Terms to Describe the Main Symptoms of Parkinson's
Bradykinesia refers to slowness of movement. Bradykinesia is most apparent when people with Parkinson's start to walk or begin to make other conscious body movements such as reaching or turning. Their movement takes extra effort and appears slow and hesitant - many appear to shuffle their feet when they walk. Fine movements, such as fastening buttons or writing, become clumsier.
Over time, unconscious movements (those that we do all the time without a thought) such as blinking of the eyes, facial expressions, swallowing, swinging of the arms, and changing posture, all can become slower. When sitting quietly, the overall appearance of someone with Parkinson's disease is one of unusual stillness. Due to slowing of facial movements, the emotions of people with Parkinson's may no longer be seen in their faces.
At its worse, bradykinesia can cause what is commonly called "freezing." When that happens, people with Parkinson's feel like they cannot move. Freezing can prevent them from getting out of bed or eating by themselves. Medication can be very helpful in improving bradykinesia.
Tremor refers to rhythmic shaking over which the person has no control. Tremors are often seen in the hands or arms, but they can also occur in the legs, feet, jaw and lips. The shaking usually happens when the body is not moving or is at rest. The shaking normally goes away when the part of the body that shakes is being used or when the person is asleep. That is why the Parkinson's tremor is sometimes described as a resting tremor.
Rigidity refers to stiffness of muscles. In the early stages of Parkinson's disease, rigidity can be mistaken for arthritis or bursitis. As the disease gets worse, rigidity and stiffness is perceived as a cramp or tired, aching muscles. Some people might experience back pain, headache, or a "Charley horse" in one of their legs. Rigidity is associated with the stooped posture that is often seen with Parkinson's disease. Rigidity responds well to a combination of medications and a vigorous stretching program.
Impaired balance refers to unsteadiness when walking or standing. In the later stages of the disease, some people have a tendency to lean to one side or the other and may even fall backward or forward, due to changes in reflexes associated with posture. These are the reflexes that facilitate rapid changes in the balance center of the brain when walking or standing. Medication is less helpful for balance problems than it is for rigidity or bradykinesia. A physical therapist can be very helpful in teaching safety maneuvers, balance exercises, and providing consultation regarding ambulation aids.
Other less frequently seen symptoms
Sometimes, Parkinson's also begins to affect mood, memory, speech, sexual functioning, and the ability to sleep and swallow. Changes may also occur in bowel and bladder functioning.
These symptoms may affect some people who have Parkinson's disease, but they do not affect everyone. As the disease progresses, worsening symptoms cause many individuals with Parkinson's to eventually require assistance in their homes with daily living activities.
How common is Parkinson's?
Over one million people in the United States have Parkinson's disease. Most people who are diagnosed are over age 50-60, but about ten percent of those diagnosed each year are age 40 or younger. Both men and women get Parkinson's disease, but it is slightly more common in men.
In addition to those who are diagnosed, it is possible that many others have the disease but have not yet sought medical help for it. Sometimes, people who have symptoms of Parkinson's wait a long time to seek help due to fear, embarrassment or hope that it will get better on its own, which unfortunately only worsens the disease. Generally, the earlier the diagnosis, the more effective treatment can be.
What causes Parkinson's Disease?
No one knows what causes Parkinson's disease. We know that it affects cells called neurons that are located in a small area at the base of the brain called the substantia nigra. These neurons normally make a chemical called dopamine.
The brain is the control center for the body. The brain controls movements, sensations, feelings and personality. Dopamine is one of the chemicals needed to help the brain function smoothly and control movement of the body. Dopamine helps nerve impulses to transmit messages to muscles, resulting in what we know as normal body movement.
Parkinson's disease results when neurons die and less dopamine is made. When the supply of dopamine is decreased by approximately 50% - 60%, symptoms of Parkinson's begin to start. Over time, as more neurons are lost and the supply of dopamine is lower and lower, symptoms become more severe.
Although research is still being done in this area, the cause of the cell death that leads to Parkinson's disease is unknown. Scientists are debating whether the nerve cell loss is something that has a genetic link, or whether it happens slowly after being exposed to a toxic substance. It may be a combination of these two things.
How can we be sure it is Parkinson's?
An accurate diagnosis of Parkinson's disease can be difficult to make. As of yet, there is no specific diagnostic test that can be used to confirm the diagnosis. However, an MRI scan or blood tests can be used to rule out other disorders that have some symptoms similar to Parkinson's. Diagnosis is made by a physician based on a physical examination of the patient, focused on the body movement symptoms that are associated with Parkinson's, along with the patient's medical history.