Parkinson’s and Parkinsonism

What is Parkinson’s Disease?

Parkinson’s disease (PD) is a degenerative disorder of the central nervous system. Other names include primary parkinsonism, idiopathic parkinsonism, paralysis agitans or hypokinetic rigid syndrome (HRS). The average age of diagnosis is 62, but those exposed to certain solvents can develop symptoms decades earlier.

The progressive impairment and deterioration of neurons in a part of the brain known as the substantia nigra lead to Parkinson’s. These neurons no longer produce dopamine, a vital brain chemical, that blocks messages from the substantia nigra to the corpus striatum, an area of the brain that helps coordinate intentional body movement. In the absence of this disease, this line of communication is smooth and muscle movement remains balanced. The lack of dopamine impairs the ability for the affected person to control his or her body movements.

A common way Parkinson’s is defined is idiopathic parkinsonism because there is no known cause to the disease. Some research links genetics to the disease, but it isn’t definitive in all cases. Recent research suggests pesticides and solvents play a critical role in causing Parkinson’s. Certain occupations, including welders, painters and steamfitters, have cases causally linked to the disease.

In 1990, Parkinson’s caused 44,000 deaths. By 2013, that number jumped to 103,000.

 

Parkinson’s disease vs. Parkinsonism

Parkinsonism is defined as a clinical syndrome with symptoms including bradykinesia, tremor, instability with posture and rigidity. It shares similar symptoms to Parkinson’s disease, but it isn’t a progressive neurodegenerative disease and is categorized as a symptom complex, meaning the various symptoms occur together to characterize the illness.

Lewy bodies are protein aggregates called alphasynuclein in the brain’s neurons and are found in patients with Parkinson’s disease. They allow the dopamine replacement treatments to alleviate the various symptoms. Parkinsonism, however, doesn’t respond to the treatments found to work with PD.

 

Symptoms of Parkinson’s

Symptoms of Parkinson’s disease may present themselves differently in each individual, with the early signs so mild they go unnoticed. When symptoms begin to appear, they typically occur on one side of the body. Even after the symptoms move to both sides, the original side will remain worse.

 

Early Warning Signs

  • Twitching of the limbs, including slight shaking in thumb, chin, lip, hands or legs.
  • Loss of smell with foods like pickles, licorice and bananas.
  • Constipation and strained bowel movements without other common factors, such as lack of water or fiber in diet or medication that may cause constipation.
  • Hunching, stooping or slouching instead of being able to hold your body upright.
  • Changes in handwriting, including smaller letters, is a common sign of Parkinson’s disease.
  • Changes in voice, especially speaking lower, softer or more hoarse.
  • Sudden movements while sleeping, including thrashing, kicking, punching and falling out of bed.
  • A masked face making it appear like you’re mad or depressed with a blank stare and lack of blinking.
  • A stiff body that causes trouble when moving or walking is an early sign. Look for arms not swinging when walking or a stiffness and or pain in the shoulder or hips.
  • Dizziness or fainting when standing up.

The seemingly common nature and gradual progression of these signs make it challenging to see there is a bigger issue. As the disease progresses, these early warning signs turn into the common symptoms associated with Parkinson’s disease.

 

Common Symptoms

Tremor
One of the most common characteristics of Parkinson’s disease is a shaking hand while it is at rest. The rubbing of the forefinger and thumb in a back and forth manner is called a pill-rolling tremor.
Rigidity in the muscles
Stiff muscles may be felt in any part of the body, making it challenging to move and limiting range of motion.
Impaired balance and posture
A stooped standing position and lack of balance may occur with Parkinson’s disease.
Challenges in writing
Writing may look small and become more difficult.
Bradykinesia, or slowed movement
PD can slow movement as it reduces the overall ability to move, turning simple tasks into time-consuming and difficult challenges. Short steps, difficulty getting out of a chair and dragging feet are caused by bradykinesia.
Changes in speech
As with the early warning sign, speech may become softer and come out in a monotone without inflection. Other issues can involve speaking faster, slurring the words or hesitating before starting a sentence.
Loss of automatic movements
Unconscious movements, such as smiling, gesturing while talking, swinging your arms and blinking may be lost with Parkinson’s disease.

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