Learn The First Symptoms And When To Get Treatment
Parkinsons disease is a neurological disorder that affects about 1 million people in the United States. It primarily affects neurons in the brain that produce the neurotransmitter dopamine, a chemical messenger that sends signals from the brain to cells throughout the body.
Parkinsons is a degenerative illness, meaning it starts with mild symptoms that become worse over time. The early signs of Parkinsons are usually subtle, but ultimately the disease can cause debilitating symptoms that disrupt both physical and cognitive abilities.
The cause of Parkinsons is unknown, but may be a combination of genetics, lifestyle and environmental factors. The risk increases with age, but between 2 and 10 percent of people who develop the disease are diagnosed before age 50.
Early symptoms of Parkinsons
Parkinsons does not affect everyone the same way. Symptoms can vary from person to person, and the disease may progress at different rates, says Melissa Houser, MD, a neurologist at Scripps Clinic Torrey Pines. In fact, the first signs of Parkinsons may be vague or associated with other conditions like respiratory infections, making it difficult to know if they are caused by the disease or something else.
According to the Parkinsons Foundation, the following can be early symptoms. If you or a loved one has more than one of them on a regular basis, its a good idea to make an appointment with the doctor.
Tremor
Loss of smell
Handwriting changes
Sleeping problems
Voice changes
Accept What You Can No Longer Do
Over time, it may seem as though you are losing your independence because you can no longer do all the things you once did. As these losses occur, you will probably go through the five stages of grief identified by Dr. Elisabeth Kübler-Ross. They include denial, anger, bargaining, depression and acceptance. Being aware of the issue or loss to which you are reacting will help you to move from one stage to another more easily.
No matter what your symptoms are, motor or non-motor symptoms, dont let Parkinsons beat you!
Is Parkinsons Disease Inherited
Scientists have discovered gene mutations that are associated with Parkinsons disease.
There is some belief that some cases of early-onset Parkinsons disease disease starting before age 50 may be inherited. Scientists identified a gene mutation in people with Parkinsons disease whose brains contain Lewy bodies, which are clumps of the protein alpha-synuclein. Scientists are trying to understand the function of this protein and its relationship to genetic mutations that are sometimes seen in Parkinsons disease and in people with a type of dementia called Lewy body dementia.
Several other gene mutations have been found to play a role in Parkinsons disease. Mutations in these genes cause abnormal cell functioning, which affects the nerve cells ability to release dopamine and causes nerve cell death. Researchers are still trying to discover what causes these genes to mutate in order to understand how gene mutations influence the development of Parkinsons disease.
Scientists think that about 10% to 15% of persons with Parkinsons disease may have a genetic mutation that predisposes them to development of the disease. There are also environmental factors involved that are not fully understood.
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Is Parkinsons Disease Fatal
Parkinsons disease itself doesnt cause death. However, symptoms related to Parkinsons can be fatal. For example, injuries that occur because of a fall or problems associated with dementia can be fatal.
Some people with Parkinsons experience difficulty swallowing. This can lead to aspiration pneumonia. This condition is caused when foods, or other foreign objects, are inhaled into the lungs.
What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
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What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
What Are The Treatments
Currently there is no cure for Parkinsons disease.
Symptoms can be mild in the early stages of the condition and people might not need immediate treatment. Your doctor and specialist will monitor your situation.
There are several different types of drugs used to treat Parkinsons disease. Drug treatments are tailored to each individuals needs and are likely to involve a combination of different drugs. Your medication should be reviewed regularly. It is likely that, over time, changes will be made to the types of drugs you take and the doses you take each day.
The main types of drug treatment for Parkinsons disease are:
- drugs which replace dopamine
- drugs which mimic the role of dopamine
- drugs which inhibit the activity of acetylcholine
- drugs which prevent the body breaking down dopamine
- other drugs such as anti-sickness medication
Everybody is affected differently by medication. The possible side effects of Parkinsons disease drugs include nausea , vomiting , tiredness and dizziness. Some people might experience confusion, nightmares and hallucinations. For some people, dopamine agonists have been linked to compulsive behaviour such as addictive gambling or hypersexuality .
