What Are The Symptoms Of Parkinsons Disease
Symptoms of Parkinsons disease and the rate of decline vary widely from person to person. The most common symptoms include:
Other symptoms include:
- 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.
- Sleeping disturbances including disrupted sleep, acting out your dreams, and restless leg syndrome.
- Pain, lack of interest , fatigue, change in weight, vision changes.
- Low blood pressure.
How You Lose Dopamine Production
Damaged nerve cells can be what results in a decreased ability of the brain to create dopamine. Generally, some kind of degradation of the brain cells will reduce dopamine production.
There is some genetic link to parkinsons disease. For example, specific genetic mutations can impact the dopamine production. Far more common is that exposure to something in the environment can impact the brain.
Symptoms Of Parkinson’s Disease
These common symptoms of Parkinson’s disease often begin gradually and progress over time:
- Shaking or tremor
- Poor posture
- Slowing of body movements
As the disease continues to progress, additional symptoms can occur such as slurred or soft speech, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, loss of bladder control, anxiety, depression, inability to regulate body temperature, sexual dysfunction, decreased ability to smell, restless legs and muscle cramps.
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Clinical History And Testing
Diagnostic tests can be used to establish some features of the condition and distinguish them from symptoms of other conditions. Diagnosis may include taking the person’s , a physical exam, assessment of neurological function, testing to rule out conditions that may cause similar symptoms, brain imaging, to assess cognitive function,, or myocardial scintigraphy. Laboratory testing can rule out other conditions that can cause similar symptoms, such as abnormal , , , or vitamin deficiencies that may cause symptoms similar to dementia.
Dementia screening tests are the and the . For tests of attention, , , and can be used for simple screening, and the Revised Digit Symbol Subtest of the may show defects in attention that are characteristic of DLB. The , and are used for evaluation of executive function, and there are many other screening instruments available.
If DLB is suspected when parkinsonism and dementia are the only presenting features, PET or SPECT imaging may show reduced dopamine transporter activity. A DLB diagnosis may be warranted if other conditions with reduced dopamine transporter uptake can be ruled out.
Since 2001, – has been used diagnostically in East Asia , but not in the United States. MIBG is taken up by nerve endings, such as those that innervate the heart, and is for scintigraphy with radioactive 123iodine. Autonomic dysfunction resulting from damage to nerves in the heart in patients with DLB is associated with lower cardiac uptake of 123I-MIBG.
What Are The Symptoms
The four main symptoms of Parkinson’s are:
- Tremor, which means shaking or trembling. Tremor may affect your hands, arms, or legs.
- Stiff muscles.
- Slow movement.
- Problems with balance or walking.
Tremor may be the first symptom you notice. It’s one of the most common signs of the disease, although not everyone has it.
More importantly, not everyone with a tremor has Parkinson’s disease.
Tremor often starts in just one arm or leg or on only one side of the body. It may be worse when you are awake but not moving the affected arm or leg. It may get better when you move the limb or you are asleep.
In time, Parkinson’s affects muscles all through your body, so it can lead to problems like trouble swallowing or constipation.
In the later stages of the disease, a person with Parkinson’s may have a fixed or blank expression, trouble speaking, and other problems. Some people also lose mental skills .
People usually start to have symptoms between the ages of 50 and 60. But sometimes symptoms start earlier.
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Oxidative Stress And Parkinsons Disease
The cause of cell death in neurodegenerative diseases such as Parkinsons disease remains largely unknown. However, the formation of free radicals and the occurrence of oxidative stress may be a common component of many, if not all, such disorders. For example, in Parkinsons disease key alterations occur in the substantia nigra in regards to iron handling, mitochondrial function and antioxidant defenses, particularly in regards to reduced glutathione . These changes dramatically increase oxidative stress and free radical production and are accompanied by evidence of free radical mediated damage in the form of increased lipid peroxidation and damage to the DNA. Increased lipid peroxidation and damage to the DNA causes more and more inflammatory chemicals to be released, initiating a process that perpetuates neurodegeneration.
