Parkinson's disease (PD) is a progressive neurodegenerative disease that affects motor and non-motor skills and affects one percent of people over the age of 60. It is a progressive disorder of the central nervous system that often causes tremors, muscle stiffness, slow movement and poor balance. If you suspect that you, or someone you are fond of, have Parkinson's disease, it is important to know which pathways to take to be sure of such a diagnosis. Start by trying to identify the symptoms of the disease at home and then consult your doctor for an accurate medical diagnosis.
Steps
Part 1 of 3: Recognizing the Symptoms of Parkinson's Disease
Step 1. Look for tremors in the hands and / or fingers
One of the first symptoms reported to doctors by many patients, later diagnosed with Parkinson's disease, is an involuntary tremor that can affect the hands, fingers, arms, legs, jaw and face.
- The causes of tremors can be many. Parkinson's disease is one of the most common causes, and tremors are often the first sign of the disease.
- Tremors and other symptoms may initially present asymmetrically on only one side of the body or may be more noticeable on one side than the other.
- A repetitive motion with the thumb and finger, described as "counting coins" because it appears that the person is actually counting coins with the fingers, is characteristic of the tremor associated with Parkinson's.
Step 2. Check if the gait is shuffling
A common symptom of the disease is shuffling walking with short steps and a tendency to lean forward. People with MP often find it difficult to balance and are sometimes prone to fall forward and gradually accelerate their pace to prevent this from happening. This type of walking is called "festination" and is a very common symptom of the disease.
Step 3. Observe the posture
Sufferers often lean forward at the waist when standing or walking. This is because Parkinson's disease can cause problems with posture, balance and muscle stiffness. There is a tendency to flex the arms and head and the person appears to be bent with the elbows flexed and the head lowered.
Check for postural stiffness. Stiffness, or resistance to limb movement, presents itself as a "cogwheel" or jerky and is a distinctive feature of Parkinson's that manifests itself with a rigid movement when trying to move a patient's arm with simple flexion and extension movements. Stiffness and resistance to movement is most evident in passive wrist and elbow movements
Step 4. Check for slowed or distorted movements
Some symptoms of the disease stem from the most prominent symptom resulting in slowed movements, also known as bradykinesia. This fundamentally affects motor functions such as walking, balancing, writing and even what are often considered reflex or involuntary.
- Look for changes in voluntary movements. In addition to involuntary movements, Parkinsonians may have disturbances in voluntary movements that add to the slowing down. Some medications used for treatment can cause abnormal involuntary movements or an amplification of movements called dyskinesia. These changes (dyskinesias) can appear similar to a "tic" and worsen if there is psychological stress.
- Advanced dyskinesia has been found more often in patients treated for some time with the drug levodopa.
Step 5. Examine cognitive disturbances
Some cognitive impairments are common but usually occur late in the course of the disease.
Step 6. Check the language
About 90% of people with PD will show signs of speech impairment at one time or another. These can manifest themselves through quieter speech, wheezing or hoarse voice, and reduced precision in word choice.
The voice often becomes soft or whispered as the vocal cords lose mobility
Step 7. Watch for signs of depression or anxiety
Up to 60% of PD sufferers may experience symptoms. The disease affects certain areas of the brain responsible for stabilizing mood and this increases the likelihood of depressive disorders, especially in association with quality of life in patients with advanced Parkinson's.
Step 8. Check for any gastrointestinal problems
The muscles used to push food through the digestive system are also affected by the disease. This can lead to various gastrointestinal problems ranging from incontinence to constipation.
These same symptoms also often present with difficulty swallowing food
Step 9. Look for sleep disturbances
Many of the involuntary movements associated with Parkinson's make it progressively difficult to sleep through the night. Other symptoms - such as muscle stiffness that makes it difficult to turn to bed or bladder problems that lead to frequent getting up at night to urinate - aggravate the sleep disruptions that Parkinson's sufferers suffer from.
Part 2 of 3: Testing for Parkinson's Disease
Step 1. Check for symptoms at home
While symptoms alone do not warrant an accurate diagnosis, you can check them as suggested elsewhere in this article to give your doctor a complete picture of the situation. If Parkinson's disease is suspected, your doctor may first propose a physical examination and evaluation of the same symptoms that you may have noticed yourself.
- Rest your hand in your lap and check for tremor. Unlike most other forms of tremor, the one associated with Parkinson's disease is worse when one is "at rest".
- Observe the posture. Most people with the disease usually lean slightly forward with their head down and elbows flexed.
Step 2. Consult your doctor
Ultimately, only he can provide a diagnosis. Make an appointment and tell him your medical history and concerns. If you think Parkinson's is a possible cause, then you will likely do some tests to establish the diagnosis.
