early-signs-and-symptoms-of-parkinson’s-disease

Parkinson’s Disease is a neurological condition that typically affects patients above the age of 60. The early signs and symptoms of Parkinson’s Disease can be hard to spot, since they often appear sporadically, and are mild during their initial appearance. Timely diagnosis and intervention is crucial for optimum treatment. Here, we take a closer look at the early signs of Parkinson’s Disease.

Understanding Parkinson’s Disease

Parkinson’s Disease is one of the most common neurodegenerative conditions in the world. It primarily damages dopamine-producing neurons in a specific area of the brain called substantia nigra. Since dopamine is involved in sending messages to the parts of the brain in charge of coordination and movement, the declining levels affect movement. The exact cause of Parkinson’s Disease is still not known, although it is attributed to a combination of environmental and genetic factors. There is no known cure, however, diagnosis and treatment may help control symptoms.

Early signs and symptoms of Parkinson’s Disease

Early symptoms of Parkinson’s Disease are often very mild. Moreover, symptoms vary from person to person. One of the most common symptoms are tremors, although it is neither a necessary nor a sufficient condition for diagnosis. Moreover, there are several other symptoms that may be overlooked because they have nothing to do with movement. In general, we can classify the early symptoms of Parkinson’s Disease into two categories, motor and non-motor.

Motor symptoms

These relate to movement, functionality, coordination, and balance. Symptoms may initially manifest on one side of the body, before affecting both sides. Generally, two or more of the following motor symptoms are necessary for the doctor to consider a diagnosis of Parkinson’s Disease.

  • Tremor: A classic sign of Parkinson’s Disease, tremors can manifest in a single hand, foot, or leg, and can also occur in the jaw, chin, tongue, or mouth. They usually occur when the affected body part is at rest. Some patients may also experience internal tremors that are not apparent to observers.
  • Bradykinesia: The word means ‘slow movement’ in Greek. It results in a general slowing-down of movement as well as a decreased eye-blink rate and reduced facial expressions (known as facial masking). Fine motor skills may also be compromised.
  • Rigidity: The limbs and/or torso may feel tight or stiff. This is one of the early signs of Parkinson’s Disease that is often mistaken for something else, such as Arthritis or injury.
  • Dystonia: Rapid involuntary movements are among the common early symptoms of Parkinson’s Disease. Parts of the body such as the limbs, neck, or torso may twist into an unnatural stance.
  • Posture: Patients with Parkinson’s Disease often develop a leaning or slouching posture during the initial stages. This tends to worsen as the disease progresses.
  • Problems with gait: During the early stages of the condition, the patient may experience difficulties with the gait such as a drop in the natural swing of the arms while walking. They may also develop a shuffling gait or take smaller, slower steps.

Non-motor symptoms

A patient may experience some of these for months or even years without realising it. We list out some of the commonly observed non-motor symptoms as follows.

  • Vocal changes: The patient may experience a softening or hoarsening of the voice or a loss in the natural variations of the voice while talking, leading to a monotone. This is one of the very early signs of Parkinson’s Disease that others may remark on before the patient notices it themselves.
  • Reduced sense of smell: The patient may lose some or all of their ability to smell. This, in fact, could occur years before other symptoms follow. About 70-90% of Parkinson’s Disease patients experience loss of smell.
  • Cognitive changes: Many patients will experience trouble with concentration, multi-tasking, word-finding, and decision-making.
  • Sleep problems: This is one of the common early signs of Parkinson’s Disease. Patients may have trouble falling asleep and / or staying asleep. They may also experience highly vivid dreams or make uncontrollable movements during their sleep.
  • Constipation: Many patients with Parkinson’s Disease have difficulty moving their bowels in the early stages. In fact, about 25% of patients experience constipation before any motor symptoms show up, increasing the risk of misdiagnosis.
  • Psychosis: Whether as an early symptom or as a consequence of disease progression, over half of all Parkinson’s patients experience hallucinations, delusions, and / or paranoia.
  • Depression/Anxiety: These are often observed as part of the early signs of Parkinson’s Disease and happen as a result of lowered dopamine levels. However, they are often treated as conditions in themselves rather than being indicative of an underlying condition.
  • Weight loss: Patients may experience weight loss due to reduced food intake that happens, due to loss of smell or mood swings, or increased energy requirements due to tremors.

