Common Symptoms Of Parkinsons Disease
Symptoms generally develop slowly over years, and the progression of symptoms is often different from one person to another due to the diversity of the disease. According to The Parkinsons Foundation, there are three telltale symptoms that can help doctors make a diagnosis:
Bradykinesia, or slowness of movement, coupled with tremor or rigidity must be present for a PD diagnosis to be considered. Prior to experiencing motor symptoms, stiffness and tremor, often people will complain of sleep problems, constipation, decreased ability to smell and restless legs.
Postural instability often accompanies motor symptoms and can lead to imbalance and falls common among Parkinsons patients. Additional movement symptoms can include:
What Is Multiple System Atrophy
Multiple system atrophy is a progressive neurodegenerative disorder characterized by a combination of symptoms that affect both the autonomic nervous system and movement. The symptoms reflect the progressive loss of function and death of different types of nerve cells in the brain and spinal cord.
Symptoms of autonomic failure that may be seen in MSA include fainting spells and problems with heart rate, erectile dysfunction, and bladder control. Motor impairments may include tremor, rigidity, and/or loss of muscle coordination as well as difficulties with speech and gait . Some of these features are similar to those seen in Parkinsons disease, and early in the disease course it often may be difficult to distinguish these disorders.
MSA is a rare disease, affecting potentially 15,000 to 50,000 Americans, including men and women and all racial groups. Symptoms tend to appear in a persons 50s and advance rapidly over the course of 5 to 10 years, with progressive loss of motor function and eventual confinement to bed. People with MSA often develop pneumonia in the later stages of the disease and may suddenly die from cardiac or respiratory issues.
While some of the symptoms of MSA can be treated with medications, currently there are no drugs that are able to slow disease progression and there is no cure.
MSA includes disorders that historically had been referred to as Shy-Drager syndrome, olivopontocerebellar atrophy, and striatonigral degeneration.
Benefits Of Inpatient Rehabilitation
Inpatient rehabilitation hospitals are required to provide an interdisciplinary approach to patient caremeaning specialists from many disciplines are involved in creating and implementing a patients care plan. Interdisciplinary team members include physical, speech and occupational therapists, rehabilitation physicians, nurses, case managers, dietitians and pharmacists. Patients participate in three hours of therapy each day for a total of 15 hours per week, and an individualized plan of care is created for each patient to meet their needs while providing necessary intervention to make functional gains. Inpatient rehabilitation can be beneficial for both MS and Parkinsons disease.
Educational sessions with the patient and family members can also improve understanding for all involved in the patients care about the progression of each disease and ways to combat symptoms.
Bethany Moss is a physical therapist at Encompass Health Rehabilitation Hospital of Jonesboro. She is a PWR! certified therapist and a LVST BIG certified clinician.
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Multiple Sclerosis Vs Parkinsons Disease Differences In Symptoms Causes And Treatment
Multiple sclerosis is an autoimmune condition that affects the nervous system, while Parkinsons disease is a progressive neurological disorder affecting movement. Symptoms of multiple sclerosis and Parkinsons disease are quite similar at times, but there are distinct differences setting the two conditions apart.
Causes of multiple sclerosis and Parkinsons disease are not well known, although there is some speculation to their roots. We will outline those speculated causes and highlight the symptoms, risk factors, complications, treatment, and therapies for both multiple sclerosis and Parkinsons disease to raise your awareness on each disorder.
So What Is It Is It Parkinsons Disease Or Is It Something Else
The answer is not easy, but many who feel they have more than Parkinsons may in fact have multiple system atrophy .MSA is a very rare disorder that has similarities and features of Parkinsonism.However, it is so rare that many physicians are unfamiliar with it and so the diagnosis is not considered. As a result, a likely diagnosis of MSA might be delayed by years and even missed all together. Whats more, due to many symptoms that could possibly be attributed to other conditions diagnosing MSA can be challenging, even to the most experienced doctors. This can be very frustrating to those who know it is more than PD.
