Parkinson’s disease usually takes a gradual course, which is why symptoms are often nonspecific at the beginning. Over time, however, the characteristic signs of Parkinson’s disease then become more pronounced. Typical symptoms are a slowing down of movement (bradykinesis) as well as a lack of movement (hypokinesis), which can extend to immobility (akinesis). In addition, there is usually muscle stiffness (rigor), postural instability (postural instability), and tremor (tremor). However, the resting tremor that is often first associated with Parkinson’s disease does not necessarily occur.
Parkinson’s disease: definition
For all Parkinson’s symptoms, they are often associated with the disease but do not necessarily occur. They can also vary significantly in intensity from patient to patient. By definition, Parkinson’s is said to occur whenever a slowing of movement occurs together with one of the other three leading symptoms – tremor, rigor, and postural instability.
Parkinson’s symptoms in the early stages
The symptoms that occur in the early stages of PD are usually not very specific and often resemble rheumatic diseases: For example, there is painful tension in the shoulders or arms, usually on one side. In addition, olfactory disturbances, sleep disturbances and a general feeling of tiredness as well as sweating and constipation can occur. Depressive moods or changes in personality can also be the first signs that point to Parkinson’s disease. If the disease progresses further, the first movement disorders become noticeable: Fine motor activities such as brushing teeth, combing hair or writing become increasingly difficult for those affected. Over time, writing becomes smaller and less legible. In addition, the coordination of various movements causes problems for Parkinson’s patients. The slowing of movement also changes the gait of those affected: Steps become smaller, the gait becomes shuffling and the upper body is bent forward. Instead of both arms, usually only one arm swings when walking, and after a while this arm also stops swinging. In addition to the altered gait pattern, facial expression also decreases over time (mask face) and the blinking of the eyelids becomes less frequent. Often, the voice becomes softer. Another typical feature is a tremor at rest, which affects the arms much more than the legs. The tremor is – as the name suggests – much more pronounced at rest than during movement. A rest tremor is primarily typical of Parkinson’s disease, but it can also have other causes, such as diseases of the cerebellum.
Symptoms in advanced stages
In the advanced stage, movement disorders continue to increase: in addition to the typical symptom of movement slowing, pronounced muscle stiffness now increasingly occurs, which is caused by increased muscle tone. Due to the muscle stiffness, fast movements such as those that occur when braking a movement are no longer possible. A sign of muscle stiffness is, for example, slightly bent arms. If the disease progresses further, falls also occur more frequently because the posture becomes more unstable. As the holding and positioning reflexes diminish, it is also more difficult to keep one’s balance and to catch oneself in the event of a fall. In the advanced stage, trembling of the hands also becomes more pronounced. In addition, the following symptoms may also occur:
- Bladder weakness
- Erectile dysfunction
- Difficulty swallowing
- Increasing salivation
In addition to physical symptoms, Parkinson’s disease often causes psychological symptoms: Many affected suffer from anxiety disorders or depression. In about 20 percent of those affected, it also comes to memory disorders, which may indicate the onset of Alzheimer’s disease or dementia.
Akinetic crisis
In the late stages of Parkinson’s disease, the patient may become completely unable to move within a very short period of time. This is called an akinetic crisis. Usually, this symptom occurs within a few days. Since the affected person can no longer speak or swallow at the last, they must be taken to a clinic immediately.An akinetic crisis can be triggered, among other things, by the discontinuation of Parkinson’s medication or a significant reduction in the dose. In addition, it can also be caused by severe infections, surgery and a lack of fluids. Therefore, it is especially important to make sure that Parkinson’s patients always consume enough fluids.
