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Does Parkinson’s Affect Your Face

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Parkinson’s disease symptoms: Muscle stiffness can make ...

Cognitive impairment can occur due to stress, particularly if the patient feels they are a burden to their caregiver, are experiencing a decline in daily functioning, have a worsening quality of life, are dealing with rising medical costs, or are concerned about their mortality.

According to the National Parkinson Foundation, some of the common cognitive issues people living with Parkinson’s disease face include:

  • Slowness of thinking
  • Struggling to find the right words in conversations
  • Declining visual perception
  • Lack of reasoning skills
  • Declining general intelligence

Some Parkinson’s disease medications can help with areas such as motivation and concentration, but there are no medications that can improve memory function.

MORE:How does Parkinson’s disease affect the brain?

Parkinsons’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Pain In Parkinson’s Disease

Doctors categorize pain as nociceptive, which refers to pain from tissue damage, or as neuropathic, which refers to pain that arises from the nerves. Some pain is both nociceptive and neuropathic. Most people with PD experience nociceptive pain.

This type of pain is generally localized to a specific area of the body. The most common areas for people with PD to experience pain are the neck, upper back, and the extremities . Neuropathic pain is less common in PD, although it may be caused by akathisia, an extreme restlessness.1

The pain caused by PD can generally be classified by one of five causes:

  • Musculoskeletal pain related to poor posture
  • Nerve or root pain, which is commonly related to arthritis in the neck or back
  • Pain due to dystonia, the prolonged twisting or contraction of a muscle group
  • Discomfort due to extreme restlessness
  • A pain syndrome known as “primary” or “central” pain that arises from the brain1
  • Skin Cancer And Parkinsons Disease

    Melanoma is a type of skin cancer consistently linked to PDPeople who have had melanoma are at an increased risk for PD and people who have PD are at an increased risk of melanoma. Epidemiological studies have shown an increased risk of non-melanoma skin cancers in PD patients as well. Always be sure to talk to your doctor about any skin concerns.

    Tips and Takeaways

    • Non-motor symptoms such as sweating dysregulation and seborrheic dermatitis can be symptoms of PD
    • Seborrheic dermatitis can usually be treated with lifestyle changes and over-the-counter creams. Sometimes prescription-strength creams are necessary
    • Although many treatments have been developed for excessive sweating, they have not been tested specifically in people with PD. Discuss with your doctor to find out if any are a possibility for you.
    • There is a link between PD and melanoma which you can read about in a prior blog.
    • If any symptom is causing you discomfort or interfering with the quality of your daily life, be sure to discuss it with your doctor as it may be something that can be improved with treatment or modifications.

    Do you have a question or issue that you would like Dr. Gilbert to explore?

    Dr. Rebecca Gilbert

    APDA Vice President and Chief Scientific Officer

    I Wont Lie There Are Many Down Times But I Have A Choice Do Nothing And Achieve Nothing Or Battle On; I Chose The Battle

    Does it hinder your creativity?

    It makes all the other things that I did, apart from photography, a chore and no longer a means of relaxation. I love drawing but it is so slow and I need to concentrate so hard that the sheer joy of flowing strokes becomes a battle.

    How has it affected you outlook on life?

    I won’t lie, there are many down times but I have a choice – do nothing and achieve nothing, or battle on; I chose the battle.


    Explain the concept behind your ‘Concrete’ project. Why did you decide to do it?

    Since I picked up the camera again, I would occasionally ask my subject if they wouldn’t mind placing their face in water and looking at the camera. I just liked the effect. Then early last year it dawned on me, “I was making people cry because I wouldn’t, couldn’t, real men don’t cry!” So then I thought why not do something with the images to raise awareness of Parkinson’s disease. I call it ‘Concrete’ after a little poem that I wrote.

    The photos are incredibly stark representations – how did you get the reactions out of your subjects for each emotion?

    Facial Masking Can Make It Hard To Gauge The Mood Of A Person With Parkinson’s


    Without facial movement, your expression may come across as emotionless, causing you to seem upset or annoyed when you’re not, says physician Chris Airey, MD, medical director at Optimale. He notes that Parkinson’s can affect both voluntary and involuntary facial movements.

