Tuesday, July 16, 2024

Parkinson’s Disease Cardinal Signs

Trouble Moving Or Walking

Parkinson’s Disease [Part 1] | The 4 Cardinal Signs

Do you feel stiff in your body, arms or legs? Have others noticed that one or both of your arms doesnt swing like it used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of PD. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.

What is normal?

If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.

Stages Of Parkinsons Disease

Doctors use different rating scales to assess a patients case but the most commonly used is theHoehn and Yahrscale, which divides the symptoms into five stages.

Stage 1. Mild symptoms that affect only one side of the body and do not impair the daily life of a person.

Stage 2. Symptoms develop into secondary motor types and eventually affect both sides of the body. This stage evolves months or years after the first stage starts.

Stage 3. Symptoms compromise the daily activities of a person although he or she can still function independently when doing basic tasks like eating and bathing. Movement becomes considerably slow and a persons balance becomes compromised. At this stage, the symptoms are so marked that there is no doubt about the diagnosis of PD.

Stage 4. The patient may still manage certain activities like walking unassisted or with tools like walkers. However, the symptoms become so debilitating that the patient needs assistance with daily living.

Stage 5. The disease has become so advanced that the patient is usually confined to a bed or a wheelchair. This stage requires around-the-clock assistance and monitoring since the patient has a high risk of getting into an accident. This is especially needed if the patient develops hallucinations or dementia.

About 50% to 80% of those with Parkinsons eventually experience dementia as their disease progresses.

How to Prevent Parkinsons Disease

The Cardinal Symptoms Lead To Secondary Motor Symptoms Like:

  • Hypomimia Reduction in facial expressions or showing emotions on the face.
  • Dysarthria Weakened or difficulty in controlling the muscles used for speech like the tongue, larynx, and vocal cords.
  • Dysphagia Swallowing difficulties, including coughing or choking when a person eats or drinks.
  • Sialorrhoea Difficulty in controlling saliva secretion, which leads to excessive drooling.
  • Micrographia Abnormally small handwriting that results from the rigidity of the fingers or hands.
  • Festination Short, shuffling steps instead of normal strides that makes a person appear to be hurrying even though forward propulsion is slow.
  • Dystonia An involuntary or uncontrolled contraction of one muscle, a muscle group, or the whole body.
  • Glabellar reflexes Normally a person blinks when tapped lightly between the eyebrows then stops blinking when the tap is repeated several times, but a person with PD continues to blink so long as the tap is done.

A person may also exhibit non-motor symptoms like:

  • Sleep problems.

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Common Motor Symptoms That Require Management

  • Tremor is a prominent and early symptom of PD .
  • Slowness, or bradykinesia, a core feature of PD.
  • Rigidity is the third prominent feature on examination.
  • A combination of bradykinesia and rigidity leads to some other characteristic features of PD, such as micrographia.
  • The fourth prominent feature of PD is gait disturbance, although this is typically a late manifestation. Flexed posture, ataxia, reduced arm swing, festination, march-a-petits-pas, camptocormia, retropulsion, and turning en bloc are popular terms to describe the gait in PD. Gait disorder is not an early feature of PD but is frequently described as it is easy to recognize and cinches the diagnosis in later stages.

The rate of progression of the disease may be predicted based on the following:

  • Males who have postural instability of difficulty with gait.
  • Patients with older age at onset, dementia, and failure to respond to traditional dopaminergic medications tend to have early admission to nursing homes and diminished survival.
  • Individuals with just tremors at the initial presentation tend to have a protracted benign course.
  • Individuals diagnosed with the disease at older age combined with hypokinesia/rigidity tend to have a much more rapid progression of the disease.

The disorder: leads to disability of most patients within ten years has a mortality rate three times the normal population.

Parkinsonâs cannot yet be cured . A lot of financial and other resources are being expended on research to find a cure.

Stooping Or Hunching Over


Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of PD.

What is normal?

If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

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Tremors Can Be A Sign Of Parkinsons But Also Of More

Consumer Reports has no financial relationship with any advertisers on this site.

This article was written by Marvin M. Lipman, former chief medical adviser for Consumer Reports and clinical professor emeritus at New York Medical College.

I thought I had Parkinsons disease! the 65-year-old stock analyst exclaimed.

Over the past six months, her handwriting had deteriorated to the point that she was having difficulty signing checks. Because a good friend of hers had recently received a diagnosis of Parkinsons disease, she feared the worst.

I began to suspect that her concern was groundless when I noticed that both of her hands shook and that she had a barely noticeable to-and-fro motion of her head two signs that are uncommon in Parkinsons disease.

And as she walked toward the examining room, her gait was normal and her arms swung freely hardly the stiff, hesitant shuffle so often seen with Parkinsons.

The exam turned up none of the other cardinal manifestations of Parkinsons: the typical masklike facial expression the slowed, monotonous speech pattern and the ratchet-like sensation the examiner feels when alternately flexing and extending the patients arm.

Moreover, her hand tremors seemed to improve at rest and worsen when asked to do the finger to nose test.

The diagnosis was unmistakable: She had essential tremor, a nervous-system problem that causes unintentional shaking, most often starting in the hands.