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Dementia With Lewy Bodies
DLB is second only to Alzheimers as the most common cause of dementia in the elderly. It causes progressive intellectual and functional deterioration. In addition to the signs and symptoms of Parkinsons disease, people with DLB tend to have frequent changes in thinking ability, level of attention or alertness and visual hallucinations. They usually do not have a tremor or have only a slight tremor. The parkinsonian symptoms may or may not respond to levodopa.
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Symptoms Of Depression In Ms
Like Parkinsons disease, vegetative or somatic symptoms do not tend to be good diagnostic discriminators for depression in MS. Some vegetative symptoms may be specifically related to fatigue rather than depression, but this area is fraught with methodological and conceptual difficulties. One study has indicated that disinterest in sex was uniquely related to depression in MS . Important clues to depression in MS are illustrated in table 4.
Important clues to depression in multiple sclerosis
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Common Misdiagnosis: Multiple Sclerosis
One of the most common answers to the question was multiple sclerosis . Both diagnoses have an effect on the central nervous system. These diagnoses also frequently cause muscle spasms, balance changes, tremor, and impaired memory. However, these are two separate diagnoses.
One difference is that MS is often diagnosed when someone is in their 20s, while most people receive a PD diagnosis in their 60s. Also, MS is an autoimmune disease that over time causes nerve damage. Parkinsons affects the brain. The brain starts producing less and less dopamine, which is responsible for controlling movement.
Yes, with MS which I was worried about for years, but right now I do not know which one is worse. However, my meds are helping a lot. My new saying is It is what it is, aka just live on. My neurologist says that I have stage one mild Parkinsons disease.
My husband was diagnosed with MS back in 1993 when he had a mini stroke. He was diagnosed with Parkinsons in 2014.
Comparison Of Static Sway Performance Between Groups Within One Balance Task
During side-by-side stance, significant differences between the groups were found for sway area , velocity in ML direction , acceleration in ML direction and jerk in ML direction . Post hoc tests revealed that PD patients showed significantly higher velocity in ML direction , compared to healthy adults . MS patients showed a significantly higher acceleration and jerk in ML direction, and a tendency toward a larger sway area , compared to the healthy adults .
Figure 3. Sway parameters of healthy adults , Parkinson’s disease and multiple sclerosis patients. sway area, velocity in antero-posterior direction, velocity in medio-lateral direction, acceleration in AP direction, acceleration in ML direction, jerk in AP direction and jerk in ML direction. The black horizontal lines indicate a significant difference between the groups, the grey horizontal lines indicate a tendency toward a difference between the groups. * indicates a significant difference compared to the side-by-side stance, # indicates a significant difference compared to the semi-tandem stance.
There were no significant differences between PD and MS patients in any of the three tasks .
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Different Pathologies Are Associated With Different Postural Sway Behavior Under Increasingly Complex Conditions
Our study shows clear differences in postural adaptation strategies between PD and MS patients. PD patients do not seem to adapt more to increasingly difficult static balance tasks than the healthy adults, although PD patients have lower postural stability and increased fall risk compared to age-matched healthy adults . It could be that the PD patients are not able to adapt their sway much because of their bradykinesia and rigidity. However, it is also known that rigidity can increase postural sway by preventing the use of flexible responses and thereby aggravating the deterioration of postural reflexes . MS patients increased their sway a lot, especially area, acceleration and jerk, when adapting to the most complex task. It is known that more than 80% of the MS patients have spasticity and that spasticity has a negative effect on postural stability . When we consider the results of our study and those of another study together, it seems likely that MS patients have substantial sway problems especially when the base of support is narrow , such as during the tandem stance. A timed 3 m tandem walk was also significantly better in separating asymptomatic and symptomatic MS patients compared to a timed 25-foot walk .
