Problems With Balance Or Walking
Bradykinesia can also contribute to increasing instability, walking difficulties and changes in gait. An early symptom of this is a decrease in the natural swing of one or both arms when walking. As things progress, the steps you take may become slower and smaller, and you may start shuffling your feet.
Some people with Parkinsons disease may also experience freezing episodes where it can feel like their feet are stuck in place, which can increase the risk of falling.
Conditions Misdiagnosed As Parkinson’s Disease
Parkinsons disease, especially in its early stages when symptoms are mild, is not an easy disease to diagnose. The non-specific, and easily overlooked nature of the signs of Parkinsons make it difficult to spot, and unlike many illnesses, there is no one laboratory test or radiological exam that will provide a definitive diagnosis of Parkinsons disease.
Patients exhibiting Parkinsons-like symptoms may undergo blood and urine tests, or CT or MRI scans to exclude other conditions, but none of these will provide a diagnosis of Parkinsons disease. The best way to test for Parkinsons disease is to conduct a systemic neurological examination that includes tests to gauge a patients reflexes, muscle strength, coordination, balance, gait, and overall movement. Even so, according to information presented on The Michael J. Fox Foundation for Parkinsons Research, up to 25 percent of Parkinsons disease diagnoses are incorrect.
So, why is there confusion about diagnosing Parkinsons disease? The simple answer is that symptoms of Parkinsons disease are not clear cut, and therefore, it is easy to mistake them for other conditions, or to classify them as parkinsonian when they are not.
Here is a brief overview of the top ten conditions mistaken for Parkinsons disease:
Beyond those top three, there are other conditions that are often confused with Parkinsons disease, including:
Parkinson’s Care And Diagnosis
The early signs of Parkinson’s disease can be few and far between, and it can be especially difficult to notice symptoms if they occur sporadically. If you or your loved one experience more than one of the symptoms on this list, it might be time to see a doctor. Since no definitive test for diagnosis exists, the majority of doctors approach diagnosis through a “process of elimination.”
They will most likely test for diseases that can be clinically proven in an effort to rule out Parkinson’s disease. It is important to receive a diagnosis so those with the disease can begin receiving appropriate Parkinson’s care.
We have several communities at Walker Methodist that are Struthers Parkinson’s Care Network partners. They include:
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How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.
If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.
What You Can Expect
Parkinson does follow a broad pattern. While it moves at different paces for different people, changes tend to come on slowly. Symptoms usually get worse over time, and new ones probably will pop up along the way.
Parkinsonâs doesnât always affect how long you live. But it can change your quality of life in a major way. After about 10 years, most people will have at least one major issue, like dementia or a physical disability.
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What Are The 5 Stages Of Parkinson’s Disease
Parkinson’s disease is a neurological movement disorder that’s progressive, meaning symptoms worsen over time. According to the Parkinson’s Foundation, most people move through the stages of Parkinson’s disease gradually .
There’s no lab test that can tell a person which stage their disease is in. Instead, it’s based on how severe a person’s movement symptoms are, and how much the disease impacts their ability to go about daily life.
While the stages of Parkinson’s disease can look a little different for everyone, here’s a typical pattern of the disease, per the Parkinson’s Foundation:
How Is Parkinsons Diagnosed
Doctors use your medical history and physical examination to diagnose Parkinson’s disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.
Researchers believe that in most people, Parkinson’s is caused by a combination of environmental and genetic factors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.
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Is Early Diagnosis Possible
Experts are becoming more aware of symptoms of Parkinsons that precede physical manifestations. Clues to the disease that sometimes show up before motor symptoms and before a formal diagnosis are called prodromal symptoms. These include the loss of sense of smell, a sleep disturbance called REM behavior disorder, ongoing constipation thats not otherwise explained and mood disorders, such as anxiety and depression.
Research into these and other early symptoms holds promise for even more sensitive testing and diagnosis.
For example, biomarker research is trying to answer the question of who gets Parkinsons disease. Researchers hope that once doctors can predict that a person with very early symptoms will eventually get Parkinsons disease, those patients can be appropriately treated. At the very least, these advances could greatly delay progression.