Diagnosing Parkinson’s Disease

If you observe any of the early signs and symptoms of Parkinson’s Disease in yourself, remember not to panic. Quite often, those same signs and symptoms could point to other causes that are much less serious, and even curable. As soon as possible, consult a doctor and describe the nature and frequency of your symptoms, in detail. Here are a few frequently asked questions by doctors to access the severity of your conditions:

  • What medical conditions do you currently have or have you had in the past, including details of any medication you are on
  • Whether your sense of smell has been affected
  • Whether you have experienced sensations such as your feet appearing ‘frozen’ to the floor
  • Whether your handwriting has become smaller and more cramped
  • Whether you have sleep trouble
  • Whether you have noticed changes in your temperament and mood

On the basis of a preliminary examination, if the doctor suspects that you may have Parkinson’s Disease, they will refer you to a neurologist for further check-ups. The neurologist will test your mobility, balance, coordination, gait, and muscle tone through various exercises. They may also recommend that you see a movement disorder specialist. Finally, they may recommend a dose of dopamine to evaluate your response. If your symptoms improve significantly afterwards, you most likely have Parkinson’s Disease. 

Once your diagnosis is confirmed, talk to your doctor about the best treatment options and make any lifestyle changes that you are advised to. A mix of Physical and Occupational Therapy can help greatly with movement control and give you a high degree of functionality. Above all, take the support of your loved ones during this time and don’t be afraid to seek help, whether it’s asking a friend to drive you to the doctor’s or talking to a counsellor about your diagnosis.

FAQs

  • What age does Parkinson’s Disease usually start?

Most cases of Parkinson’s Disease are diagnosed when the patient is 60 or older. Symptoms typically develop in mid or late life. Young people rarely get the disease.

  • Can Parkinsons be cured if caught early?

There is no cure at present for Parkinson’s Disease. However, treatment can slow disease progression and keep symptoms in check. The sooner the treatment begins, the better the results.

  • How does a person with Parkinson’s feel?

Patients with Parkinson’s Disease may experience muscle spasms, tremors, and problems with walking and balance. As the disease progresses, patients tend to experience sleep disorders, learning and memory problems, difficulty talking, and mental conditions such as paranoia, hallucinations, or Depression.

  • What can be mistaken for Parkinson’s?

Several other conditions could also have symptoms that resemble the early symptoms of Parkinson’s Disease. Some of these include essential tremor, Viral Parkinsonism, Post-traumatic Parkinsonism, Progressive Supranuclear Palsy, and Multiple System Atrophy.

  • Can Parkinson’s stay mild?

Stage 1 of Parkinson’s Disease is the mildest, and may last for about 3 to 7 years. While the disease will eventually progress, the right treatment can reduce the intensity of the symptoms.

  • Can you have Parkinsons without tremors?

Tremors are one of the most common, very early signs of Parkinson’s Disease. However, not all patients experience it. Some may experience a general stiffness in their limbs or a slowing down of movement, without tremors.

  • Can a blood test detect Parkinson’s Disease?

At present, there is no blood test to detect Parkinson’s Disease. Your doctor will make a diagnosis based on what your symptoms are and what a brain scan reveals.

  • What disease has the same symptoms as Parkinson’s Disease?

The early signs of Parkinson’s Disease are very similar to those of other movement disorders. Most notably, Progressive Supranuclear Palsy (PSP) has early signs and symptoms that almost completely overlap with those of Parkinson’s Disease.

  • Are leg cramps associated with Parkinson’s?

Muscle cramps (Dystonia) are among the frequently observed early symptoms of Parkinson’s Disease. Patients most commonly experience them in their feet, calves, and neck.

  • Does Parkinson’s cause muscle and joint pain?

As Parkinson’s Disease progresses, reduced mobility and the increased tendency to fall can lead to pain in muscles and bones. Those with muscle tightness may also experience a pulsing type of pain.

  • How long can you have Parkinson’s before diagnosis?

Because the early symptoms of Parkinson’s Disease are often very mild, it is possible for someone to display symptoms for almost up to a decade, before getting a diagnosis.

  • Is back pain associated with Parkinson’s?

Parkinson’s Disease can cause posture to stoop as the disease progresses, which often leads to pain in the upper and lower back, and the neck.

In conclusion, Parkinson’s Disease is a chronic condition for which early diagnosis and treatment is crucial to prolong good functionality, and slow down disease progression. By knowing how to spot the early signs and symptoms of Parkinson’s Disease, you can benefit from an early diagnosis and also set your mind at rest sooner if you don’t have Parkinson’s.

Dr Na'eem Sadiq is a respected stem cell specialist at Plexus, and a prominent neurologist in Bangalore. He studied neurology and clinical neurophysiology in London, and worked with some of the most prestigious medical institutions in England, and the Middle East. He completed his MBBS at Bellary Government Medical College, and a postgraduate degree in psychiatry from NIMHANS in Bangalore.

Dr Na'eem has perfected his knowledge and expertise in Continuing medical education (CME), and training in tissue culture, Stem Cell Therapy, and neurology. Dr Na'eem Sadiq possesses an undying passion to improve people’s lives. This led to the creation of Plexus, a neuro and Stem Cell Research centre in Bangalore in neurosurgery, and neurorehabilitation.