    According to the Parkinson’s Foundation, trying to understand a person with Parkinson’s mood can be further complicated by other symptoms on top of facial masking. Facial expressions are an essential part of how we communicate. When you have a straight face along with speech changes, such as a low voice, which is common among Parkinson’s patients, it can be challenging for people to understand your mood, the experts at the foundation explain.

    A Day In The Life Of A Parkinsons Disease Sufferer

    A Typical Morning

    What is Parkinson’s disease?

    Parkinson’s disease is largely thought of as a condition of affecting motor control. James Beck, PhD, vice president of scientific affairs for the Parkinson’s Disease Foundation , says that while every case is different, the four cardinal signs of the disease are tremor, muscle rigidity, bradykinesia or akinesia , and problems with walking and balance. These symptoms occur as cells in a part of the brain known as the substantia nigra begin to die off, for reasons that remain unknown. These cells produce an important chemical neurotransmitter known as dopamine. Without dopamine, the brain is unable to control muscle movement. But dopamine is so much more than that. You may have heard it referred to as the “happiness” neurotransmitter, so it’s no surprise that two of the non-motor symptoms of Parkinson’s disease are depression and apathy. Add to that pain from rigid muscles, blood pressure instability, drooling, sweating, constipation, impaired cognition, and absolutely crushing fatigue, and you’ve got yourself a disease that affects just about every facet of life. “A person with mid-stage Parkinson’s disease walking around may look like they are drunk,” says Dr. Beck. “They commonly have slurred speech, and swallowing is another problem, which can contribute to drooling. This constellation of motor effects looks like drunkenness, but their minds are clear.”

    Treatment for Parkinson’s

    Getting Help

    How Does Parkinson Disease Affect The Body

    Dr. Robert Hutchmanresting tremorerectile dysfunction

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    Adjusting My Medication Regime Really Helped

    “I was having problems physically expressing my emotions, but my mental health issues continued to affect me too. So not only could I not move my facial muscles easily, but the feelings of motivation, enjoyment and enthusiasm all seemed to have waned and diminished within me.”

    Mark was prescribed selegiline and co-careldopa, which helped to boost his dopamine levels. After a few months, he started noticing improvements in his motivation and the strength in his facial muscles began to return.

    “After I was prescribed the right medication, friends and family said I looked much happier, and that I was smiling and laughing more. Adjusting my medication regime really helped.”

    Mark also keeps his Parkinson’s symptoms at bay with his local Walsall 5km Parkrun, physiotherapy, and pilates. And he enjoys the benefits of being a member of Parkinson’s UK. 

    He says: “I went to the Parkinson’s UK Members’ Day. It was truly inspiring. It made me feel more positive, and I realised just how much help is available. I’m learning to cope with my condition and I’m grateful to have excellent support from my wife, family and friends. I now realise that most things in life are never as bad as they first appear.”

    How Exercise Can Help

    Research shows that regular exercise has significant benefits for Parkinson’s patients. Since the disease affects flexibility, strength, and balance, patients are encouraged to use targeted exercise routines to manage the disease.

    A study review published in the Clinical Journal of Sport Medicine that exercise improves overall physical performance in Parkinson’s patients. The authors concluded that future research should examine the long-term effects of exercise programs.

    As a rock climber, I spend a lot of time pulling on jagged edges. I’ve learned that it’s important to balance muscle growth with the opposite action. I’ve integrated pushing into my routine to balance the pulling that I do on a rock wall. Focusing on both pushing and pulling helps my body to stay balanced and prevents injuries.

    While I haven’t yet encountered a rock climber with Parkinson’s, the same premise could apply. If Parkinson’s causes constant muscle contractions, how can we encourage those muscles to extend and relax? Yoga emphasizes both strength and flexibility. And it’s possible to a routine at home. Starting a yoga practice might offer a solution to managing muscular changes.

