Parkinson disease is a progressive alteration of the brain tissue that typically affects an area in the brain called substancia nigra. This is a key area to perform and coordinate movements, and Parkinson patients have an abnormal accumulation of proteins in deposits called Lewy bodies. These abnormal deposits start creating alterations in the neuronal impulse and give rise to many alterations, especially in the musculoskeletal system.
It is known that many people have Lewy bodies in their brains without experiencing Parkinson symptoms. However, when 60% of dopaminergic neurons are affected by these deposits, patients start experiencing Parkinson symptoms. However, if you catch the disease in its early phase, it is possible to provide an effective treatment that significantly reduces your chance of complications. These are the most important signs and symptoms to detect this disease:
1-Shaking and tremors
It is usually the first alteration, but it usually remains undetected for a while because in the early stage, it is very mild. Tremors are involuntary contractions of the muscles, usually in the extremities, that result in shaking, especially when trying to do a fine or precise movement. In many cases, tremors are found in one extremity but not in the other, which is why it is called asymmetric resting tremor. This symptom is intermittent and becomes more severe as the disease progresses. Thus, it might not be the first sign to rely upon if we want an early diagnose of Parkinson’s disease.
2-Rigid muscles
The musculoskeletal system is one of the most commonly affected in Parkinson’s disease. Muscles become tense and rigid, and patients often report stiffness in their articulations. When they undergo tests, they are all apparently fine and show no alteration because the origin of this alteration is nervous, not a problem in the muscle itself. It is an involuntary resistance against the movement and can be further divided into an oscillating resistance (which continuously comes and goes) or a smooth resistance (maintained with the same intensity throughout time).
3-Dystonia
Muscles become rigid in Parkinson, but may also undergo spasms and something called dystonia. This is an involuntary contraction of the muscle that extends for a long time and leads to an unnatural position in the affected extremity. This is often experienced in the lower extremities, and patients feel their foot suddenly becomes difficult to move, start contracting, and feels very painful as it twists into an arching flexion. This torsion or inversion of the foot is often described as one of the worst sensations and commonly appears when the patient is worn down or very tired.
4-Slow movements
This is an initial symptom of Parkinson’s disease, but it might also be a bit difficult to trace in mild cases. Patients with Parkinson’s disease become progressively slow in activities such as walking, standing up, and performing easy motions. Facial expressions may slow down as well, and this may also affect the tone and speed of the patient’s speech. Sometimes this slow muscle response leads to drooling and difficulty to manage their own fluids in severe cases.
5-Balance problems
All of the musculoskeletal problems described above are usually located in the upper and lower limbs impairing the ability of the patient to walk properly and maintain balance. As the disease progresses and more neurons are taken, muscular discomfort turns into posture instability, a difficulty to control the muscle tone in your legs and feet. There are a series of tests doctors need to perform to evaluate your postural stability. Thus, if you notice you’re capacity to walk, stand or maintain your balance is becoming affected, talk to your doctor about your symptoms and be as accurate as possible in describing your problems.
6-Incontinence
There is smooth muscle in the urinary bladder as well, and this muscle is responsible for contracting and releasing in order to control your urinary function. In patients with Parkinson’s disease, the urinary bladder eventually becomes overactive and the smooth muscle starts contracting and relaxing unexpectedly. Since this is not skeletal muscle and it is totally involuntary, it is impossible to stop this outcome, and its consequence. This is why patients with an advanced Parkinson’s disease, and especially women, often experience incontinence.
7-Insomnia
It is common for Parkinson’s disease patients to have 5 hours of sleep or even less. They usually suffer from a condition named sleep apnea, a common disorder where the patient stops breathing while he’s asleep and wakes up snoring. Additionally, it is highly likely they will need to wake up in the middle of the night to take a leak. As we will see further, Parkinson patients may also suffer from depression, a condition that is also associated with sleep deprivation.
8-Fatigue
It is increasingly difficult to move and think, and apparently easy tasks become a challenge in patients with Parkinson’s disease. This whole situation leads to feeling overly tired and fatigued. Additionally, they are known to have sleeping problems, which contribute to the problem and lead to daytime sleeping, drowsiness, irritability, and other additional problems.
9-Speech problems
Patients with Parkinson’s disease have a problem in the musculoskeletal system, which is also found in the phonatory apparatus. To speak properly we need a combined and specialized movement of the tongue, the mouth, and the vocal cords. When Parkinson’s disease symptoms are extended to this area, the patient starts having problems to articulate speech. Even before having these problems, their speech changes and becomes monotone, soft, and very slow, and fluency becomes severely affected as the disease progresses. In some cases, patients with Parkinson develop additional problems such as stuttering and breathing heavily between one set of words and the other. Each one of these symptoms should be evaluated by a professional to understand the root cause and what we can do about it.
10-Difficulty to swallow
This symptom is also known as dysphagia, and typically appears as a result of a musculoskeletal alteration in the structures associated with swallowing. It is only seen in advanced cases of Parkinson, and it is often associated with drooling and the risk of breathing food or liquids. These patients need to be carefully observed to prevent severe complications.
11-Depression
Parkinson’s disease is a degenerative disease that affects your body functions and impairs your ability to perform day-to-day activities. Patients with advanced disease are at increased risk of depression, especially as their disability becomes more severe, and when they do not have coping strategies. Additionally, the brain in patients with Parkinson starts losing dopaminergic neurons, and they release a neurotransmitter called serotonin. Lacking serotonin leads to depression and further increases the risk of these patients to have mood problems.
12-Anxiety
Anxiety is deeply associated with depression, and sometimes, they are both at the same time in the same patient. Similar to depression, anxiety is also triggered by a reduction of serotonin in the brain, which is triggered by Parkinson’s disease. Additionally, patients with increasing symptoms, slow movements, and so many difficulties and limitations often feel anxious and nervous. One common concern in these patients, especially in older adults, is the possibility of falling and enduring a fracture. This and many other recurring thoughts contribute to feeling anxious and often leads to depression at some point.
13-Cognitive disturbances
Patients with Parkinson’s disease usually have some degree of cognitive problems and cognitive decay. This is more than expected because the disease features a loss of neurons and a reduction of brain activity. In advanced stages of the disease, Parkinson patients may develop dementia symptoms, which feature memory problems and learning difficulty. Among the different types of dementia, the most common is Alzheimer’s disease, and it is closely linked with Parkinson’s. It is known that even when the disease starts, there’s a mild decay of cognitive function, but it will be not until 8 years later than these cognitive issues become more severe and noticeable. This is why a careful assessment should be made as soon as possible to give these patients a better quality of life, improve their body functions, and prevent the most feared consequences of Parkinson’s disease.
There is still much to know about Parkinson’s disease, and new drugs and alternative treatments are continuously developing to guarantee a better quality of life in these patients. Thus, even if there’s no known cure for Parkinson just yet, the current treatment protocol has better results than that of previous decades, and more options are currently under active research to bring better options, and hopefully, a cure.
In the meantime, prevention is the key to make your life better, and if you have Parkinson signs and symptoms, the best recommendation is to talk to your doctor and follow his instructions. By doing this, you will be detecting the disease at the earliest time possible, reducing your risk of complications, and improving your quality of life. Even though it may be hard sometimes, and you will get ups and downs throughout the course of the disease, it is possible to live with Parkinson, stay healthy, and feel both happy and fulfilled.