Parkinson’s Disease and Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
Changes In Sleeping Patterns
As Parkinsons progresses, you can also develop problems with sleep patterns. These may not happen in the early stages, but can be noticeable later. You might wake up often in the middle of the night or sleep more during the day than you do at night.
Another common sleep disturbance for people with Parkinsons is rapid eye movement sleep behavior disorder. This is when you start acting out your dreams in your sleep, such as verbally and physically, which can get uncomfortable if someone is sharing your bed. Dr. Rundle-Gonzalez says many times a bed partner will be the one to notice sleep problems.
REM sleep behavior disorder can also happen in people who dont have Parkinsons. However, if this isnt something youve dealt with before, its likely related to your disease. There are medications your doctor can prescribe to help you sleep comfortably through the night.
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Early Warning Signs Of Parkinsons Disease
Signs vary from person to person, and some patients dont experience any early warning signs. However, early symptoms include:
1. Tremors: While most people are familiar with the shaking that comes along with this illness, it usually starts with less noticeable tremors. It could be just a finger, or the chin before it overtakes the hands or face.
2. Interrupted Sleep: Parkinsons Disease can first present with sudden jerking movements when laying down to sleep. These movements can result in frequent disruptions in sleep throughout the night subsequently causing the patient to be exhausted during waking hours.
3. Difficulties When Writing: If once upon a time, you could write without any issues, but now getting the words on paper is burdensome or if youve noticed significant differences in your handwriting, this is cause for concern.
4. Stooped Posture: Parkinsons will often make it difficult to stand up straight. While by itself, poor posture is not necessarily a sign of PD, coupled with some of the other symptoms on this list, its a red flag.
5. Walking Becomes Difficult: Walking is something that most people take for granted until this most mundane of activities becomes painful. Whether its hard to move your arms as you walk, or your legs feel stiff, or you are taking small shuffling steps, these are early signs of PD.
7. Limited Range of Motion: This is due to constant muscle stiffness, even if you havent changed your daily routines.
Exercise And Healthy Eating
Regular exercise is particularly important in helping relieve muscle stiffness, improving your mood, and relieving stress.
There are many activities you can do to help keep yourself fit, ranging from more active sports like tennis and cycling, to less strenuous activities such as walking, gardening and yoga.
You should also try to eat a balanced diet containing all the food groups to give your body the nutrition it needs to stay healthy.
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Stage Three Of Parkinsons Disease
Stage three is considered mid-stage and is characterized by loss of balance and slowness of movement.
Balance is compromised by the inability to make the rapid, automatic and involuntary adjustments necessary to prevent falling, and falls are common at this stage. All other symptoms of PD are also present at this stage, and generally diagnosis is not in doubt at stage three.
Often a physician will diagnose impairments in reflexes at this stage by standing behind the patient and gently pulling the shoulders to determine if the patient has trouble maintaining balance and falls backward . An important clarifying factor of stage three is that the patient is still fully independent in their daily living activities, such as dressing, hygiene, and eating.
The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
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Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
Signs Of Parkinsons Disease
In 1817, Dr. James Parkinson published An Essay on the Shaking Palsy describing non-motor, as well as, motor symptoms of the illness that bears his name. Parkinsons is not just a movement disorder, explained Dr. Shprecher. Constipation, impaired sense of smell, and dream enactment can occur years before motor symptoms of Parkinsons. The latter, caused by a condition called REM sleep behavior disorder, is a very strong risk factor for both Parkinsons and dementia . This has prompted us to join a consortium of centers studying REM sleep behavior disorder.
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Tremor In Other Conditions
While tremor is a common symptom of Parkinsons, it can also be a symptom of other conditions, most notably essential tremor. The main difference between Parkinsons tremor and most other types of tremor is that in Parkinsons resting tremor is most common. Other conditions are usually characterized by action tremor, which tends to lessen at rest and increase when youre doing something, like trying to make a phone call or take a drink.
Tremors of the head and voice are also common in essential tremor but rare in Parkinsons.
