Symptoms of Parkinson's

Physical and Pyschological Symptoms

Primary Physical Symptoms include:

Tremors – The shaking of part of the body that most commonly begins in a hand. Tremors also often occur in the fingers, forearms, foot, mouth, or chin. Typically, tremors take place when the limbs are at rest as opposed to when there is movement. However, it is not uncommon that a person with Parkinson's disease does not experience a substantial tremor.
Rigidity – Also known as stiff muscles, often produce muscle pain that is increased during movement and most often occurs in your limbs and neck. If the stiffness is severe, it may limit the range of movements and mobility.
Impaired posture & Poor balance – Posture may become stooped which is caused by the loss of reflexes. This causes unsteady balance, which oftentimes leads to falls but does not morally occur until the later stages of the disease.
Bradykinesia – Over time, voluntary movement may begin to slow down causing simple tasks, such as walking, to become very difficult and time consuming. This happens because of delayed transmission signals from the brain to the muscles. When you walk, your steps may become short and shuffling or your feet may freeze to the floor, making it hard to take the first step.
Loss of automatic movements – Actions that you make unconsciously such as blinking, smiling and swinging your arms when you walk are called autonomic movements. In Parkinson's disease, these movements may become diminished and over time, lost completely.
Speech changes – Individuals with Parkinson's disease may speak more softly, rapidly or in a monotone. Also, speech is sometimes slurred, words are repeated, or there is hesitation before specking.
Dementia - Some people develop problems with memory and mental clarity in the later stages of Parkinson's disease.

Secondary Physical Symptoms include:

Constipation
Difficulty swallowing
Choking, coughing, or drooling Excessive salivation
Excessive sweating
Loss of bowel and/or bladder control
Loss of intellectual capacity
Anxiety, depression, isolation
Scaling, dry skin on the face or scalp
Slow response to questions
Small cramped handwriting
Soft, whispery voice

Psychological Symptoms include:

Anxiety- Most often, anxiety is characterized by tension, excitability of the autonomic nervous system, a feeling that a disaster is about to occur, and continuous feeling that you are in danger. Between 29% and 75% of Parkinson patients have or have had anxiety disorders. Anxiety is commonly accompanied by depression and is suggested that 92% of Parkinson's patients who have had an anxiety disorder have also had a depressive disorder. Different anxiety disorders that can occur in Parkinson patients include panic disorders, phobias, obsessive-compulsive disorders, and social phobias. Although the cause of anxiety in Parkinson’s patients is unknown, it is thought that there may be a neurochemical basis as well as trauma caused by the disease. Patients may also develop anxiety with the increase of motor impairment. Feeling embarrassed about a disability in a social atmosphere often leads to the diagnosis of an anxiety disorder. In addition, it is suggested that some drugs used in treatment of Parkinson’s disease can cause anxiety. There are a variety of available treatments for those who suffer anxiety. The classes of drugs include: tricyclic antidepressants, selective serotonin reuptake inhibitors, nonselective monoamine oxidase inhibitors, benzodiazepines, and busiprone.
Depression- Commonly found symptoms include a significant weight change, insomnia, psychomotor retardation, fatigue or loss of energy, feelings of worthlessness or guilt, decreased concentration and indecisiveness, and reoccurring thoughts of death or suicide. At least five of these symptoms must be present in order to be diagnoses as depression. Depression is a common psychological symptom of Parkinson's, occurring in 40% to 50% of patients with this disease. It is suggested that it may have both a biochemical and a psychological cause. Some of the factors that have been found to be correlated with the amount of depression in Parkinson patients include: early onset of the disease, duration of the disease, cognitive impairment, inability to participate in normal activities, inability to develop effective coping strategies, and lack of social support. The pharmacological treatment of depression includes: serotonin precursors, tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRI’s). Electroconvulsive Therapy (ECT) can also be used for treatment and is shown to relieve depression and improve other symptoms of the disease.
Psychosis- This difficult symptom can be characterized by visual hallucinations, belief that one is being persecuted, belief that one is in danger, and fear of being spied upon, threatened, or followed. Psychosis is a very difficult symptom to deal with for both Parkinson patients and those who are caring for them. It occurs in 10% to 15% of all patients with Parkinson's disease. The older a patient is and the further advanced the disease, the more likely psychoses are to occur. Cognitive impairment is also correlated with psychosis. Clozapine is a relatively new drug that has been discovered that treats psychoses in relation to Parkinson’s without exacerbating the other signs and symptoms caused by the disease.

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