What Treatments Are Available For Tremors

Of all Parkinsons disease symptoms, the effect of drug treatments on tremors are the most unpredictable.When starting Parkinsons medicine treatments, you and your family should not judge their effectiveness by decreased tremors, but the simplification of daily tasks.Some medication, such as anticholinergics and propranolol, can be specifically used to treat tremors. However, they are not recommended for the elderly.When tremors become too overwhelming, deep brain stimulation can be considered. This is the most effective and reliable treatment available for tremors.Some medications can make your tremors worse. Discuss this with your neurologist.

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What Medications And Treatments Are Used

Medication treatments for Parkinsons disease fall into two categories: Direct treatments and symptom treatments. Direct treatments target Parkinsons itself. Symptom treatments only treat certain effects of the disease.


Medications that treat Parkinsons disease do so in multiple ways. Because of that, drugs that do one or more of the following are most likely:

Several medications treat specific symptoms of Parkinson’s disease. Symptoms treated often include the following:

  • Erectile and sexual dysfunction.
  • Hallucinations and other psychosis symptoms.

Deep brain stimulation

In years past, surgery was an option to intentionally damage and scar a part of your brain that was malfunctioning because of Parkinsons disease. Today, that same effect is possible using deep-brain stimulation, which uses an implanted device to deliver a mild electrical current to those same areas.

The major advantage is that deep-brain stimulation is reversible, while intentional scarring damage is not. This treatment approach is almost always an option in later stages of Parkinson’s disease when levodopa therapy becomes less effective, and in people who have tremor that doesnt seem to respond to the usual medications.

Experimental treatments

Researchers are exploring other possible treatments that could help with Parkinsons disease. While these arent widely available, they do offer hope to people with this condition. Some of the experimental treatment approaches include:

What Is Parkinson’s Disease

Parkinson’s Disease (Shaking Palsy) – Clinical Presentation and Pathophysiology

Parkinson’s disease is a progressive disorder of the nervous system. Due to increased changes in heredity, men are more likely to develop Parkinson’s than women. The disease usually develops around age 60. Ongoing exposure to herbicides and pesticides may put an individual at a slightly increased risk.

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Is Parkinsons Disease Treated By A Neurologist

People with Parkinsons disease will usually require a team of healthcare professionals to help them manage the condition.

A neurologist, a doctor specializing in conditions of the brain and nervous system, will be one of the main people involved in treating Parkinsons.

Other healthcare professionals who may help treat Parkinsons can include:

  • a persons regular doctor
  • a physical therapist
  • a speech or occupational therapist
  • mental health professional
  • other specialists, such as a gastroenterologist, if people experience other symptoms of Parkinsons such as digestive issues

What Are The Stages Of Parkinsons

  • Stage 1 Symptoms are seen on one side of the body only.
  • Stage 2 Symptoms are seen on both sides of the body. There’s no impairment of balance.
  • Stage 3 Balance impairment has begun. In this mild to moderate stage of the disease, the person is still physically independent.
  • Stage 4 This stage is marked by severe disability. The person is still able to walk or stand unassisted but may need a walker to get around.
  • Stage 5 The person requires a wheelchair or is bedridden unless assisted in standing and walking.

Additional reporting by Ingrid Strauch.

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What Is Parkinsons Disease

Parkinsons Disease, sometimes called PD, is a disorder of the nervous system.

The brain has a substance called dopamine produced by the substantia nigra,found in the cells of the midbrain, the upper part of the brainstem. The disease targets and damages the cells of the substantia nigra. When the cells are reduced by 60 to 80 percent, a person starts to show symptoms of PD.

Since dopamine is a chemical that is vital for the smooth coordination of muscles and movement, a persons inability to properly do common activities like walking and writing are some of the initial symptoms of PD. Moreover, Parkinsons is a chronic and progressive disease, which means that its symptoms worsen as the illness develops.

Conflict Of Interest Statement

Safinamide  A New Therapeutic Option to Address Motor Symptoms and ...

EB has equity stake in Motac holding Ltd. and receives consultancy payments from Motac Neuroscience Ltd., companies which pre-clinical activity has no relationship with the present study.

The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Tremors In Parkinsons Disease: What They Are Types Of Tremors And More

Getting the trembling associated with Parkinsons under control can be a challenge, but treatments can help.

Don RaufJustin Laube, MDNicole Rerk/Shutterstock

Tremors are a defining characteristic of Parkinsons disease, affecting about 8 out of 10 people with this movement disorder. Many people think the involuntary shaking motion is the main problem for patients. While it is certainly an irritating symptom that individuals want to get under control, other characteristics of the disease can be more debilitating.

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What Are The Early Warning Signs Of Parkinson’s Disease

Parkinsons warning signs can be motor symptoms like slow movements, tremors or stiffness. However, they can also be non-motor symptoms. Many of the possible non-motor symptoms can appear years or even decades ahead of motor symptoms. However, non-motor symptoms can also be vague, making it difficult to connect them to Parkinson’s disease.