What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy. This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinson’s will affect your life
For more information, visit our Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
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Stiffness And Slow Movement
Parkinsons disease mainly affects adults older than 60. You may feel stiff and a little slow to get going in the morning at this stage of your life. This is a completely normal development in many healthy people. The difference with PD is that the stiffness and slowness it causes dont go away as you get up and start your day.
Stiffness of the limbs and slow movement appear early on with PD. These symptoms are caused by the impairment of the neurons that control movement. A person with PD will notice jerkier motions and move in a more uncoordinated pattern than before. Eventually, a person may develop the characteristic shuffling gait.
How Is Parkinson’s Diagnosed
There are no tests that show that you have Parkinson’s. Your doctor will base a diagnosis on your symptoms, medical history and a detailed physical examination.
They will ask about your symptoms. They may also ask you to do some simple mental or physical tasks, such as moving or walking around.
It can be hard to diagnose Parkinsons in the early stages because symptoms are usually mild at first. If your doctor thinks you might have Parkinson’s, they will refer you to a specialist. This will usually be a neurologist or a geriatrician .
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Why Is Expert Care Important
Early expert care can help reduce PD complications. Findings show that 60 percent of people with Parkinson’s fall short of getting the expert care they need. The National Parkinson Foundation has estimated that about 6,400 people with Parkinson’s die unnecessarily each year due to poor care.
Trained neurologists will help you recognize, treat and manage the disease. Common approaches include medication, surgical treatment, lifestyle modifications , physical therapy, support groups, occupational therapy and speech therapy. The best approach is interdisciplinary care, where you are seen by multiple specialists on a regular basis and all of the specialists talk and arrange the best possible coordinated care. This is what is referred to as a patient-centric approach to Parkinson’s care.
Early Symptoms Of Parkinson’s Can Be Overlooked
Symptoms of Parkinson’s disease are divided into 2 groups: motor symptoms and non-motor symptoms.
Early non-motor symptoms can be subtle and it’s possible to overlook them as signs of Parkinson’s: for example, anxiety and depression, fatigue, loss of smell, speech problems, difficulty sleeping, erectile dysfunction, incontinence and constipation. Another sign of Parkinson’s is handwriting that becomes smaller.
Motor symptoms of Parkinson’s can include tremor , slowness of movement , muscle rigidity and instability .
It’s possible for non-motor symptoms to start occurring up to a decade before any motor symptoms emerge. Years can pass before symptoms are obvious enough to make a person to go to the doctor.
There’s no ‘one size fits all’ when it comes to Parkinson’s disease different people will experience different symptoms, and of varying severity. One in 3 people, for example, won’t experience tremor.
On average, 37 people are diagnosed with Parkinson’s every day in Australia. Parkinson’s Australia
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How Common Is Parkinson’s
About 1 in 500 people have Parkinsons. Most people develop it between 55 to 65 years of age.
- Parkinsons is most common in older people. About 1 in 100 people over the age of 60 are diagnosed with Parkinsons.
- Parkinsons in people younger than 60 years of age is known as early-onset Parkinsons. Of people diagnosed with Parkinsons, about 1 in 20 are younger than 40 years.
- In rare cases, Parkinsons-like symptoms can occur in children and teenagers. This is known as juvenile parkinsonism and is considered to be a separate condition to Parkinsons.
There is a very small increase in Parkinsons risk in people with family/whnau who have Parkinsons.
Stage Two Of Parkinsons Disease
Stage two is still considered early disease in PD, and it is characterized by symptoms on both sides of the body or at the midline without impairment to balance. Stage two may develop months or years after stage one.
Symptoms of PD in stage two may include the loss of facial expression on both sides of the face, decreased blinking, speech abnormalities, soft voice, monotone voice, fading volume after starting to speak loudly, slurring speech, stiffness or rigidity of the muscles in the trunk that may result in neck or back pain, stooped posture, and general slowness in all activities of daily living. However, at this stage the individual is still able to perform tasks of daily living.
Diagnosis may be easy at this stage if the patient has a tremor however, if stage one was missed and the only symptoms of stage two are slowness or lack of spontaneous movement, PD could be misinterpreted as only advancing age.
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