Symptoms tend to appear gradually, normally in just one side of the body at first, although both sides will be affected as Parkinson's progresses. Each person will encounter different symptoms, in terms of severity and rate of progression, and there may be fluctuations from day to day, with 'good' and 'bad' days being experienced.
The three main physical, motor-symptoms are:
Balance and posture can deteriorate as Parkinson’s progresses, resulting in problems with walking, turning around, rolling over in bed, and transfers, such as getting in and out of a chair or bed. Postural imbalance is therefore sometimes quoted as the fourth main symptom.
Communication difficulties are also common. Speech, facial expressions, body language and handwriting are affected in many people. Facial expression and body language are very important as they reveal emotions; people with Parkinson’s can be misunderstood because changes in facial expression are slow and limited, and body language is considerably diminished. Some people with Parkinson's say they can’t show on the outside how they feel on the inside.
Other symptoms include sleep disturbances, depression and anxiety, pain, and fatigue. Swallowing and memory problems may also occur in the later stages of the condition.
Progression is usually very gradual. Many people believe they had Parkinson's for some time - often two to three years - before seeking a formal diagnosis. Often it is only when the symptoms become noticeable or begin interfering with daily activities that a visit to the doctor is prompted.
Symptoms and responses to treatment are different for each individual, so it is not possible to accurately predict progression. For some it may take many years for the condition to develop, for others it may take less time.
Since its launch in Mumbai in 2003, The Global Declaration for Parkinson's Disease has received the support and signatures from around the world, including:
Because Parkinson's has symptoms similar to a number of other neurological disorders, and because every case is unique, it is not always easy to diagnose the condition.
A specialist doctor or neurologist will look for two or more of the main three symptoms (tremor, rigidity and slowness of movement/bradykinesia) and the way in which these symptoms have developed. Then, your general medical history will be discussed and a clinical examination made before any diagnosis is given. Sometimes it may take several examinations over a period of time before the diagnosis can be made confidently.
Although the brain is affected, a brain scan is not usually able to positively confirm a diagnosis of Parkinson's. Some scans can be used to eliminate other disorders that cause similar symptoms, but a confirmed diagnosis of Parkinson's disease relies on observation of symptoms and a physical examination.
'Parkinsonism' is an umbrella term used to describe various conditions that all have tremor, rigidity and slowness of movement as their main symptoms. The most common form of 'Parkinsonism' is Parkinson's, but other conditions such as Multiple System Atrophy (MSA), Vascular Parkinsonism and Progressive Supranuclear Palsy (PSP) also exist.
Whilst treatment is constantly improving, researchers have not yet been able to find a way to prevent or cure Parkinson's. But the symptoms can be effectively controlled, often using a combination of the following:
There is no single, optimal treatment because the condition affects each individual differently. You will need to work with your doctor to find the right balance of treatments for your specific symptoms. Regular reviews will be required and adjustments made as symptoms alter.
Although the condition wasn’t called Parkinson's until the 19th century, it has been known for hundreds of years. In the ancient Indian medical system of Ayurveda it was called ‘Kampavata’.
Many different professionals will be able help you. Your ‘Multi-disciplinary Team’ includes a wide range of professionals – some who will help you now, others later on. But your most regular contacts will be your family doctor and a doctor with a special interest in Parkinson’s. They will check your symptoms, prescribe and adjust medication when necessary and give general advice on day-to-day living with Parkinson's. It is important to have a good relationship with them, so you feel comfortable discussing any problems.
The multidisciplinary team is the group of professionals who will be able to provide a complete programme of care that should tend to all your current and future needs. For example, dieticians will help you to eat the right foods to keep healthy, pharmacists will offer advice on taking your medication, and physiotherapists can help you to stay active.
See also section on The Multidisciplinary Team.
Ask your doctor about the services each of these professionals provide and don’t be afraid to request a referral if you think they will help your specific needs.
Launched on 11 April 1997, the World Charter for people with Parkinson's disease has received the support and signatures of influential people from around the world, including:
See also Multiple Focal Points on Parkinson's Disease video.