheumatoid muscle pain in the neck, back, arms and legs,
  • Constipation due to decreased bowel movement,
  • reduced and later lack of swinging of an arm when walking or running,
  • Slowing down of movements (e.g. washing, eating, dressing etc. takes longer than usual),
  • incipient stiffness in the limbs,
  • Difficulty getting up from a chair,
  • increasing anxiety,
  • slow, quiet language,
  • Decrease in mental flexibility,
  • Changes in the typeface,
  • Changes in facial expression,
  • Circulatory weakness,
  • Disorders of the sense of smell and taste,
  • increasing difficulties with all things of daily life.

What are the main symptoms of Parkinson's disease?

The various early symptoms increase in the course of the disease. In the course of time, four predominantly motor symptoms come to the fore, which are the main symptoms (cardinal symptoms) of the disease. These are:

  • Sedentary lifestyle (akinesia)
  • Muscle stiffness (rigor)
  • Tremor (tremor)
  • Disturbance of postural stability and gait security (postural instability)

Sedentary lifestyle (akinesia)

The central symptom of Parkinson's disease is what is known as akinesia or akinesia. Voluntary movements of the trunk, arms, legs and facial muscles as well as speech are impaired. The movements are slowed down (bradykinesia). Posture, gait, facial expressions, language and fine motor skills are particularly affected; at the beginning, the symptoms only affect one side of the body.

  • It is typical, for example, that an arm or leg can only be started after a delay. The problem can appear very suddenly, that is, from one moment to the next, familiar sequences of movements can no longer be performed.
  • In the course of time, gait disorders often occur, for example one leg is often dragged along and the gait pattern becomes smaller. Problems when starting ("starting inhibition"), when getting up and when stopping quickly are very common. When turning movements, patients need more intermediate steps.
  • As the disease progresses, there are problems with balance and an increased tendency to fall. Some severely affected people become faster and faster when walking until their legs can no longer keep up, and thus increasingly run the risk of falling.
  • Affected people usually have a bent posture, with all large joints held in flexion. Often one arm hangs limply and does not move with movements.
  • The facial expressions diminish (hypomimia), the facial expression becomes more rigid - this is also known as the "masked face". The corners of the mouth stand still, the eyelids are closed less often than normal. Parkinson's patients often appear to be uninterested and disinterested.
  • Speech disorders: The language becomes quieter and more monotonous as the disease progresses. Often those affected become faster and faster towards the end of a sentence and then leave out parts of the word or repeat themselves.
  • Emotions can often no longer be expressed clearly.
  • Difficulty swallowing leads to an increase in saliva in the mouth and thus to salivation.
  • The declining coordinative mobility or dexterity can cause various problems in everyday life, for example, when writing, handicrafts, up buttons and go on to tie shoelaces.
  • The typeface can change overall, it becomes smaller ("micrograph").

Muscle stiffness (rigor)

The arms and legs of the person affected can hardly be moved passively due to an increased muscle tone ("waxy resistance"). Those affected perceive this as stiffness and painful tension all over the body and at the same time feel weak because the increased muscle tone has to be overcome with every movement. In the wrist in particular, a so-called gear wheel phenomenon can occur when trying to passively move it: This creates the impression that there is a gear wheel in the joint, over whose teeth it is moved.

Tremor (tremor)

The fingers, hand or arm, and less often the leg, tremble while the respective part of the body is actually at rest. With targeted movements of the affected limbs it usually disappears. The tremor usually starts on one side and usually has a frequency of four to five tremors per second. The tremor can become more noticeable with psychological stress or tension. Later in the course of the disease, both halves of the body are affected.

Note The description of Parkinson's disease as "shaking paralysis" is due to the typical occurrence of the tremor. Nevertheless, around 30 percent of those affected never experience tremor in the course of the disease.

The so-called pill-turning phenomenon is characteristic of the disease: the person affected rub their thumb and forefinger together as if they were moving a ball or pill back and forth between them.

Disturbance of posture stability and gait security

Another major symptom of Parkinson's disease is impaired postural stability. This means that the reflexes that normally keep the body balanced when moving are disturbed. As a result, unforeseen movements can no longer be easily compensated for. This can be demonstrated by responding to a slight push backwards: Usually such a push can be offset by a quick step backwards. Parkinson's patients are unable to do this and tend to fall or take several small steps to compensate.

What other symptoms can I experience?

In addition to the main symptoms, Parkinson's disease often has other, predominantly non-motor disorders. However, these do not have to be present or their severity can differ greatly between those affected.

Possible accompanying symptoms include:

  • Sensory symptoms: sensory disturbances (dysesthesia), pain, olfactory disorders.
  • Vegetative symptoms: increased sebum production in the face (seborrhea), disorders of blood pressure (drop in blood pressure when standing), temperature regulation, bladder and bowel function and sexual functions.
  • Mental symptoms: mainly anxiety, depression, frustration, confusion, obsessive-compulsive behavior.
  • Sleep disorders: vivid and unpleasant dreams associated with talking and violent movements.
  • Cognitive symptoms: e.g. disturbances in attention, memory, drive and reasoning, in advanced stages dementia.

The mental health of Parkinson's patients is often severely stressed. In addition to the increasing physical limitations, anxiety, depressive moods etc. also lead to a significant reduction in the quality of life. In addition, Parkinson's disease often leads to memory disorders and even dementia.

In the majority of patients, appropriate therapy can lead to a significant improvement in symptoms and thus an increase in quality of life, especially at the beginning of the disease. More on the topic: Parkinson's disease: Therapy

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