Parkinson's usually has a gradual course, so the symptoms are often nonspecific at the beginning. Over time, however, the hallmarks of Parkinson's disease become increasingly apparent. Typical symptoms include a slowing of movement (bradykinesis) and a lack of exercise (hypokinesia), which can range to immobility (akinesia). In addition, there is usually muscle rigidity (rigor), a postural instability (postural instability) and a tremor (tremor). However, resting tremor, which is often the first to be associated with Parkinson's disease, does not necessarily occur.
For all Parkinson's symptoms, these are often associated with the disease, but not necessarily occur. Their intensity can also differ significantly from patient to patient. By definition, Parkinson's is always referred to when a slowing of movement occurs in concert with one of the other three key symptoms-tremor, rigor, and postural instability.
Parkinson's symptoms in the early stages
The symptoms that occur in the early stages of Parkinson's disease are usually less specific and often reminiscent of rheumatic diseases: For example, it comes to painful tension in the shoulders or arms, which usually occur on one side. In addition, there may be olfactory disturbances, sleep disturbances and a general sense of tiredness as well as sweating and constipation. Depressive moods or personality changes may also be the first signs of Parkinson's.
If the disease progresses, the first movement disorders become noticeable: Fine motor activities such as brushing, combing or writing are becoming increasingly difficult for those affected. Thus, over time, writing becomes smaller and more illegible. In addition, the Parkinson's patient prepares the coordination of various movements problems. Due to the slowing down of movement, the affected person's gait also changes: the steps become smaller, the gait shuffles and the upper body is bent forward. Instead of both arms swinging when walking usually only one arm, after some time, this arm is no longer mitschwwungen.
In addition to the altered gait, the facial expression also decreases with time (mask face) and the blinking becomes less common. Often, the voice is also quieter. It is also typical that a rest tremor occurs, from which the arms are significantly more affected than the legs. The tremor is - as the name suggests - at rest much more pronounced than when moving. A resting tremor is primarily for Parkinson's disease, but it may also have other causes such as cerebellar disease.
Symptoms in the advanced stage
In the advanced stage, the movement disorders continue to increase: in addition to the typical symptom of slowing down movement now also increasingly pronounced muscle stiffness, which is caused by an increased muscle tone. Due to the muscle stiffness, fast movements such as those occurring when braking a movement are no longer possible. A hallmark of the stiffening of the muscles are, for example, slightly angled arms.
If the disease continues to progress, it also falls more often because the posture is unstable. In addition, as the holding and adjusting reflexes diminish, one can keep the balance worse and it is harder to catch in a fall. In the advanced stage, the trembling of the hands also appears more clearly. In addition, the following symptoms may occur:
- erectile Dysfunction
- difficulties swallowing
- Increasing salivation
In addition to physical symptoms, Parkinson's Disease often includes mental health problems: Many sufferers suffer from anxiety disorders or depression. In about 20 percent of those affected, there are also memory disorders that may indicate an onset of Alzheimer's disease or dementia.
In the late stages of Parkinson's disease, the patient may become completely immobilized within a very short time. This is called akinetic crisis. This symptom usually occurs within a few days. Since those affected last can no longer talk and swallow, they must be immediately taken to a clinic.
An akinetic crisis can be triggered inter alia by the discontinuation of Parkinson's drugs or a significant reduction in the dose. In addition, it can also be caused by serious infections, surgery and a lack of fluids. Therefore, it is particularly important to ensure that Parkinson's patients always take enough liquid.