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Parkinson’s

Parkinson’s disease is a movement disorder of the nervous system that worsens over time. The nervous system is a network of nerve cells that controls many parts of the body, including movement.

Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand or sometimes a foot or the jaw. Tremor is common in Parkinson’s disease. But the disorder also may cause stiffness, slowing of movement and trouble with balance that raises the risk of falls.

In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Symptoms get worse over time.

Although Parkinson’s disease can’t be cured, medicines may help symptoms get better. Sometimes a healthcare professional may suggest surgery to help control parts of the brain. This surgery may help lessen symptoms.

Symptoms

Parkinson’s disease symptoms can be different for everyone. Early symptoms may be mild, and you may not even notice them. Symptoms often begin on one side of the body, then affect both sides. Symptoms are usually worse on one side than the other. Some Parkinson’s disease symptoms are similar to those of other disorders.

Parkinson’s symptoms may include:

Tremor

This rhythmic shaking usually begins in the hands or fingers. Sometimes tremor begins in the foot or jaw. You may rub your thumb and forefinger back and forth. This is known as a pill-rolling tremor. Your hand may tremble when it’s at rest or when you’re under stress. You may notice that you shake less when you’re doing some sort of task or moving around.

Slowed movement

Slowed movement, also called bradykinesia. Parkinson’s disease may slow your movement, making simple tasks more difficult. It may be hard to get out of a chair, shower or get dressed. You may have less expression in your face. It may be hard to blink.

Rigid muscles

You may have stiff muscles in any part of your body. Your muscles may feel tense and painful, and your arm movements may be short and jerky.

Poor posture and balance

Your posture may become stooped. You may fall or have balance problems.

Loss of automatic movements

You may be less able to make certain movements that you typically do without thinking, including blinking, smiling or swinging your arms when you walk.

Speech changes

You may speak softly or quickly, slur, or hesitate before talking. Your speech may be flat or monotone, without typical speech patterns.

Writing changes

You may have trouble writing, and your writing may appear cramped and small.

Nonmotor symptoms

These may include depression, anxiety, constipation, and sleep problems. They also may include acting out dreams, needing to urinate often, trouble smelling, problems with thinking and memory, and feeling very tired.

Risk Factors

Your chances of developing Parkinson’s are dependent on the complex interaction between genetics and environmental factors. Genetics has caused about 10-15% of all Parkinson’s cases. Scientists have currently identified dozens of gene mutations linked to Parkinson’s. Not only does having a relative raise your chance of developing the disease from 1% to 2%, but environmental factors also play a huge role in its beginning.

Factors like:

Head Injury

Traumatic brain injury — an injury that results in an alteration in the level of consciousness — has been associated with an increased risk of developing PD years after the injury; however, the mechanisms underlying this are unclear.

Area of Residence

There are differences in the geographic distribution of PD. These could be due to differences in environmental factors and genetic risk factors.

Occupation

Certain occupational categories or job titles have been associated with a higher incidence of PD, but results have been inconsistent.

Exposure to Metals

Occupational exposures to various metals have been suggested to be related to the development of PD. But long-term exposure to metals is not easily measured and the results of studies measuring PD risk and specific metals have been inconsistent.

Solvents and Polychlorinated Biphenyls (PCBs)

Trichloroethylene (TCE) is a solvent used in many industries and is the most common organic contaminant in groundwater. Exposure to TCE was found to be associated with PD among workers whose factory jobs resulted in long-term exposure. PCBs have been found in relatively high concentrations in the brains of people who had PD. Occupational exposure to PCBs has been associated with greater risk of Parkinson’s in women, but not in men.

Exposure to Herbicides and Pesticides

A strong link has been shown between PD and exposure to pesticides and herbicides. For example, paraquat, a herbicide, has been strongly linked to the development of Parkinson’s.

Age

Largest risk factor for developing PD. About one percent of people over age 60 have PD.

Gender

PD is more common in men than in women.

Early Signs

Tremor

Have you noticed a slight shaking or tremor in your finger, thumb, hand or chin? A tremor while at rest is a common early sign of Parkinson’s disease.

Small Handwriting

Has your handwriting gotten much smaller than it was in the past? You may notice the way you write words on a page has changed, such as letter sizes are smaller and the words are crowded together. A change in handwriting may be a sign of Parkinson’s disease called micrographia.

Loss of Smell

Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about Parkinson’s.

Trouble Sleeping

Do you thrash around in bed or act out dreams when you are deeply asleep? Sometimes, your spouse will notice or will want to move to another bed. Sudden movements during sleep may be a sign of Parkinson’s disease.

Trouble Moving or Walking

Do you feel stiff in your body, arms or legs? Have others noticed that your arms don’t swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem “stuck to the floor.”

Constipation

Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of Parkinson’s disease and you should talk to your doctor.

A Soft or Low Voice

Have other people told you that your voice is very soft or that you sound breathy and/or hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson’s disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.

Dizziness or Fainting

Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson’s disease.

Stooping or Hunching Over

Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease.

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