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Understanding the Faces of Parkinson’s Disease

April is Parkinson’s Awareness Month, and its purpose is to help people become aware of this disease and its symptoms. 

Parkinson’s Disease was first discovered by a physician by the name of James Parkinson.  The red tulip is used as the symbol highlighting the uniquely personal effects of this disease and the way it progresses differently in each person.  The uncertainty of this progression can be difficult, as individual patients can manifest different symptoms at varying rates of severity during the person’s unique disease cycle.

What is Parkinson’s Disease?

It is a brain disorder that can result in uncontrollable and unintended movements.  Its root cause is the loss of nerve cells in the substantia nigra, the part of the brain that controls movement. 

Parkinson’s causes a loss of dopamine, a brain chemical responsible for feelings of satisfaction, pleasure, and motivation.  When dopamine has been depleted, it causes patients to experience trouble with movement, suffer from muscle cramps and stiffness, as well as develop feelings of sadness. 

Sixty thousand new cases of Parkinson’s Disease are diagnosed each year, mostly in persons over the age of 55.

Early Symptoms of Parkinson’s Disease

At the beginning of this disease, you may notice in yourself, or in a loved one, some minor symptoms.  It begins slowly, becoming progressively worse over time.  Some early symptoms may include mild shaking or tremors, difficulty with movement, and a change in posture or balance. As these are noticed, it is a good idea to consult your physician right away.

Five Stages of Parkinson’s Disease

According to the Hoehn & Yahr Scale, there are five stages of progression with this disease.  Of course, as every person progresses differently, this scale is only a guide to general disease progression.

1. A Change in Habits.  This is the introductory stage that includes things such as issues with movement that can include tremors or shaking.  Changes in facial expression and the ability to show emotion in the face are also possible with disease progression. These symptoms may only affect one side of the body at first.  People in this stage are still independent, and daily life is only slightly impaired.  This stage can last for a period of time or can progress quickly.
2. Stiffness and Problems with Posture.  This is the moderate stage, where the patient may see a worsening in tremors.  Speech can be affected, with symptoms that may be seen on both sides of the body. A stooped appearance may become common in this stage. Patients can still experience a high level of function and independence as friends and loved ones begin to notice these symptoms.
3. Reflex and Balance Problems.  This is similar to stage two but involves greater reflex and balance issues, which can include frequent falls. Stage-three patients may still be relatively independent. Patients can benefit from support to accommodate the lifestyle changes to help them cope.
4. Motor Skills.  In this stage, daily tasks become more difficult to perform.  Some patients may be unable to stand or walk without assistance.  At this stage, patients may no longer be able to live alone, or will need devices, such as walkers, to assist with mobility. 
5. Stiffness.  In this final stage, stiffness becomes severe, making it very difficult or even impossible to stand or walk.  A wheelchair for mobility, along with supervised assistance with daily living becomes increasingly necessary.  More severe forms of dementia can be seen and may result in delusions, hallucinations, and confusion.

Diagnosis

A physician, or neurologist, must be consulted for a proper diagnosis.  The first clues could include the presence of early symptoms such as small tremors, balance, or posture issues. 

Physicians work to rule out symptoms associated with other neurological diseases.  Initial questions will be asked about any history of tranquilizer use, head trauma, or stroke.  A CT scan, or an MRI, may be performed to detect abnormalities in the brain.  

After the primary diagnosis, testing for responsiveness to Parkinson’s medication can be completed.  Some of the activities physicians may perform to determine symptoms include:

• Observing the arms and legs at rest for signs of tremors.  When muscles are flexed, the tremors may disappear.
• Observing the face for signs of animation and tremors.  Patients may lose the ability to show emotion in the facial area.
• Move the neck to check for stiffness or pain.
• Observe the patient standing up from a seated position.
• Have the patient walk down the hall to observe gait.
• Pull patient backwards and/or forward to observe balance.
• Check for how quickly balance is regained from a stumble.

Medical Treatment

Medication to relieve symptoms, and to restore chemical balance in the brain, is often administered.  Surgery is another option where it can be performed on the deep brain structures involved with motion control. 

Prevention and Steps to Avoid Progression

There is no guarantee that a person may or may not get Parkinson’s Disease; nor is there a guarantee that progression can be avoided once diagnosed.  But here are some steps that can be practiced to support your health and safety.

• Reduce inflammation through diet.
• Avoid environmental toxins.
• Avoid stress.
• Keep up with daily activities.
• Exercise daily.  Chair exercises for seniors are great.
• Simplify the daily routine.
• Stay positive.
• Make easy changes:
  • Remove throw rugs to prevent falls.
  • Install grab bars in bathroom, particularly the areas around the tub and toilet.
  • Consume a high-fiber diet, including fruits and vegetables, and consume foods high in Omega-3 fatty acids.
  • Drink plenty of liquids, especially water.

No one knows the path this illness will take for any individual.  However, awareness and education on Parkinson’s can empower you to make the best possible choices, be an advocate for yourself or your loved one, and maybe even limit the progression and direction of the disease. To observe Parkinson’s Awareness Month this April, you can:

1. Attend a local event to support families such as a barbeque, walk, or fund-raising event.
2. Support others on social media using the hashtag #parkinsonsawareness to help increase awareness.
3. Visit the neurologist.  Stop putting off a visit that can help—it’s better to be safe than sorry.

As you become aware of Parkinson’s Disease and its many faces, please offer support and care for those who are living with this disease and walking this path.

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