    What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms

    Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinson’s disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didn’t exercise or didn’t start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.

    Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinson’s, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.

    Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments — whether medicines or deep brain stimulation — are optimal; and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.

    Improve the quality of your sleep.

    What Is A Parkinsons Tremor

    Other health issues can also cause tremors, like multiple sclerosis or essential tremor. But Parkinson’s tremors are different because they’re usually:

    • Resting. Parkinson’s tremors happen when your muscles are still. They go away when you move. They also lessen while you . For example, if you’re sitting in a chair with your arm relaxed, you may notice that your fingers . But if you’re using your , like when you shake someone else’s hand, the tremor eases or stops.
    • Rhythmic. Parkinson’s tremors are slow and continuous. They aren’t random tics, jerks, or spasms.
    • Asymmetric. They tend to start on one side of your body. But they can spread to both sides of the body.

    How Can Hypomimia Impact The Life Of People With Parkinsons

    The loss of facial expressiveness can negatively impact social interactions and relationships, particularly when combined with other symptoms such as speech difficulties and changes in body language or gesturing. The person’s ability to physically express thoughts and feelings is reduced, and others may have difficulty in understanding them or may misinterpret them – for example, thinking they are unhappy because they do not smile. could also affect a person’s confidence to go out or participate in activities.

    Alongside a reduction in their own facial expressions, people with Parkinson’s can also find it difficult to recognise emotions from other people’s expressions. Research has suggested that these two issues may be linked, in that we understand others’ actions and emotions by internally “simulating” their movements. If our own facial movements are reduced, this may affect the ability to simulate and interpret others’ facial expressions.

    Can Masked Face Be Treated

    Parkinson’s disease: Feeling this sensation in your eyes ...

    There are no specific medications for treating masked face. However, treatments for Parkinson’s disease can help reduce masked face, as well as other symptoms of this condition.

    Some medications used to treat Parkinson’s disease focus on increasing dopamine activity in the brain. Some examples of these medications include carbidopa and levodopa.

    Levodopa is one of the main medications used to treat Parkinson’s. It is a natural chemical that converts to dopamine in the brain. It is often paired with carbidopa, which helps levodopa work more efficiency and prevents certain side effects like nausea and vomiting.

    Together, carbidopa-levodopa can be given as an:

    • oral medication
    • inhalant
    • infusion that is administered through a feeding tube directly into the small intestine

    Other medications for rigidity, as well as facial exercises and physical therapy, may also be recommended to treat masked face.

    Participating in activities that you love or feel passionate about may help improve your facial expressions. This includes creative pursuits, such as singing, dancing, or watching movies and plays.

    Why Does Parkinsons Disease Cause A Mask

    PD is a chronic, progressive disease that affects the nerves, especially the nerves that control muscle movement. There are at least 43 muscles in the face, which move in concert to create expressions ranging from happiness to anger and despair. Dopamine is the neurotransmitter that transmits the signal from the brain to the muscles to produce movement. When PD damages the nerve cells that produce dopamine, the motor symptoms and ability to control muscles are affected.4,5

    What Are The Symptoms Of Parkinsons Disease

    Symptoms of Parkinson’s disease and the rate of decline vary widely from person to person. The most common symptoms include:

    Other symptoms include:

    • Decreased facial expressions: You may not smile or blink as often as the disease worsens; your face lacks expression.
    • Speech/vocal changes: Speech may be quick, become slurred or be soft in tone. You may hesitate before speaking. The pitch of your voice may become unchanged .
    • Handwriting changes: You handwriting may become smaller and more difficult to read.
    • Depression and anxiety.
    • including disrupted sleep, acting out your dreams, and restless leg syndrome.
    • Pain, lack of interest , fatigue, change in weight, vision changes.
    • Low blood pressure.

    Which Body Parts Do Parkinsons Tremors Affect

    There are five main places you’ll have Parkinson’s tremors:

    1. Hands. Parkinson’s disease tremors often start in the fingers or hands with what’s called a pill-rolling motion. Imagine holding a pill between your thumb and index finger and rolling it back and forth.

