Features
PARKINSON'S DISEASE
Parkinson’s Disease (PD) is a common disease. It’s a degenerative disorder of the central nervous system first described by James Parkinson in 1817.
CLINICAL FEATURES.
A tetrad of hypo- and bradykinesia(slowness), resting tremor, postural instability(imbalance), and rigidity(stiffness) are the core features of Parkinson disease. These are evident as expressionless face, poverty and slowness of voluntary movement, “resting” tremor, stooped posture, axial instability, rigidity, and festinating gait.
1
Tremor
The characteristic tremor, which usually involves a hand, is often listed as the initial sign. In 20 to 25 percent of cases the tremor is mild and intermittent or evident in only one finger or one hand not used in voluntary movement (hence the term resting tremor).
One side of the body is typically involved before the other, and the classic tremor then remains asymmetrical as the illness advances.
Rigidity
Rigidity and hypertonous may not be important early findings. These features tend to appear in the more advanced stages of the disease. Once rigidity develops, it is constantly present, and sometimes associated with cog wheel phenomenon.
Bradykinesia
Bradykinesia refers to slowness in both the initiation and execution of movement. The quality of volitional and postural movements are affected. The patient is slow and ineffective in attempts to deliver a quick hard blow; he cannot complete a quick (ballistic) movement.
Alternating movements, at first successful, if repeated become progressively impeded and finally are blocked completely.
shortterm
Initial symptoms in patients with Parkinson disease
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Tremor 70%
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Gait disturbance 11%
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Stiffness 10%
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Slowness 10%
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Muscle aches 8%
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Loss of dexterity 7%
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Handwriting disturbance 5%
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Depression, nervousness, other psychiatric disturbance 4%
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Speech disturbance 3%
SCALES USED BY THE CLINICIANS TO GAUGE THE PROGRESSION OF THE DISEASE
Modified Hoehn and Yahr scale
Hoehn and Yahr stages follow a simple rating scale, first introduced in 1967. Clinicians use it to describe how motor symptoms progress in Parkinson’s Disease.
On this scale, 1 and 2 represent early-stage, 2 and 3 mid-stage, and 4 and 5 advanced stage Parkinson’s.
Stage One
During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. Changes in posture, walking and facial expressions occur.
Stage Two
Symptoms start getting worse. Tremor, rigidity and other movement symptoms affect both sides of the body. Walking problems and poor posture may be apparent. The person is still able to live alone, but daily tasks are more difficult and lengthy.
Stage Three
Considered mid-stage, loss of balance and slowness of movements are hallmarks. Falls are more common. The person is still fully independent, but symptoms significantly impair activities such as dressing and eating
Stage Four
At this point, symptoms are sever and limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and is unable to live alone.
Stage Four
At this point, symptoms are sever and limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and is unable to live alone.
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