Parkinson's disease is a disorder of the nervous system that primarily affects bodily movement. Impairment or death of nerve cells in the brain leads to the development of the condition. The loss of these neurons causes essential neurotransmitter levels to decrease. This, in turn, leads to abnormal brain activity that affects one's control of muscle movement. Older individuals are the most common group diagnosed with Parkinson's.
One of the earliest and most widely occurring symptoms of Parkinson's disease is resting tremors. Usually, this begins with the trembling or shaking of one finger. Sometimes the hand or foot on one side of the body experiences tremors or, in rare cases, the face or jaw. The tremors usually begin when the affected body part is relaxed, which is why they are called "resting tremors." Not all tremors are symptomatic of Parkinson's, however.
In healthy individuals, muscles contract with movement and relax at rest. However, those with Parkinson's experience stiff muscle tone. This means the muscles of an affected body part do not relax completely even at rest. This leads to a limited range of motion, which is uncomfortable and sometimes painful. This muscle rigidity is mostly felt in the shoulders, trunk, limbs, or neck, though it can occur anywhere in the body. Many affected individuals do not swing their arms while walking, for example, due to muscle rigidity.
Also known as bradykinesia, slowness of movement is a distinctive feature of Parkinson's disease that causes people to perform ordinary activities, such as walking, moving, or changing clothes, more slowly than normal. They also experience a reduction in spontaneous movements and difficulty performing repetitive movements. Some telling signs of bradykinesia include a slow walk with short, shuffling strides and slow, soft speech. Ordinary tasks such as eating, dressing, and brushing teeth take longer, and these deficiencies become more noticeable as the disease progresses.
Postural instability is common among people with Parkinson's and usually appears in the later stages of the disease. They are unable to maintain an upright posture because of lost reflexes. In advanced stages, individuals may be unable to maintain balance in general, falling over when only slightly jostled. Turning, pivoting, and standing upright also become difficult.
As Parkinson's progresses, the symptoms become increasingly hard to miss. Many people develop changes in their facial appearance and speech patterns. The face tends to have a fixed, vacant expression called the "Parkinson's mask." Loss of facial muscle movement restricts facial expressions, including smiling, frowning, and laughing. Similarly, weakened throat muscles cause the individual's speech to become low-toned, unclear, and sometimes slurred. Choking, coughing, and drooling may develop at advanced stages.
A freezing gait differs from muscle rigidity and bradykinesia. People with Parkinson's sometimes hesitate to move forward and report feeling as if their feet are glued to the ground. This freezing is often temporary, with the person assuming a normal gait after the first stride. However, it can cause a loss of balance and increases the risk of a fall. This is especially true when it occurs during pivoting, walking on uneven surfaces, or on stairs.
An early indicator of Parkinson's is a change in the size of a person's handwriting. Often, a marked decrease in the letter sizes and spaces between the words becomes noticeable. This sign is called micrographia and occurs because changes in parts of the brain that control motor skills make it difficult for individuals with Parkinson's to control the movement of their fingers and hands.
Tossing and turning even while deeply asleep can be a sign of Parkinson's. Some individuals may even fall out of bed during the night. This symptom interrupts sleep patterns and decreases sleep quality, which can exacerbate other symptoms. Half of all people with Parkinson's disease have muscles that do not completely relax during sleep. This increases the risk of leg cramps and abnormal leg movements at night. Some people even "act out" their dreams by moving their limbs. It is also common for people with Parkinson's to experience excessive sleepiness during the day.
Straining to move the bowels can be a sign of Parkinson's and is also one of the most overlooked symptoms. Parkinson's affects the nervous system that controls the movement of muscles, so it is logical that it should also affect the bowels and bladder. The bowel can lose its sensitivity and become inefficient, slowing down the digestive process and the movement of waste, leading to constipation.
Parkinson's disease severely affects the central nervous system. As the disease progresses, changes in the skin can develop. Many individuals with the disease experience excessive sweating or hyperhidrosis for no apparent reason. For women, this symptom can feel similar to hot flashes during menopause. In addition, medications used to treat Parkinson's disease can cause excessive sweating.
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