Even before motor symptoms occur, clinical depression and anxiety may set in. Forgetfulness, slurring, difficulty swallowing, sleep disorders, and dizziness are common. Patients experience tremors starting in the thumb and index finger, foot or jaw. Limb motility and facial expressions are compromised, muscles are constricted, and posture balance and coordination becomes a challenge.
James Parkinson was least aware that his 6 cases of “Shaking Palsy” would become the second most common nerve degeneration disorder in the world, second only to Alzheimer’s disease. Named after the doctor who gave the world insight into it, Parkinson’s disease tends to affect people above 60 years, and men much more than women.
Parkinson’s is one of those flighty conditions – we don’t yet have a cure and what causes it is not exactly clear either. A poor production of the neural chemical dopamine is associated with it. Replacing the deficiency of dopamine with external dopamine tablets gives significant relief.
The symptoms of Parkinson’s differ from person to person and start subtly as early as in the 30s and 40s. The disease is characterized by a triad of trembling, rigidity, and slowness of movement. The symptoms are broadly classified into motor symptoms and non-motor(sensory) symptoms.
- Tremors: Parkinson’s Disease is invariably associated with tremors or “shaking,” which are commonly experienced in the hands or fingers, especially when the hand is at rest. Tremors due to Parkinson’s disease are characterized by a back and forth movement, are repeated at about 4 to 6 beats per second, and generally start with the hand (a finger and a thumb specifically), though it may also occur in the foot or the jaw. It is often called “pill rolling movement” because the shaking of the thumb and first finger makes it seem like the person is rolling a small pill between them.
- Slow movements or Bradykinesia: Slowness of movement or bradykinesia is a common symptom. The arms, legs, and other parts of the body slow down considerably, making simple everyday tasks such as dressing, brushing, or bathing time-consuming and frustrating. It is accompanied by a slowness in facial expressions. Involuntary actions such as smiling, frowning, and blinking are affected too. Together these tend to create a set, often grim facial expression, called the “masked face” and considered a classic sign of Parkinson’s.
- Rigidity: The muscles of the body become rigid and stiff. The scope of movement of the body decreases as muscles become tense and contracted, causing aches and pains. When you try to move the arms of a person with Parkinson’s you’ll find the movements to be jerky and restricted.
- Postural Instability: Problems with balance and coordination while standing and walking are rampant, causing falls and spills. These also lead to a restriction in the person’s mobility outside home and affects their independence – one major reason people with Parkinson’s become homebound.
Several non-motor symptoms are increasingly recognized as characteristics of Parkinson’s disease.
- Depression and Anxiety: Clinical depression and anxiety are symptoms of Parkinson’s disease. If left untreated, they can be harmful and will hinder the quality of life of the patient. They appear well before the other symptoms of Parkinson’s are noticed and can be successfully treated once detected.
- Cognitive Impairment: A decline in memory and intellectual functioning is characteristic of Parkinson’s disease. This manifests strongly in the later stages of the disease. People tend to forget things, especially connected to everyday affairs, and even lose the thread of conversation at times.
- Slurring and Changes in Speech: The speech of people with Parkinson’s may become extremely soft and flat, like a monotone. Some people may slur or hesitate while talking. Others might start talking too fast.
- Swallowing Problems: Swallowing of food, water, and saliva becomes difficult for a person with Parkinson’s. Coughing, choking, or drooling tends to become commonplace as the disease progresses.
- Sleep Disorders: Difficulty falling asleep and staying asleep is a common symptom of Parkinson’s disease. It may be one of the earliest symptoms of the disease and can help doctors diagnose the condition even before motor symptoms set in.
- Blood Pressure: A sudden drop in blood pressure on changing positions – e.g., while getting up or moving from one place to another – may cause dizziness, lightheadedness, loss of balance, or even fainting. This is called postural hypotension. The only way to avoid it is to steer clear of any sudden movements.
Most of the non-motor symptoms of Parkinson’s can be treated with medications like levodopa, while physical therapy is prescribed for rigidity and other symptoms. But do remember that the presence of one or some of these symptoms does not confirm the presence of Parkinson’s. A thorough examination by a doctor is a necessary step in diagnosis.