How Is It Treated
Currently, there are no treatments to delay the progressive neurodegeneration of MSA, and there is no cure. There are treatments to help people cope with the symptoms of MSA.
In some individuals, levodopa may improve motor function however, the benefit may not continue as the disease progresses.
The fainting and lightheadedness from orthostatic hypotension may be treated with simple interventions such as wearing compression stockings, adding extra salt and/or water to the diet, and avoiding heavy meals. The drugs fludrocortisone and midodrine sometimes are prescribed. In 2014, the U.S. Food and Drug Administration approved the medication droxidopa for the treatment of orthostatic hypotension seen in MSA. Dihydroxyphenylserine helps to replace chemical signals called neurotransmitters which are decreased in the autonomic nervous system in MSA. Some medications used to treat orthostatic hypotension can be associated with high blood pressure when lying down, so affected individuals may be advised to sleep with the head of the bed tilted up.
Bladder control problems are treated according to the nature of the problem. Anticholinergic drugs, such as oxybutynin or tolteridine, may help reduce the sudden urge to urinate.
Fixed abnormal muscle postures may be controlled with injections of botulinum toxin.
Sleep problems such as REM sleep behavior disorder can be treated with medicines including clonazepam, melatonin, or some antidepressants.
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What Makes Them Different
MS and Parkinsonâs have different causes. They usually start to affect you at different ages, too.
MS often affects people between ages 20 and 50, but children get it, too. Parkinsonâs usually starts at age 60 or older, but some younger adults get it.
MS is an autoimmune disease. That means your bodyâs immune system goes haywire for some reason. It attacks and destroys myelin. As myelin breaks down, your nerves and nerve fibers get frayed.
In Parkinsonâs, certain brain cells start to die off. Your brain makes less and less of a chemical called dopamine that helps control your movement. As your levels dip, you lose more of this control.
Some genes may put you at risk for Parkinsonâs, especially as you age. Thereâs a small chance that people who are exposed to toxic chemicals like pesticides or weed killers can get it, too.
These symptoms are more common if you have MS. They are not usually found in Parkinsonâs:
Summary Parkinsons Vs Myasthenia Gravis
Parkinsons and myasthenia gravis are neurological disorders that have a very deteriorating impact on the quality of life of the patient. The main difference between Parkinsons and myasthenia gravis is their autoimmune component.
Reference:
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image courtesy:
1. Sir William Richard Gowers Parkinson Disease sketch 1886 2 By Sir_William_Richard_Gowers_Parkinson_Disease_sketch_1886.jpg:derivative work: Malyszkz Sir_William_Richard_Gowers_Parkinson_Disease_sketch_1886.jpg via Commons Wikimedia2. DiplopiaMG1 By James Heilman, MD Own work via Commons Wikimedia
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Diagnosis Of Depression Post
A number of factors can make the diagnosis of depression difficult post-CVA. Communication difficulties, impairments of facial and emotional expression, and disturbance in vegetative functions can make assessment of mental state extremely difficult. A deterioration in function over a few days or weeks following a period of improvement is one clinical clue for the development of depression.
Extreme abulia can sometimes be mistaken for depression and can be related to either frontal and diencephalic lesions. The patient may appear to be extremely retarded but may function at a high level within a structured environment. Dopamine agonists, such as bromocriptine, have been used to treat abulia.
Pathological emotionalism is relatively common after stroke, affecting up to 20% of patients in the first six months post-stroke but tending to improve over the following year. Severe examples of pathological emotionalism have been treated with antidepressant medication and levodopa.
Research To Find Msa Biomarkers And An Earlier Msa Diagnosis
An important goal of the Coalitions MSA Research Program is to fund and encourage the development of biomarkers to distinguish PD from MSA at a much earlier stage.The stakes are high.An accurate biomarker could lead to quicker development of treatments.In fact, a concern in past clinical trials of MSA treatments that failed is that maybe the patients in the trial are too late stage to show effectiveness.Increasing the number of known early stage MSA patients could improve the likelihood of finding treatments and even a cure.