Non-motor symptoms that might be early warning signs include:

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What Lifestyle Changes May Help Reduce The Parkinsons Tremors

Doctors may advice certain lifestyle changes in order to manage the symptoms of Parkinsons disease and also the tremors associated with it. They may include-

Green Tea: Research shows that green tea may be beneficial in reducing tremors in Parkinsons disease. The patient may substitute his daily consumption of tea with green tea for increased benefits.

Reduce Meat: Patient with Parkinsons disease should limit his consumption of animal and plant protein of his daily diet.

Regular Activity: Exercising everyday may help with reduction of tremors and other symptoms like muscle stiffness in Parkinsons disease.

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Symptoms Of Parkinsons Tremor

Introduction to Parkinson’s Disease: The Cardinal Symptoms

Like most symptoms of Parkinsons disease, it is usually asymmetric. It starts generally on one side, which remains the more affected side forever. Having a tremor on one side does not mean that the other side will begin to shake as well. Many people have tremor on only one side throughout their illness.

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What Causes Parkinson’s

Generally. Generally Doctor’s are unaware of the cause.

Genetically. About 15-20% of Parkinson’s cases report having a relative with the disease, however researchers have found that people with an affected first-degree relative, have a 4-9% higher chance of developing Parkinson’s.

Chemically. In 2009, the Department of Veterans Affairs added Parkinson’s to a list of diseases possibly associated with exposure to Agent Orange. Another compound, a synthetic neurotoxin agent called MPTP can also cause immediate and permanent parkinsonism. This compound was discovered in the 1980s in those who injected themselves with a synthetic form of heroin contaminated with MPTP. Cases of this MPTP induced Parkinson’s are rare. A veteran who was exposed to this herbicide may have a strong case for a VA service connected compensation claim for benefits.

What Are The Symptoms

The best-known symptoms of Parkinsons disease involve loss of muscle control. However, experts now know that muscle control-related issues arent the only possible symptoms of Parkinsons disease.

Motor-related symptoms

Motor symptoms which means movement-related symptoms of Parkinsons disease include the following:

Additional motor symptoms can include:

  • Blinking less often than usual. This is also a symptom of reduced control of facial muscles.
  • Cramped or small handwriting. Known as micrographia, this happens because of muscle control problems.
  • Drooling. Another symptom that happens because of loss of facial muscle control.
  • Mask-like facial expression. Known as hypomimia, this means facial expressions change very little or not at all.
  • Trouble swallowing . This happens with reduced throat muscle control. It increases the risk of problems like pneumonia or choking.
  • Unusually soft speaking voice . This happens because of reduced muscle control in the throat and chest.

Non-motor symptoms

Several symptoms are possible that arent connected to movement and muscle control. In years past, experts believed non-motor symptoms were risk factors for this disease when seen before motor symptoms. However, theres a growing amount of evidence that these symptoms can appear in the earliest stages of the disease. That means these symptoms might be warning signs that start years or even decades before motor symptoms.

Non-motor symptoms include:

Stages of Parkinsons disease

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Walking Or Gait Difficulties

Bradykinesia and postural instability both contribute to walkingor gaitdifficulties in Parkinsons, particularly as the disease progresses. A common, early symptom of Parkinsons disease is a decrease in the natural swing of one or both arms when walking. Later, steps may become slow and small, and a shuffling gait may appear. Gait problems in Parkinsons disease can also include a tendency to propel forward with rapid, short steps . People with advanced Parkinsons disease may experience episodes of freezing, in which the feet appear to be glued to the floor.

What Are Some Signs Of Parkinson’s

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Tremors. Shaking can begin in a limb.

Slowed movement. Parkinson’s may reduce the ability to move and slow movement. Steps may become shorter when walking.

Rigid muscles. Muscle stiffness may occur in any part of the body and can cause pain. Impaired posture and balance. Posture may become stooped, balance problems may also result.

Loss of Automatic Movements. Decreased ability to perform unconscious movements including blinking, smiling or swinging arms while walking.

Speech Changes. One may start to speak softly, quickly, slur or even hesitate before talking. Speech may be more of a monotone rather than with the usual speech inflections.

Writing Changes. It may become hard to write or text size may become smaller.

Dementia. A person with Parkinson’s disease has 2-6 times the risk of exhibiting symptoms of dementia compared to the general population.

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Cardinal Signs And Symptoms

Cardinal signs and symptoms are specific even to the point of being pathognomonic. A cardinal sign or cardinal symptom can also refer to the major sign or symptom of a disease. Abnormal reflexes can indicate problems with the nervous system. Signs and symptoms are also applied to physiological states outside the context of disease, as for example when referring to the signs and symptoms of pregnancy, or the symptoms of dehydration. Sometimes a disease may be present without showing any signs or symptoms when it is known as being asymptomatic. The disorder may be discovered through tests including scans. An infection may be asymptomatic which may still be transmissible.

Elimination Of Other Conditions

Although no test can diagnose Parkinson’s disease itself, your doctor may order blood tests or imaging studies to rule out other possible causes of your symptoms.

Your doctor will want to know about any medications or recreational drugs you take, since some drugs can cause symptoms similar to those of Parkinson’s.

Parkinson’s disease doesn’t show up on radiological studies like X-ray, MRI , or CT scans.

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