The initial signs of Parkinson's are often quite subtle; they include lack of facial expression, slow movement, and a tendency to speak softly and monotonously. Confusion of these symptoms with the signs of normal aging often contributes to underdiagnosis, misdiagnosis, and lack of treatment in the elderly. Diagnosing the condition is primarily a matter of clinical judgment and the process of elimination, since there's currently no unequivocal neurodiagnostic test.
Most symptoms involve some aberration of normal movement, resulting from the garbling of chemical signals between cells that happens when dopamine-producing cells die. Symptoms vary in kind and intensity from person to person and may grow progressively worse over a couple of decades. The common symptoms include:
Other possible symptoms include difficulty getting up from a seated position or turning over in bed; decrease in walking arm swing on one or both sides; mild dragging of one foot; disordered sleep, and constipation. Dementia frequently—though not always—develops as time goes on. Depression is often seen in people with Parkinson's, possibly a result of the loss of dopamine.
Developing an objective tool that would allow doctors to judge the severity of a patient's Parkinson's disease has been difficult. The classification most widely used to stage disease severity is the Hoehn and Yahr Scale. This system puts symptoms into five stages:
Last reviewed on 04/11/2006
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