    2. Foot. A Parkinson’s foot tremor is more likely to happen while you’re sitting or lying down with your feet at rest. If the tremor moves into your thigh muscles. It could look like your whole leg is shaking.

    Foot tremors disappear when you stand or walk because those are active movements. A foot or leg tremor while you’re standing may be another condition.

    3. Jaw. This is common in people with Parkinson’s. It may look like you’re shivering. It can become bothersome if the tremor makes your chatter. If you wear , it could make them shift or fall out.

    Chewing eases the tremor, so gum might help.

    4. Tongue. It’s rare, but a tremor can cause your entire head to shake.

    5. Internal. Some people with Parkinson’s say they can feel a shaking sensation in their chest or . But can’t be seen from the outside.

    How Does Parkinsons Disease Affect The Body

    Recognising the signs

    A combination of signs can help a doctor make an early diagnosis. If Parkinson’s disease is diagnosed early, the chances of being able to treat and manage the condition are greater. Individual signs may not be an indication of Parkinson’s disease. Some signs such as loss of smell could be caused by an infectious illness, or joint stiffness by conditions like arthritis.

    Parkinson’s is most commonly diagnosed with a very physical examination and assessment of a person’s medical history. There are very specific markers for diagnosis which doctors use to assess for possible Parkinson’s disease. These markers have a lot to do with a combination of very specific signs and symptoms and if recognised early enough, can be better managed.

    1. Primary motor symptoms

    2. Secondary motor symptoms

    Other motor symptoms include:

    Some individuals may also experience the following:

    • Hunched over / stooped posture – When standing, the body may begin to slouch or lean inwards, causing a hunched over appearance.
    • Impaired gross motor coordination
    • Impaired fine motor dexterity and motor coordination
    • Difficulties with swallowing or chewing
    • Cramping
    • Production of excess saliva and drooling
    • Sexual dysfunction
    • Dystonia
    • Akathisia

    3. Non-motor symptoms

    Symptoms that do not involve physical movement or coordination, and often precede motor problems, can include:

    Symptoms are initially mild, even if they develop suddenly, and typically affect one side of the body at first.

    Hand And Finger Stimulation Exercises

    I have done a lot of hand/finger stimulation and experimented to optimize such exercises, in the spirit of Curiosity and Play. I’ve personally found significant benefit in pursuing this line of research. Indeed, I have managed to recover a lot of my independence and quality of life through hand and finger therapy, and I know just how much of a major part it has played in my own progressive symptom reduction.

    I therefore encourage everyone with PD to do as much hand and finger stimulation as possible, through games and play and self-discovery. By doing nothing, the only thing that will happen is that out situation will rapidly become worse, because we will lose the use of our hands quicker and consign ourselves to increased suffering. By applying neuroplasticity techniques , we can delay the worse ravishes of the disease or even, like in my own case, continuously push the symptoms back and recover some independence. I feel this is an important message for those newly diagnosed, in particular.

    Here are some suggestions of the type of stimulatory exercises and games which can help, more ideas which I have personally found beneficial will be provided in forthcoming articles.

    Tips For Coping With Breathing Difficulties

    • Work with your doctor to identify and treat any non-PD causes of shortness of breath, such as lung disease, heart disease or lack of physical conditioning and endurance.
    • Exercise as much as possible. Shortness of breath may lead a person to move less. Less physical activity reduces the ability to take deep breaths. Staying active improves pulmonary function.
    • Take steps to cope with anxiety. Talk with your doctor to figure out what sets off anxiety and find treatments and techniques that work for you.
    • Speak to your doctor about getting an evaluation performed by a speech-language pathologist  who can help you address issues related to swallowing.
    • Give up smoking.

    Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

    Are There Any Medications Or Therapies That Can Treat Hypomimia

    Movement problems in Parkinson’s are usually treated with levodopa or a dopamine agonist medication, which can improve symptoms, but side-effects can also occur. Medications are specifically tailored to the individual according to their symptoms and how well they respond. Dopaminergic medications can reduce muscle rigidity, which should help to improve facial movements.