Based on available research, it is probable that the onset of oxidative stress is a common mechanism by which neuronal death occurs contributing to the progression of Parkinsons disease. Therefore, therapeutic strategies aimed at limiting free radical production and oxidative stress and/or damage may slow the advancement of Parkinsons disease.
Reasons Why Parkinsons Disease Occurs
The scientific reason given for Parkinsons disease is that the patient has lost nerve cells in the part of the brain called the substantia nigra. A very important chemical called dopamine is produced by the substantia nigra. The loss of the ability to produce dopamine contributes to the early stages of Parkinsons disease.
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How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
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How Is Parkinson’s Disease Managed
Your doctors will tailor your treatment based on your individual circumstances. You will manage your condition best if you have the support of a team, which may include a general practitioner, neurologist, physiotherapist, occupational therapist, psychologist, specialist nurse and dietitian.
While there is no cure for Parkinson’s disease, symptoms can be treated with a combination of the following.
What If I Carry The Gene
There are ongoing clinical trials testing therapies to treat people who have Parkinson’s and carry certain gene mutations. Proving that it can be important to know which gene mutation you carry. Consult with your doctor when considering a genetic test to determine if you are eligible to participate in gene-based clinical trials.
The Parkinsons Foundation study, PD GENEration: Mapping the Future of Parkinsons Disease, is the first national study to offer genetic testing and counseling at no cost for those with a confirmed Parkinsons diagnosis. Learn more and enroll at Parkinson.org/PDGENEration.
*Please note that not all content is available in both languages. If you are interested in receiving Spanish communications, we recommend selecting both” to stay best informed on the Foundation’s work and the latest in PD news.
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Causes And Risk Factors For Parkinson’s Disease:
Toxic Substances That Have Been Linked To Parkinsons Disease
There are numerous environmental toxins that researchers have tied to the neurological disorders known as parkinson disease. Here are some that have been linked:
- Agent Orange This was a chemical defoliant used in Vietnam that is already tied to cancer. While there is no definitive link with Parkinsons, the VA at least believes that there is a possibility that the two are tied.
- Solvents Some studies have shown a link between Trichloroethylene, a substance contained in many solvents, and Parkinsons.
- PCBs polychlorinated biphenyls were extensively used in the 1970s. They have been often found in the brains of people who have suffered from Parkinsons.
- Pesticides and herbicides -substances such as insecticides, pesticides and herbicides contain chemicals that researchers have strongly linked with higher incidences of Parkinsons. One of the leading contributors is considered to be Paraquat. For information on Paraquat Parkinsons lawsuits, look here.
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How Does Parkinsons Affect The Face
Everyday tasks such as getting dressed, writing, picking something up off the floor take twice as long as they used to. Some people describe the feeling of slowness and stiffness as walking through molasses or moving in slow-motion. Because subconscious muscle movements of the face are responsible for ones facial expressions and others interpretation of our mood, patients can be thought to be upset or depressed when they are not. This is known as having a masked face.
Deep Brain Stimulation For Parkinson’s: Am I A Candidate
Deep brain stimulation is not a cure, but it can relieve your symptoms from Parkinson’s disease when medications are not an option. Only you and your doctor can decide if this surgical procedure is right for you. You may be a candidate for deep brain stimulation if:
- You have idiopathic Parkinson’s disease. Patients with atypical parkinsonism are not candidates.
- You have good motor function and independence during your best “on” state when taking the drug Sinemet.
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Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
How Can I Cope Better With Having Parkinsons Disease
One of the most important things you can do when you feel your Parkinsons is becoming unmanageable is seek help from your healthcare professional, who can provide you with strategies to strengthen your mental health and improve your quality of life. Parkinsons Queensland also has a range of helpful resources available that can assist with learning how to better manage Parkinsons disease.
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No One Definitive Cause Of Parkinsons
There are no biomarkers or objective screening tests that indicate one has Parkinsons. That said, medical experts have shown that a constellation of factors are linked to it.