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The Evolution Of Treatment For Parkinsons Disease
Researchers have found that people with Parkinsons have low levels of dopamine, a neurotransmitter that sends signals between nerve cells and helps control body movements. Levodopa is currently the main drug-based treatment of choice for Parkinsons disease. It works by replacing missing dopamine and reducing motor symptoms, such as muscle stiffness.
While this medication has been around for more than half a century, during that time research has made significant strides in improving diagnosis and delaying disability for people with Parkinsons. When I started in the field, we would think in terms of people having considerable problems 5 to 10 years after diagnosis, says Dr. Shulman. Today its quite common to see people who are 15 or more years after diagnosis who live active livesnot to say asymptomatic, but theyre able to maintain a good lifestyle in many cases.
Part of this progress has been due to an expansion of medications and surgical treatment options, allowing doctors to fine-tune a persons treatment plan to their specific symptoms and needs. Surgical treatmentsincluding deep brain stimulation and focused ultrasoundcan improve symptoms and reduce involuntary movements. While they were previously thought to be a last resort, doctors have learned that surgical interventions can have a positive impact on disability and quality of life when used in earlier stages of Parkinsons disease.
Lifestyle Changes To Improve Outcomes
Dr. Shulman and Dr. Mowry also shared how making certain lifestyle changesincluding regular exercise, a healthy diet, and plenty of quality sleepcan help people with Parkinsons and MS.
Exercise
Research shows that a combination of aerobic exercise, muscle strengthening, and stretching has the power to improve outcomes, symptoms, and mobility for people living with Parkinsons and MS.
Right now, if you were to ask what intervention has the most evidence delay the progression of Parkinsons disease, that is exercise, Dr. Shulman says. What you find is that there is a huge difference in the number of connections in the motor pathwaysa huge difference in the survival of the neurons, the nerve cells in those pathwaysand I think thats what were seeing in our patients.
Based on smaller studies, exercise also appears to be beneficial for managing some MS symptoms that dont typically respond well to medication. These symptoms include fatigue, which is one of the major symptoms of MS, as well as depression and anxiety. Exercise also reduces insulin resistance , which in turn lowers the risk of health issues like diabetes and high blood pressureboth of which have been shown to accelerate damage to the brain.
Diet
While overall research is inconclusive, one study suggests that people who eat a Mediterranean-style dietincluding fruits, vegetables, and fish and avoiding red meat and fatty foodsmay have a lower risk for developing MS.
For example:
Sleep
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Risk Factors For Depression In Ms
There appears to be a complex relation between disability, pain, fatigue, perception about prognosis, location of lesion, and depression in MS. Most of the magnetic resonance imaging studies have not located a depressogenic MS lesion except for a possible relation between severity of depression and right temporal lesions.
Depression In Parkinsons Disease
Diagnosis and management of depression in Parkinsons disease is important for two main reasons: firstly, depression is common in PD , and secondly depression causes significant morbidity in terms of quality of life, disability , and carer stress. This effect is independent from the effect of motor disability.
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Cerebral Palsy Vs Parkinsons Disease
Parkinsons disease is a nervous system disorder that affects a persons movement. It occurs when certain nerve cells in the brain break down or die. Parkinsons is a progressive condition wherein symptoms start mild and worsen over time.
Symptoms of Parkinsons disease vary greatly based on age and severity. They often affect one side of the body more than the other. These symptoms include :
- Muscle stiffness
- Delayed movements
Like CP, Parkinsons does not have a cure. As for causes, cerebral palsy can often be linked to a specific birth injury, while many cases of Parkinsons are of unknown origin. Both genetic and environmental factors may play a role in the development of Parkinsons . Additionally, the onset of Parkinsons usually occurs later in life, with most people developing the disease at 60 years of age or older. CP is most commonly diagnosed during childhood.
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