Parkinson's Disease Signs and Symptoms

May range from a minor flu-like illness to a severe liver disease ending in hepatic failure and death; there are

usually several distinct stages:

Cogwheel rigidity

This describes the rachet-like catches that occur when a sufferer's arm is put through passive movements. It is

due to the hypertonia of muscles that equally affects opposing muscles.

Lead-pipe rigidity

This describes another possible presentation of the muscle rigidity and is a general resistance to movement. With either muscle rigidity, there may be pain, cramping and decreased strength. However, the patient retains normal sensation and reflexes in the limbs. The patient's writing becomes small and hard to read.

Bradykinesia

The patient exhibits a general slowing of all voluntary movements.

Akinesia

The  patient  exhibits  a  paucity or even an absence of spontaneous movements associated with the typical

animations of a normal individual.

Festinating gait

This term describes the patient's difficult process for initiating walking from a standing position. The patient takes several small, awkward steps and then breaks into a jog or run to prevent himself from falling. The typical patient pose during walking includes small, shuffling steps often dragging the feet, a slightly bent over posture, and having the arms in 90 degree flexion and held tightly at his sides.

Propulsion of Retropulsion

This describes the patient who falls forward or backward, respectively, upon being pushed.

Fixed facial mien

The typical facial expression of the Parkinson patient is one of a fixed, immobile nature, with a monotonous voice.

There may be drooling at the corners of the mouth. The eyes stare and do not blink as often as normal.

Resting tremor

This is the classic tremor of the Parkinson patients. It occurs during rest, and is described as a pill-rolling of the fingers with the hand bent in flexion. It is often unilateral, but may become bilateral. Although it is most pronounced in the hands, it is also seen in the legs, lips, tongue, and eyelids (when they are firmly closed). The tremor disappears upon voluntary movement and during sleep. It worsens with fatigue, emotional stress and embarrassment, and many patients will try to hide the affected hand by keeping it in their pocket, or by covering

it with their unaffected hand during the interview.

Depression

About half of Parkinson patients present with or will develop depression.