What are the major symptoms of Parkinson’s disease? In what ways individuals should take precautions?

Parkinson’s disease is a neurodegenerative disorder characterized by progressive deterioration of mobility. It results in significant disability and takes a toll on the caregivers. The symptoms start slowly. Initially it maybe barely visible, starting as subtle tremors on one side of the body. There is slowness on one side of the body along with stiffness. Stiffness is due to rigidity which is due to increased tone of the muscles.

There is also postural instability which can cause tendency to fall. There is reduced arm swing. Speech becomes soft with low volume. It usually develops after the age of 60. In about 10% of the patients develop Parkinson’s before the age of 50. This is called as young onset Parkinsonism. It is usually genetic.

Symptoms of Parkinson’s disease is due to neurotransmitter abnormality in a part of the brain called basal ganglia. This is a part of the brain which controls movement. Neurons of the basal ganglia produces dopamine. There is progressive degeneration of these neurons. An abnormal protein accumulates in the brain called as Lewy bodies.

Symptoms of Parkinson’s Disease-Symptoms usually start on one side and gradually involves both sides. Symptoms of Parkinson’s disease can be remembered by the mnemonic TRAP (Tremor, Rigidity, Akinesia and Postural instability)

1. Tremor- There is rhythmic shaking of the hands. The classical tremor of Parkinson’s disease is characterized by shaking of the thumb and index finger called a pill rolling tremors. This is present predominantly at rest.
2. Rigidity- This is characterized by increased tone in the muscles. This causes stiffness of the limbs. The patient may experience pain the limbs and around the shoulder due to this.
3. Akinesia or bradykinesia – This is characterized by slowness of movements. It usually starts on one side of the body. Caregivers notice decreased arm swing on one side of the body. There is also slowness of walking, patients walk in a short shuffling manner. There is difficulty in wearing footwear. Patients find it difficult to get up from sitting position.
4. Postural instability- This causes tendency to fall especially while turning around. Patients develop a stooped posture while walking.
5. Changes in speech and writing-speech becomes soft or low volume. Patients speak monotonously. In advanced stages patients may develop difficulty in swallowing. They may have difficulty in swallowing their own saliva which results in drooling of saliva. Writing becomes affected. The handwritten letters become smaller; patients may have difficulty in signing their signature.

What are the precautions that can be taken?

Regular exercise helps in reducing the risk of Parkinson’s disease. This should include aerobic activity, strength training and balance training. Regular exercise helps in improving balance and coordination.

Eating a healthy diet – Healthy diet helps in improving our overall health. Eating whole foods like fruits and vegetables along with legumes and whole grains is important. Balanced amount of Omega3 and omega 6 fatty acids is important. Foods containing antioxidants like purple grapes, blueberries, strawberries, dark green vegetables like broccoli and spinach. Fish is an important source of omega 3 fatty acids. Getting enough Vitamin D and avoiding caffeine may help.

In today’s world avoiding stress and getting enough sleep is very important. Stress helps in reducing inflammation which helps in reducing the risk of Parkinson’s. Sleep helps in clearing unwanted proteins which may get deposited leading to neurodegeneration.
Healthy food, regular exercise along with regular medications can help in controlling Parkinsonism.

Dr. Rohit Pai, Consultant Neurology, KMC Hospital, Mangaluru