About Parkinson’s Disease
It’s important to take the time to fully understand the diagnosis and symptoms of Parkinson’s in order for individuals, their families and caregivers to adapt to the unique challenges and progressions of the disease.
How is Parkinson’s Disease Diagnosed?
Diagnosis of Parkinson’s disease, especially in the early stages, can be challenging. In a lot of cases, an internist or family physician is the first to make a diagnosis. Many people will seek additional opinions from a movement disorder specialist, neurologists with experience and specific training in the assessment and treatment of Parkinson’s Disease and related disorders. In many cases it can take years before a person is accurately diagnosed. Symptoms and progression of symptoms varies widely between individuals, which adds to the complexity of diagnosing Parkinson’s disease.
Parkinson’s Disease is referred to as a “clinical” diagnosis, meaning that an individuals symptoms, history, and a physical exam are used to make the diagnosis. Although there is not a specfic lab or imaging test that can make a diasnosis, certain tests such as magnetic resonance imaging of the brain (MRI brain), a dopamine transporter scan (DaT scan), or blood work can be used to support the Parkinson’s Disease diagnosis or to rule out other conditions that can appear as Parkinson’s Disease.
If you are experiencing symptoms that resemble Parkinson’s Disease, make an appointment with your primary care physician, neurologist, or a movement disorder specialist. Doctors will:
> Observe facial expressions for animation
> Observe arms and hands at rest for signs of tremors
> Gently rotate your neck to see if any stiffness is present
> Ask you to stand from your chair
> Observe your gait as you walk down a hallway
> Carefully pull you backwards to observe your balance
> Determine wow quickly you are able to regain your balance
Primary symptoms of Parkinson’s
Symptoms a person has and how quickly conditions develop will differ from person to person. Be sure to consult with your doctor to determine if the symptom’s you’re experiencing may be a sign of Parkinson’s Disease or a sign of other health concerns. In order to consider a diagnosis of Parkinson’s disease, a person must have bradykinesia (slowness of movement), plus one or more additional symptoms.
Motor Symptoms
People are more familiar with the motor (movement) symptom’s of Parkinson’s Disease. These signs effecting movement are noticeable from the outside and are used by physicians to make a diagnosis. The three primary motor symptoms of Parkinson’s Disease are:
> Slowness (Bradykinesia) - a decrease in spontaneous and voluntary movement; may include slower walking, less arm swinging while walking, or decreased blinking or facial expression.
> Stiffness (rigidity) - increased muscle stiffness detected by a physician at an examination.
> Tremor - rhythmic, involuntary shaking that occurs in a finger, hand or limb when it is relaxed and goes away during voluntary movement.
> Additional motor symptoms - can include challenges with balance and coordination. These symptoms can happen at any stage of the disease, but mostly associate with later stages.
Non-motor symptoms
Non movement symptoms are referred to as the invisible symptoms of Parkinson’s Disease because they cannot be detected visibly. These common symptoms can affect the entire body, occur at any point in the disease progression, and will often differ in severity from person to person. These symptoms can also affect quality of life for patients and their families. These symptoms fall within three categories:
Autonomic Dysfunction Symptoms
> Constipation - decreased and or difficult to pass bowel movements.
> Sexual problems - decreased libido or pain in women and erectile dysfunction in men.
> Low blood pressure (orthostatic hypotension) - a decrease in blood pressure when changing body positions, such as standing from a seated position, which can cause lightheadedness, dizziness or even fainting.
> Sweating - excessive perspiration, even when you’re not hot, active, or anxious.
> Urinary problems - frequent urination, involuntary loss of urine or difficulty emptying the bladder.
Personality, mood or thinking changes
> Apathy - a lack of motivation or interest in activities.
> Memory or thinking (cognitive) challenges - these can vary widely, ranging from multi-tasking and concentration problems that don’t interfere with daily activities (mild cognitive impairment) to more significant challenges that impact a job and daily social activities (dementia).
> Hallucinations and delusions - seeing things that aren’t real (visual hallucinations) and having a false sense, often paranoia or beliefs (delusions), such as of a spouse being unfaithful, money being stolen, and so on.
> Mood disturbances - depression (sadness, loss of energy, decreased interest in activities or people) and anxiety (uncontrollable worry).
Other physical changes
> Skin changes - oily or dry skin; also an increased risk of melanoma.
> Excessive daytime fatigue - feeling drowsy, sluggish or exhausted during the day; these may be symptoms on their own or as a result of medications.
> Pain - discomfort in one part of the body or the entire body
> Drooling - build up of saliva because of decreased ability to swallow.
> Smell loss - decreased ability to detect odors.
> Speech problems - speaking in a soft or monotone voice, sometimes slurring words or mumbling.
> Sleep problems - insomnia (difficulty falling or staying asleep), restless leg syndrome, REM sleep behavior disorder (acting out in dreams).
> Vision changes - dry eyes, double vision or difficulty reading.
> Weight changes - mild to moderate weight loss can occur for some people.
> Swallowing difficulties - choking, coughing and clearing the throat when eating or drinking.