Parkinsons causes are likely a blend of genetics and environmental or other unknown factors. About 10 to 20 percent of Parkinsons disease cases are linked to a genetic cause, says Ted Dawson, M.D., Ph.D., director of the Institute for Cell Engineering at Johns Hopkins. The types are either autosomal dominant or autosomal recessive .
But that leaves the majority of Parkinsons cases as idiopathic, which means unknown. We think its probably a combination of environmental exposure to toxins or pesticides and your genetic makeup, says Dawson.
Age. The biggest risk factor for developing Parkinsons is advancing age. The average age of onset is 60.
Gender. Men are more likely to develop Parkinsons disease than women.
Genetics. Individuals with a parent or sibling who is affected have approximately two times the chance of developing Parkinsons. Theres been an enormous amount of new information about genetics and new genes identified over the past 10 or 15 years that have opened up a greater understanding of the disease, says Dawson.
Medicines For Parkinson’s Disease
Medicines prescribed for Parkinson’s include:
- Drugs that increase the level of dopamine in the brain
- Drugs that affect other brain chemicals in the body
- Drugs that help control nonmotor symptoms
The main therapy for Parkinson’s is levodopa, also called L-dopa. Nerve cells use levodopa to make dopamine to replenish the brain’s dwindling supply. Usually, people take levodopa along with another medication called carbidopa. Carbidopa prevents or reduces some of the side effects of levodopa therapysuch as nausea, vomiting, low blood pressure, and restlessnessand reduces the amount of levodopa needed to improve symptoms.
People with Parkinson’s should never stop taking levodopa without telling their doctor. Suddenly stopping the drug may have serious side effects, such as being unable to move or having difficulty breathing.
Other medicines used to treat Parkinsons symptoms include:
- Dopamine agonists to mimic the role of dopamine in the brain
- MAO-B inhibitors to slow down an enzyme that breaks down dopamine in the brain
- COMT inhibitors to help break down dopamine
- Amantadine, an old antiviral drug, to reduce involuntary movements
- Anticholinergic drugs to reduce tremors and muscle rigidity
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How Is Parkinson’s Disease Diagnosed
Diagnosis is difficult at every stage of the disease, but particularly in the early stages. No single test can provide a diagnosis. A diagnosis will likely involve physical and neurological examinations, conducted over time to assess changes in reflexes, coordination, muscle strength, and mental function. Your doctor might also see how you respond to medicine.
You may need to have brain imaging tests to rule out other conditions that might be causing your symptoms. Such tests could include MRI and CT scans and possibly some other types of scans. Blood tests may also be done to exclude other illnesses.
Fighting Symptoms Of Parkinsons
While this cascade of events appears to be both progressive and irreversible, recent research and clinical findings have identified interventions that can effectively neutralize oxidative stress and calm the inflammatory processes involved in Parkinsons disease. This multi-faceted, multi-factorial approach has generated a growing body of interest and research in the world of neuroscience and can be used to prevent and/or halt the progression of the disease.
What Else Do We Know
As scientists try to learn what’s at the root of Parkinson’s, they’re looking far and wide to pick up clues where they can.
They’ve found that people with Parkinson’s tend to have something called Lewy bodies in their brain. These are unusual clumps of a protein called alpha-synuclein. The protein itself is normal, but the clumps are not. And they’re found in parts of the brain that affect sleep and sense of smell, which could explain some symptoms of Parkinson’s not related to movement.
Your gut may also have a part in it, as some of its cells make dopamine, too. Some doctors think that this might be where the earliest signs of Parkinson’s show up, but that idea needs more research.
How Does Parkinsons Disease Affect The Brain
The part of the brain that is affected is called the basal ganglia, which functions like the autopilot of your brain, facilitating subconscious movements. Because PD causes the brain cells in this deep circuitry to deteriorate, patients natural movements become slow and stiff. Many patients describe feeling as if they had aged overnight.