There are innumerable minor, but nonetheless quite distressing, symptoms associated with Parkinson’s disease, with skin problems being one of them. Some of these skin problems may be due to the disease itself although drug therapy for Parkinson’s disease is often responsible. While the side effects of these medicines do cause significant distress at times, it is important to note that the drugs are essential in managing Parkinson’s disease and should not be stopped or changed without your doctor’s approval.
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Although tremor and rigidity are the typical symptoms of a patient with Parkinson’s disease, eye problems are quite common too, and are important because they can interfere with the quality of life of a person. When faced with eye disorders or vision problems in patients with Parkinson’s disease, it is important to bear in mind that some of these conditions may not be related to Parkinson’s. Old age, poor eyesight, complication from other chronic conditions, like diabetes, may impact on the eyesight in any person, even when Parkinson’s disease is not present.
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Speech problem or difficulty in speaking (dysarthria) is one of the most common symptoms that develop in a patient with Parkinson’s disease besides the major symptoms such as tremor, rigidity, slowness of movement and loss of postural reflexes. It is estimated that about 60 to 90 percent of patients with Parkinson’s disease have difficulty with their speech, which may take various forms such as a soft, monotonous, or slurred speech, speaking too fast or repeating words, or sometimes hesitating before speaking. Problems with speech can be due to reduced movement of the muscles involved in breathing, talking and voice intonation as a result of Parkinson’s disease.
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Urinary disturbance or problems with urination is a common, though late, feature of Parkinson’s disease and may be the cause of much embarrassment to the patient. The main function of the bladder is to store urine and then empty it at a suitable time and place but due to degenerative changes in the basal ganglia in Parkinson’s disease, there is interference with the nerve signals responsible for bladder control, resulting in an overactive or irritable bladder. This causes symptoms of urinary dysfunction such as frequency of micturition, urgency, urinary incontinence, and incomplete emptying of the bladder.
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Although insomnia may not be the most debilitating of complaints in patients suffering from Parkinson’s disease, it can nonetheless cause much distress in Parkinson’s patients and the symptoms often aggravate as the disease progresses. Insomnia is the inability to get a good night’s sleep and may be due to :
- Sleep onset problem where the patient has difficulty in going off to sleep even though he/she may be extremely tired. This is most often associated with depression or anxiety states.
- Sleep maintenance difficulty where the patient goes off to sleep easily but wakes up frequently at night. This problem is faced very frequently by Parkinson’s disease patients and they may have abrupt and agitated arousal more than five times at night. This leads to tiredness and excessive daytime sleepiness.
- Excessive daytime sleepiness is caused by inability to sleep properly at night, most often due to waking up several times at night. Dopaminergic medication as part of Parkinson’s drug therapy also contributes to daytime sleepiness in Parkinson’s disease patients.
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What is Tremor?
Tremor is the involuntary or unintentional rhythmic movement of one or more parts of the body and it may involve the hands, arms, legs, face, head, trunk, or vocal cords. It may be caused by a number of factors such as neurological disorders due to various causes with Parkinson’s disease being one of them as well as certain drugs, alcohol abuse or withdrawal, mercury poisoning, hyperthyroidism, or liver failure. Certain types of tremors may be inherited and are seen to run in families, but for which no known cause can be found, and these are called essential tremors.
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Bradykinesia is a Greek term meaning “slow movement” and was first coined by James Parkinson, after whom the disease has been named, as one of the cardinal features of Parkinson’s disease. However, it is now recognized that bradykinesia is not exclusive to Parkinson’s disease since it may be a manifestation of other neurological disorders or as a side effect of certain medications.
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A patient with Parkinson’s disease has to contend with major signs and symptoms, such as tremor, rigidity, slowness of movement, and postural disturbances, but sometimes minor problems, such as mouth ulcers can, cause much distress. It is important that care givers treat even these minor ailments with care and concern as a Parkinson’s patient is scared and concerned of even the slightest physical problem. A Parkinson’s patient may be educated about the disease but nevertheless, even unrelated signs and symptoms can be distressing and upsetting for them.
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Constipation is a frequent complaint of patients suffering with Parkinson’s disease, especially those being treated with anticholinergic medicines, but it may be treated quite effectively with change in medications, proper dietary fiber intake and lifestyle measure.When there is difficulty in passing stool, or when the interval between passing stools is lengthened beyond three days, a person may be said to be suffering from constipation.
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Since there is no definite diagnostic test to confirm the diagnosis of Parkinson’s disease, only proper history taking and examination of the patient for specific signs and symptoms can lead to diagnosis. The typical features of tremor, rigidity, bradykinesia (slowness of movement) and loss of postural reflex which is present in Parkinson’s disease is also a feature of certain other diseases, so tests may need to be done to rule out these other disorders. New tests are constantly being developed for quicker and more conclusive diagnosis of Parkinson’s disease but currently, final diagnosis is widely based on that of the practitioner’s findings and discretion.
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