- Note that the disease is not difficult to diagnose, except in the early stages. There is no single conclusive examination that the doctor will perform. Rather, it will perform several tests to rule out other conditions that have Parkinson's-like symptoms (such as stroke, hydrocephalus, or benign essential tremor). The disease that most often resembles Parkinson's is essential tremor, which is often an inherited movement disorder and is most noticeable with outstretched hands.
- Your doctor may recommend that you visit a neurologist who is a specialist in diseases of the nervous system.
Step 3. Do a physical exam
The doctor will first do a physical exam looking for several indicators:
- Is the facial expression alive?
- The presence of tremors in the arms in conditions of rest
- The presence of stiffness in the neck or limbs
- The ease of standing up from a seated position
- Is there normal walking and do the arms swing symmetrically while walking?
- In the case of a little push, are you able to regain your balance quickly?
Step 4. Arrange for other tests if needed
Imaging, such as MRI, ultrasound, single photon emission computed tomography and PET, is not usually very helpful in diagnosing Parkinson's disease. However, in some circumstances your doctor may recommend one of these tests to help distinguish between Parkinson's disease and diseases that have similar symptoms. However, given their cost, the invasive nature of the procedures, and the difficult availability of equipment, doctors are unlikely to recommend these tests as a diagnostic tool for Parkinson's in most cases.
An MRI can help doctors distinguish between PD and conditions that present with similar symptoms, such as progressive supranuclear palsy and multiple system atrophy
Step 5. Measure response to treatment
This is basically based on the increased effect of dopamine (MP-influenced neurotransmitter) in the brain. Treatment may consist of the administration of levodopa, the most effective and most commonly prescribed drug for Parkinson's, usually in combination with carbidopa. In some cases, the doctor may also prescribe a dopamine agonist, such as premipexole, which stimulates the dopamine receptors.
If the progression of symptoms is sufficient to warrant the use of drugs, the doctor may prescribe them to see if they can slow it down. PD-like diseases tend to respond less effectively to therapy. A good response to the drug makes it more likely that it is Parkinson's disease
Part 3 of 3: Treating Parkinson's Disease
Step 1. Try medications
Unfortunately, there is still no cure for Parkinson's disease. However, there are several medications available to treat many of the associated symptoms. Here are some of the commonly used medicines:
- Levodopa / Carbidopa (Sinemet, Parcopa, Stalevo, etc.): they treat the various motor disorders present both in the early and later stages;
- Dopamine agonists (Apokyn, Parlodel, Neupro, etc.): they stimulate dopamine receptors to trick the brain into believing it receives it;
- Anticholinergics (Artane, Cogentin, etc.): they are mainly used to help in the treatment of tremors;
- MAO-B inhibitors (Eldepryl, Carbex, Zelapar, etc.): help improve the effects of levodopa;
- COMT inhibitors (Comtan, Tasmar) that block the metabolization of levodopa prolonging its effects
Step 2. Exercise to slow the progression of the disease
While exercise is by no means a permanent solution to the effects of Parkinson's, it has been shown to reduce stiffness and improve mobility, gait, posture and balance. Aerobic exercises that require good biomechanics, posture, rotation, and rhythmic movements have proven to be particularly effective. The type of exercise that can help includes:
- Dance
- Yoga
- Tai Chi
- Volleyball and tennis
- Aerobics
Step 3. Consult a physical therapist
To establish the best fitness regime, taking into account the progress of the disease, a physiotherapist is indispensable. He can define a specific workout routine for areas where stiffness or reduced mobility has started.
In addition, it will be necessary to consult it to periodically update the routine to ensure maximum effectiveness and to keep up with the evolution of the disease
Step 4. Learn about the surgical options for treating Parkinson's disease
Deep brain stimulation (DBS) is a surgical procedure that has revolutionized the treatment of the disease in its most advanced stages. The procedure involves implanting electrodes in the affected brain region which are then connected to a pulse generator inserted under the collarbone. The patient is then given a control device to activate or deactivate the device as needed.
The effects of DBS are often significant, and doctors may recommend this path for those suffering from disabling tremors, those experiencing adverse side effects from medications, or in cases where they begin to lose their effectiveness
Advice
- This article provides information related to Parkinson's disease, but does not offer any medical advice. You should always see your doctor if you feel you have any symptoms related to the disease.
- Recognizing Parkinson's disease is usually simpler than other degenerative and progressive diseases, and the disease can be identified and treated effectively from an early stage.
- The use of drugs and observing a healthy lifestyle can go a long way to mitigate the consequences of this disease on the daily routine and activities of those who suffer from it.
- Realize that diagnosing Parkinson's is something only a doctor can do. You may be suspicious and you may also have a relative certainty of the presence of the disease, but only the doctor can provide an exact diagnosis.
