Parkinson's disease (PD) was first described by Dr. James Parkinson in a book entitled, "An Essay on the Shaking
Palsy", that was published in 1817. The condition was known popularly as the shaking palsy; and, in the book, he
describes a set of symptoms that bear his name to this day. Parkinson's Disease is a disorder affecting the central
nervous system. It is slowly progressive with increasing severity of symptoms. It is chronic, acting sometimes
over decades. It is idiopathic, with no proven cause. PD is not contagious and cannot be passed from one person
to another by casual or intimate contact.
Parkinson's affects all ages; most patients are over 50 years of
age. There are more patients that are diagnosed at 60 years of age than any other age -- in other words, it affects
about 1 in 100 Americans. Young Onset is a widely accepted term for those diagnosed before age 50. These cases
comprise about 20% of all Parkinson's diagnoses and of that percentage 5%-10% of those are diagnosed prior to age 40.
An estimated 1.5 million people in the United States have Pd. It affects more persons than those diagnosed with
MS (multiple sclerosis), amytrophic lateral sclerosis (ALS, or Lou Gehrig's disease), muscular dystrophy, and myasthenia
gravis combined.
Getting an accurate count of the number of people living with PD is very difficult. Many
people in early stages of the illness assume that their symptoms are the result of normal aging or other health problems,
such as arthritis. Early Parkinson symptoms are subtle and may even come and go. Often it is the spouse or other
relative who first notices slight problems with a loved one's movements. The diagnosis is sometimes very difficult
and uncertain because other conditions have symptoms that mimic those of PD. It is so important to see a neurologist
who is knowledgeable about movement disorders such as Parkinson's Disease to confirm the diagnosis and address concerns
of the patient and family.
Parkinson's Disease affects men and women in almost equal numbers. It knows
no social ethnic, economic, or geographic boundaries. There are some studies that have shown that African-American and
Asians are less likely than Caucasians to develop PD, although the reasons for this are not yet clear.
We do not
understand the cause of, nor is there currently a cure for, PD.
About PD - Symptoms
There are four main symptoms of PD, also called motor symptoms, are tremor, bradykinesia, rigidity and postural instability.
Tremor is present in appximately 70% of patients with PD. Patients with a tremor in a hand or foot while at
rest (resting tremor), usually have a more slowly progressing course of illness than those without tremor. Parkinson
tremor has a characteristic appearance, taking the form of a "pill-rolling" movement between the thumb and forefinger.
Tremor usually begins in one hand, although sometimes a foot or the jaw is affected first. A tremor is most obvious
when the affected limb is at rest or when a person is under stress. In three out of four patients, the tremor affects
only one side of the body, especially during early stages of the disease. Tremor usually disappears during sleep or
lessens with intentional movement, such as reaching out to shake hands or gripping a steering wheel. Fatigue, stress
or intense emotions may temporarily worsen the tremor.
Bradykinesia which is a profound slowness of movement and
loss of spontaneous, automatic movement, is often the most disabling symptom of Parkinson's Disease. It is particularly
frustrating because it can interfere with daily activities and is very often unpredictable. One moment the patient can
move easily, while in the next moment, they may need help.
Rigidity is very seldom the main symptom early in PD
but is experienced as a stiffness of the arms or legs beyond what would result from normal aging or arthritic changes.
Some patients have rigidity of the trunk area that may be present. Some patients refer to rigidity as "tightness"
in their limbs.
Postural instability , or impaired balance, causes patients to develop a forward or backward lean
and to fall easily.
As PD is a progressive disease, these symptoms become more pronounced. Walking, talking,
or completing simple tasks become more difficult. In more progressive states, assistance is needed to perform daily
functions. Some secondary symptoms may include micrographia (small, cramped handwriting), sleep disturbances, depression,
speech impairments, sexual difficulties, changes in personality, and dementia.
About PD - Causes