    Facial exercises are sometimes used to try and improve symptoms of hypomimia. These may help to ease rigidity and may also encourage a person to think more about how they are moving their face.

    Other non-medical therapies for hypomimia are also being developed and tested by researchers, such as using mimicry or recognition of other people’s expressions. Activities that encourage expressivity, such as dance, singing, or drama, may also help people with Parkinson’s to improve their facial expressions.

    To learn more about Parkinson’s symptoms, visit the EPDA website.

    Need to know

    Dr Judith Bek is a postdoctoral researcher in the Body Eyes and Movement lab at the University of Manchester, UK. Her research focus is on the relationship between perception and action in Parkinson’s, and healthy ageing. This includes investigating how people are influenced by seeing another person’s movement and the effects of imagined movement on physical actions. She is also interested in the impact of creative activities on the movement and wellbeing of people with Parkinson’s.

    Read more:

    What Is Happening To The Body

    Understanding the Signs and Symptoms of Parkinson

    Parkinson’s mainly affects a part of the brain called the substantia nigra pars compacta. In this part of the brain, neurons are producing dopamine, which transmits signals to other parts of the brain. When Parkinson’s occurs these neurons are damaged which reduces the amount of dopamine produced. The decrease in dopamine is causing the movements to be slower and less smooth. These side effects are seen in the movement of the face and mouth muscles, which is how speech is produced.

    What Changes Can Occur

    There are several ways PD may affect speech:

    • The voice may get softer, breathy, or hoarse, causing others difficulty hearing what is said.
    • Speech may be slurred.
    • Speech may be mumbled or expressed rapidly.
    • The tone of the voice may become monotone, lacking the normal ups and downs.
    • The person may have difficulty finding the right words, causing speech to be slower.
    • The person may have difficulty participating in fast-paced conversations.1

    Some of the medical terms that describe the speech changes that can occur with PD include:

    • Dysarthria, which is a motor speech disorder or impairment in speaking due to PD affecting the muscles required for speech
    • Hypophonia, which means soft speech, is an abnormally weak voice caused by the weakening muscles
    • Tachyphemia, also known as cluttering, is characterized by an excessively fast speed of talking and a rapid stammering that makes it difficult to understand the person speaking2,3

    Examining Muscle Weakness And Rigidity In Parkinsons Disease

    The sun peeks over the horizon, and before long Dad is up and at it. It’s a day, and he wants to time his medications to optimize control over his Parkinson’s symptoms.

    The other part of his routine revolves around his morning stretches. Muscle rigidityis the first obstacle that he faces when he wakes, and he chooses to confront it with a stretching practice.

    Parkinson’s disease claims multiple functions as it progresses. Understanding how the disease affects the patient may help to inform treatment decisions. I’m a curious person, and Dad’s stretching routine makes me wonder if Parkinson’s disease directly affects the way muscles work. I think about how muscle rigidity and weakness are linked and how others handle these symptoms.

    Muscle Weakness And Rigidity

    As his Parkinson’s progresses, Dad complains that his stiffness is slowing him down. The frequency and intensity with which it occurs seem to be increasing. To better understand the disease and how it relates to the body, I decided to explore the research.

    In an of a literature review published by the American Journal of Physical Medicine & Rehabilitation, the authors stated that “isokinetic muscle strength was decreased in patients with Parkinson’s disease and that muscle weakness was not specifically related to tremor or rigidity.”

    The Effects Of Parkinsons On Speech

    Parkinson’s disease is a nervous system disorder that slowly progresses over time. The first signs of the disease can be small, and unnoticeable at first. It may be a small tremor in your hand or a loss of expression in your face. As the disease progresses many of the people affected begin to notice an effect on their speech. Some may notice their voice gets softer and monotone, slower and slurred, and can have a hard time finding the words they want to say. The cause of this disease is usually genetic, but in some cases, it can occur because of exposure to certain toxins. The symptoms start to occur at an older age, usually when people are in their sixties.


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