Parkinson's disease is a disease that occurs when the brain stops producing regular amounts of dopamine, a chemical that controls motor skills and has important effects on the central nervous system. People with this syndrome can experience a variety of physical problems, including bradykinesia (slow movement) and difficulty in controlling muscles. As it progresses over time, learning to recognize the signs and symptoms can tell you whether you need to get an accurate diagnosis and seek treatment.
Steps
Part 1 of 2: Recognizing the Early Symptoms of Parkinson's Disease
Step 1. Watch out for any tremors or twitches
When you think about Parkinson's disease, the first thing that comes to mind is tremors. They can occur anywhere on the body: fingers, legs, an involuntarily dropping eyelid, vibrating lip or chin, and so on. Keep in mind that in some cases tremors and twitching are completely normal, for example after an intensive training session or after an injury. Some medications can also cause tremors, so ask your doctor if they depend on the medications you are taking.
Step 2. Notice if your muscles tend to tense up
After tremors, stiffness is the best-known symptom of Parkinson's disease. Check if your muscles feel tense, even when you're not exercising. You may also notice a decrease in their elasticity or an increase in pain or muscle cramps.
- Sometimes the stiffness affecting the muscles of the face favors an expression of impassivity in the person with Parkinson's disease, as if the latter were wearing a "mask". This stiffness is characterized by a fixed gaze accompanied by short blinks and an almost total absence of a smile. The impression is that the person is angry, even if in reality he is fine.
- You may also notice slouching posture due to muscle stiffness. In other words, the subject leans forward or leans more to one side than the other.
Step 3. Check your bowel activity
When one thinks of the loss of muscle control that accompanies this disease, one is led to consider the difficulties in walking, speaking, swallowing and similar problems. However, this syndrome also affects the autonomic nervous system, which controls the activity and functionality of internal organs, i.e. those that work without our awareness. When the autonomic nervous system is attacked the intestines risk not functioning properly, causing constipation.
- The difficulty of emptying the intestines daily does not necessarily indicate constipation. For some people it is normal to go 3-4 days without going to the toilet.
- Constipation is characterized by a significant loosening of the transit of stools, which are also drier than usual and difficult to pass. You may have to strain yourself when you go to the bathroom.
- Be aware of other factors that cause constipation, such as dehydration, lack of fiber, excessive alcohol consumption, caffeine intake, dairy products, and stress.
Step 4. Learn about the symptoms of the micrograph
Parkinson's disease affects fine motor skills and causes muscle stiffness, so people with it often experience increasing difficulties in writing. Micrography is a pathological change in handwriting commonly associated with this disease. So, notice if:
- The stroke becomes smaller and narrower than usual.
- You can no longer write easily.
- Hands contract as you write.
- Be aware that micrography is a sudden, not a gradual phenomenon.
Step 5. Note the vocal alterations
Speech difficulties develop in 90% of people with Parkinson's disease. The most common initial symptom is a weakening of the vocal timbre, also accompanied by breathlessness or hoarseness. Some patients complain of a certain slowdown in oral communication, while others - about 10% - speak faster, with the risk of stuttering or not being understood. It is not easy to notice these changes on your own, so ask the people around you if they detect any speech disturbances in you.
Step 6. Look out for signs of hyposmia
Over 90% of people with Parkinson's disease suffer from hyposmia, which is a decrease in the sense of smell. According to some researches, the dullness of olfactory sensitivity is an early sign of dementia that develops with the progress of this disease and can precede the onset of motor and coordination problems by a few years. If you suspect a decreased ability to smell, try sniffing bananas, pickled cucumbers, or licorice first before seeing your doctor.
Remember that a sudden loss of smell could be due to other, not alarming reasons. Before thinking about hyposmia, consider a cold, the flu, or a stuffy nose
Step 7. Notice changes in the wake-sleep alternation
Problems with sleep are early signs of Parkinson's disease and usually emerge before motor difficulties. The disorders are of various kinds:
- Insomnia (inability to sleep at night).
- Somnolence during the day (reported by 76% of cases) or "falling asleep" (sudden and involuntary drowsiness).
- Nightmares or "acting out" of the dream during sleep (impulsive actions to express conflicting and inexpressible experiences through words).
- Sleep apnea (when breathing stops for a few seconds during sleep).
Step 8. Don't underestimate the lightheadedness and loss of consciousness
Although these symptoms can have several causes, in Parkinson's patients they are due to orthostatic hypotension, which is a sharp drop in blood pressure that affects 15-50% of patients. Orthostatic hypotension causes blood pressure to drop dramatically and suddenly when standing up after lying down for some time. As a result it can cause lightheadedness, balance problems, and even loss of consciousness.
Step 9. Remember that none of these symptoms indicate Parkinson's disease
Each of the symptoms described in this section could be due to normal physical stress or another medical condition. However, if you notice multiple symptoms over a long period of time, consult your doctor so that you can undergo the necessary investigations to detect this disease.
Part 2 of 2: Follow the Diagnostic Pathway for Parkinson's Disease
Step 1. Consider the genetic causes and risks
Only 1-2% of people with Parkinson's disease have a genetic makeup that directly causes the development of the disease. Most people have "associated" genes that can increase the risk, but it is not certain that it will manifest itself even if they are genetically predisposed to the development of this syndrome. If the associated genes combine with other genes or unfavorable environmental factors they can trigger the onset of Parkinson's disease. About 15-25% of patients have relatives who have suffered from this disease.
- Age also increases the risk. Where the incidence of this syndrome reaches 1-2% of the total population, 2-4% of this slice is made up of people over 60 years of age.
- Be aware of the genetic predispositions that affect the risk of developing this disease and let your doctor know.
Step 2. Tell your doctor about your concerns
Parkinson's disease is not easy to diagnose, especially in the early stages. However, it is very important to find out before it goes too far and compromises the quality of life. If you notice at least one of the symptoms listed in the previous section and other cases have occurred in your family, consult your doctor to check your symptoms.
Step 3. Undergo the assessment exercises proposed by your doctor
There is no standard investigation for diagnosing Parkinson's disease, although some research is underway to find a biological marker - by blood tests or imaging tests - that can confirm the diagnosis. However, in the absence of an unambiguous assessment, the doctor makes use of the knowledge relating to the manifestation of the disease by combining it with the observation of the patient, who is invited to perform some simple tasks. This test identifies the symptoms listed in the previous section:
- Absence of movements of the facial muscles.
- Presence of tremors when the legs are at rest.
- Stiffness in the neck or limbs.
- Inability to get up suddenly without feeling lightheaded.
- Lack of elasticity and muscle strength.
- Inability to quickly regain balance.
Step 4. Consult a neurologist
Even if your doctor excludes any concerns, see a neurologist if you still have concerns. A specialist in this area will be more familiar with the symptoms of Parkinson's disease and may not agree with the opinion of the general practitioner.
Be prepared to carry out any investigations (blood tests, diagnostic imaging tests) that he may order to rule out that the symptoms found are due to other causes
Step 5. Learn about taking a carbidopa and levodopa drug
These are two active ingredients that act on the symptoms of Parkinson's disease. If you notice improvement since you start taking them, your doctor may use this information to confirm the diagnosis.
Take the drug following the directions. If you wait too long between doses or take it in insufficient quantities, the doctor will not be able to accurately assess to what extent the symptoms improve or worsen
Step 6. Seek another opinion
Since there is no test to detect the marker that indicates the onset of Parkinson's disease, it is very difficult to get an accurate diagnosis, especially in the early stages. A second medical opinion will therefore allow you to access the best possible treatments, whatever the cause of the symptoms.
