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Symptoms of Parkinson's disease
Parkinson's has a variety of symptoms, all of which can affect people differently.
Parkinson's disease is a chronic ailment that slowly destroys brain cells that produce a chemical called dopamine.
Dopamine helps the brain direct muscles and limbs to move purposefully and smoothly.
The decrease in dopamine can result in symptoms such as trembling, stiff limbs, slow movement, slouched posture, and poor balance and coordination.
Before these clear signs appear, however, there may be more subtle indications that something is wrong. Early signs of Parkinson's can include depression, fatigue and memory loss.
People's handwriting may become cramped and spidery. They may feel shaky and have trouble standing up from a chair or lose track of a word or thought. They may notice that their speech is too soft for others to hear.
Also, a person's face may lack expression and animation. This is sometimes called masked face.
Progression of symptoms
Parkinson's progresses more rapidly in some people than others, says the National Institute of Neurological Disorders and Stroke (NINDS).
The symptoms and their intensity vary as well. Not all people experience the same symptoms or in the same order. Some people become quite disabled, while others experience minor tremors and stiffness.
Here is a more detailed look at classic symptoms:
Trembling movements usually start in the hand and sometimes the jaw or foot, according to the NINDS.
They become more obvious when the hand is at rest or if the person is under stress. Early in the disease, tremors and other movement problems typically affect one side of the body only.
Tremors are rarely disabling and usually go away when a person is asleep or improve with intentional movements.
Most people with Parkinson's experience stiffness and resistance to movement, says the NINDS.
Because of the disease's effects on the brain and the disrupted signals it sends to muscle groups, muscles can become constantly tensed up, resulting in stiffness, pain and weakness.
Bradykinesia is the slowing down and loss of movements the body performs automatically.
The symptoms are unpredictable. Sometimes a person can move normally, but then he or she can't move at all. Simple activities such as washing or dressing can become extremely difficult or even impossible.
Impaired posture and balance
Some people with Parkinson's develop a forward or backward lean, lose their sense of balance and can fall easily.
Parkinson's may also cause people to develop a slouched appearance, with shoulders drooped and head hanging down. As the disease progresses, some people may not be able to walk easily. They may freeze midstep or fall over.
Emotional and other symptoms
Other symptoms can include:
Depression. Early in the disease, even before symptoms become noticeable, a person may feel down. These feelings may be intensified later on by drugs used to treat Parkinson's. A person should discuss his or her feelings with a doctor. Medicines for depression can help.
Emotional changes. People with Parkinson's can also become insecure, afraid to travel or socialize, or angry or pessimistic.
Memory loss, slow thought. It's not known whether Parkinson's harms a person's intelligence. Some people have difficulty focusing their thoughts, but they remain able to reason, according to the NINDS.
Difficulty swallowing and chewing. In later stages of the disease, muscles used for chewing and swallowing work less efficiently. People may choke or drool. However, medications can help offset these problems.
Soft or monotone speech, slurring and talking too fast. Speech problems affect about 50% of people with Parkinson's, according to the NINDS. Speech therapy can help people overcome some of these problems.
Constipation or urinary problems. The loss of automatic movements that comes with Parkinson's can result in incontinence, constipation or difficulty urinating. A person should discuss any of these problems with a doctor.
Oily or dry skin. Improper function of the brain can lead to oily or very dry skin.
Sleeplessness. People with Parkinson's may experience nightmares, restless sleep, emotional dreams and daytime drowsiness. Researchers haven't determined whether these symptoms are related to the disease or to the medicines used to treat it. The NINDS warns that people shouldn't take over-the-counter sleep aids without consulting a doctor.