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Signs and symptoms of Parkinson's Disease

Hi again, if you're still reading this blog series...thank you you mustn't hate the writing style - no chat GPT here.

In this quick post I just wanted to re-iterate and highlight the signs and symptoms of Parkinson's or PD as we like to shorthand it. From the most common ones that are used in diagnosis to the lesser known ones, and some that are proving to be useful early indicators.

But first...behold...a pretty infographic. Yes, it's from the last post but sometimes you gotta love a repeat especially if you like the old adage that 'a picture is worth a thousand words'.

Common signs and symptoms (S&S)

The most common signs and symptoms that indicate someone may have PD include:

  • Tremor (resting tremor mostly seen in the hands and arms)

  • Bradykinesia (Slowness of movement, especially functional tasks - think walking, folding laundry, or buttoning a t-shirt)

  • Rigidity (Stiff joints that are difficult for you and others to move. Commonly hips, elbows, shoulders and neck.)

  • Postural instability (Inability to maintain posture especially when preparing to walk or when balance is disturbed due to internal or external forces. Often presents as stooped posture, shuffling gait, abnormal turning/pivoting behaviours.)

  • Gait disturbances (Due to all of the S&S mentioned above, individuals with PD or PD-like conditions will have altered gait dynamics. This usually means that they are prone to poor static and dynamic balance which leads to an increased risk of falls.)

From a clinical perspective, for someone to be diagnosed as having PD they need to exhibit at least two of the above S&S. However, they are not the only things needed to confirm a diagnosis of PD, we will discuss this in more detail in a following post.

Non-motor S&S - below the tip of the iceberg we go

The lesser known S&S are non-motor in nature and can vary greatly from person to person. Maybe this is why they aren't as well known to most. Some of these S&S can also be present long before the more common physical signs are apparent.

  • Unexplainable fatigue

  • Mood swings and/or unexplained irritability

  • Depression or anxiety

  • Bladder and/or bowel problems

  • Hallucinations

  • Restless legs

  • Sensory changes (Loss of smell, visual issues, response to touch and pain stimuli)

  • Unexplained sweating

  • Pain (Can be widespread or very specific with no other explainable cause)

  • Impulse control disorder

  • Sleep disturbances and/or regular poor sleep

  • Speech difficulties (Related to both issues with cognitive function and muscle control)

This list is just a sample of the most common hidden (non-physical) S&S that individuals with PD may present with. As with most things in life, it is never a simple stand alone symptom - they entangle and generally have detrimental effects on other signs and/or symptoms.

Early S&S - may be useful if multiple present

The following list is not currently used as determinative evidence that an individual is going to have PD, and neither should it be. However, it is a helpful way for clinicians (GP, specialist, Physio and other allied health) to group together S&S, and alongside other testing allows the clinician to see what the future likelihood for an individual might be.

  • Problems with sleep (can be due to pain, restlessness, stiffness etc)

  • Loss of smell and changes in taste (While these tend to happen for a lot of people who never end up with Parkinson's, there has been recent research showing the prevalence as early indicators and may be linked to the speed of sensory change.)

  • Unexplained fatigue (This can be either mental, physical, or both.)

  • Frequent and/or needing to urinate with no prior warning sensation (Incontinence)

  • Noticeable tremors or uncontrolled movements

  • Difficulties with dual tasking (This can be as simple as difficulty talking and walking at the same time)

  • Issues with memory or word finding

There you have it, a quick post re-iterating the last post on signs and symptoms. Why does it feel like that this post is just as long if not longer...I don't know why people keep hinting to me that I talk to much. Until next time...

Written by

Julius Alpay (Physiotherapist)

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