The effectiveness of the main drug treatment levodopa can wear off over time and its long-term use can cause some people to develop involuntary twisting or writhing movements of the arms, legs or face . To reduce the risk, doctors might delay the use of levodopa for younger people.
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How Will Parkinson’s Disease Affect Your Life
Finding out that you have a long-term, progressive disease can lead to a wide range of feelings. You may feel angry, afraid, sad, or worried about what lies ahead. It may help to keep a few things in mind:
- Usually this disease progresses slowly. Some people live for many years with only minor symptoms.
- Many people are able to keep working for years. As the disease gets worse, you may need to change how you work.
- It is important to take an active role in your health care. Find a doctor you trust and can work with.
- Depression is common in people who have Parkinson’s. If you feel very sad or hopeless, talk to your doctor or see a counselor.
- It can make a big difference to know that you’re not alone. Ask your doctor about Parkinson’s support groups, or look for online groups or message boards.
- Parkinson’s affects more than just the person who has it. It also affects your loved ones. Be sure to include them in your decisions.
What You Can Do
As of 2021, there is no definite cure for Parkinsons disease. There is also no definite known cause. Its likely due to a combination of an individuals susceptibility and environmental factors. Most cases of Parkinsons disease happen without a genetic link.
According to research published in 2012, only report having a family member with the disease. Many toxins are suspected and have been studied, but no single substance can be reliably linked to Parkinsons.
However, research is ongoing. Its estimated that
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Changes To Your Walking
- Smaller steps
- Not swinging your arms while walking
- Multiple steps required to turn around when walking, possibly tripping up the feet
- One foot turning inward or outward a bit, causing tripping
- One arm could also be bent inward
The turning of the arm or foot, called dystonia, is often one of the first signs we see, so were always on the lookout for it, Dr. Joseph says.
Living With Parkinson’s Disease
Coming to terms with a diagnosis of Parkinson’s and living with the disease is challenging and will take a lot of adjustment. There are still things you can do that can help you to feel more in control of your situation and to stay positive. Some things that might help could include:
- choosing to lead a healthy lifestyle
- making informed decisions related to your treatment
- keeping a diary of your symptoms in preparation for meetings with health and social care professionals
- attending a self-management course
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What Causes Parkinsons Disease
Parkinsons disease occurs when nerve cells in an area of the brain called the substantia nigra become impaired or die. These cells normally produce dopamine, a chemical that helps the cells of the brain communicate . When these nerve cells become impaired or die, they produce less dopamine. Dopamine is especially important for the operation of another area of the brain called the basal ganglia. This area of the brain is responsible for organizing the brains commands for body movement. The loss of dopamine causes the movement symptoms seen in people with Parkinsons disease.
People with Parkinsons disease also lose another neurotransmitter called norepinephrine. This chemical is needed for proper functioning of the sympathetic nervous system. This system controls some of the bodys autonomic functions such as digestion, heart rate, blood pressure and breathing. Loss of norepinephrine causes some of the non-movement-related symptoms of Parkinsons disease.
Scientists arent sure what causes the neurons that produce these neurotransmitter chemicals to die.
Stage Two Of Parkinsons Disease
Stage two is still considered early disease in PD, and it is characterized by symptoms on both sides of the body or at the midline without impairment to balance. Stage two may develop months or years after stage one.
Symptoms of PD in stage two may include the loss of facial expression on both sides of the face, decreased blinking, speech abnormalities, soft voice, monotone voice, fading volume after starting to speak loudly, slurring speech, stiffness or rigidity of the muscles in the trunk that may result in neck or back pain, stooped posture, and general slowness in all activities of daily living. However, at this stage the individual is still able to perform tasks of daily living.
Diagnosis may be easy at this stage if the patient has a tremor however, if stage one was missed and the only symptoms of stage two are slowness or lack of spontaneous movement, PD could be misinterpreted as only advancing age.
