Parkinson's disease history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Common symptoms
The main clinical manifestations of Parkinson disease include tremor, rigidity and bradykinesia. Later in the course of the disease patient can have postural instability.(6 ta 10) Some studies suggest that there can be three clinical subtypes for Parkinson disease: Tremor dominant, akinetic-rigid and postural instability and gait difficulty(28 ta 30)but other studies demonstrate that clinical course of the disease can be variable and this subtypes can switch to each other through time.(37_38)
Motor symptoms
Tremor: Tremor is the most common symptom in Parkinson disease and can be the presenting sign in 70 to 80 percent of patients.(16_17) This symptom starts unilaterally mostly in hand and then progress to the other side of the body. It can also involve legs, jaw, lips and tongue.(22_15_23) PD tremor frequency is 3 to 7 Hz.(15) There is a symptom called re-emergent tremor in some of the PD patients. It manifests by postural tremor that starts after several seconds and can make it difficult to differentiate PD from essential tremor.(11_12_13)
Rigidity: Rigidity in PD in very common and can be seen in 75 to 90 percent of patients.(16ta 20) It commonly starts in the same side as the tremor. PD patients have increased resistance to passive movement of their joint and sometimes it’s known as cogwheel rigidity because of the ratchety pattern of resistance and relaxation. Some evidences suggest that superimposition of tremor on increased muscle tone creates this kind of rigidity.(22_24_25)
Bradykinesia: Bradykinesia or slowness of movement, is seen in 80 percent of PD patients.(17) the manifestation of this symptom in legs can be seen as dragging the legs, shorter steps and difficulty with standing up from a chair.(1)
Postural instability: Gait and postural problems can be the main cause of disability in PD patients and commonly doesn’t response well to dopaminergic treatment.(26_27)