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Stooping Or Hunched Posture
People who have Parkinsons disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinsons disease may start bending forward, making them appear hunched or stooped over.
Symptoms Of Parkinson’s Disease
The symptoms of Parkinson’s disease usually develop gradually and are mild at first.
There are many different symptoms associated with Parkinson’s disease. Some of the more common symptoms are described below.
However, the order in which these develop and their severity is different for each individual. It’s unlikely that a person with Parkinson’s disease would experience all or most of these.
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How Is Parkinson’s Disease Diagnosed
A person doesn’t need to have all the signs and symptoms of Parkinson’s disease to be diagnosed with it.
“In general, people have a combination of the motor symptoms and the non-motor symptoms,” says Dr. Nwabuobi. “Some people have more non-motor symptoms than motor and vice versa, but in order to have a diagnosis of Parkinson’s, you definitely need the motor symptoms. We’re looking for specific things , including a rest tremor, bradykinesia, rigidity, and poor balance.”
According to the Parkinson’s Foundation, a person needs to have two of the four main motor symptoms of Parkinson’s over a period of time to be diagnosed with the disease.
Contact Our Information And Referral Helpline
The Parkinson Canada Information and Referral Helpline is a toll-free Canada-wide number for people living with Parkinsons, their caregivers and health care professionals. We provide free and confidential non-medical information and referral services. When you have questions or need assistance, our information and referral staff help connect you with resources and community programs and services that can help you. We provide help by phone or email, Monday to Friday, 9:00 a.m. 5:00 p.m. ET.
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Acting Out What Youre Dreaming
- People with REM sleep behavior disorder might talk in their sleep and flail their arms and legs during dreams, accidentally hitting or kicking a person in the same bed.
When people learn about the sleep disorder, they often say, Ive been doing that for years. Theyre sometimes astonished to learn its an early symptom of Parkinsons, Dr. Joseph says.
Discuss With Your Physician
Non-motor symptoms can sometimes be difficult to recognize. Therefore, it is important to make your doctor aware of them.
One useful resource is the PD NMS Questionnaire. You can use this to record your symptoms and discuss them with your doctor.
Dr. Ron Postuma, whose research was funded by donations to the Parkinson Canada Research Program, has also developed tools to help people with Parkinsons and their physicians identify and manage non-motor symptoms.
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How To Cope With The Symptoms Of Parkinsons Disease
The only predictable thing about this disease is that it is unpredictable. Richard, diagnosed at 36
Tremors are the first sign noted in about half of all people with Parkinsons disease. But maybe, like 15 percent of people with the illness, you have never experienced this symptom. That is because Parkinsons disease affects everyone somewhat differently.
As you will discover, your symptoms will continue to change, often from day to day, and throughout the course of your life. But even though there is no cure for Parkinsons, the sooner you can take steps to manage symptoms when they arise, the better chance you will have at maintaining a good quality of life.That is why the first step in coping with the changes that accompany a Parkinsons diagnosis is to simply increase awareness, to notice new symptoms as well as how your body responds to certain activities, stresses and therapies. A helpful way to do this is by logging your symptom patterns in a daily journal. It is just a matter of jotting down small changes you notice in your physical and emotional health each day. That way you can discuss these issues promptly with your doctor and receive treatment.
Time Course Of Prodromal Symptoms In Controls
All signs were listed in the order of their timely occurrence from the earliest to the latest . Controls displayed a similar sequence of symptom manifestation as PD patients but at slightly higher ages, with signs related to RBD and psychiatric complaints occurring earliest, followed by constipation and hyposmia. Similarly, in controls the age of onset for slight motor symptoms was higher than for the PD group.
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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
Symptoms Of Parkinsons Disease
Parkinson’s disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Other symptoms may include depression and other emotional changes difficulty swallowing, chewing, and speaking urinary problems or constipation skin problems and sleep disruptions.
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
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