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Parkinson's: 11 Symptoms Beyond Tremor

Parkinson's: 11 Symptoms Beyond Tremor

When you think of Parkinson's disease, old man whose hands shake when standing still. And although this is one of the most important symptoms in the description of the disease, it is not the only and much less present in all patients. "Between 30 and 40% of parkinsonians do not have this symptom," explains neurologist William Rezende do Carmo, a specialist in Parkinson's, sleep and sleep disorders.

Knowing comorbidities is important to get along better with the picture and with whom. "often the family member himself can not understand the patient's comorbidities, thinks that his grandfather or his father is lazy, he stands very still, does not want to stand up, talks quietly, as if they were questions related to his will," explains the neurologist Henrique Ballalai, associate professor of the Department of Neurology and Neurosurgery at the Federal University of São Paulo (Unifesp).

Therefore, the following are the most common symptoms of Parkinson's:

Motor symptoms

Beyond of tremor during rest, which does not necessarily occur only in the hands, Parkinson's is described with the appearance of other motor signals, such as:

  • Muscle stiffness: muscles become harder and can even is getting painful
  • Akiniasis or brandy: is a specific condition of Parkinson's in which movements become slow but without losing strength
  • Change in posture and balance: the patient may present a mild tilt, walking difficulties, and a higher risk of falls.

These are the motor symptoms, also called cardinal, that determine the diagnosis, even with the next symptoms, sometimes appearing earlier. "Today it is mandatory for the patient to present the motor symptoms to beat the diagnosis hammer, but if we develop any specific Parkinson's test we can diagnose it early," says Ballalai.

Reduction of smell

Symptom known recently time, even today it is used as a diagnostic differential for Parkinson's, since even the motor symptoms can confuse this with other diseases.

"It is not known for sure why, but the degenerative process of Parkinson's also affects the cells which connect the nose to the brain, which affects not only the sense of smell but also the taste, "says neurologist Ballalai.

But this perception is not always felt by the patient. "The process is very gradual, so the patient loses that sensation so slowly that he gets used to it," explains neurologist Rezende do Carmo.

Constipation

Parkinson's can affect the autonomic nervous system responsible for the body's functions are performed automatically, without us being aware - like breathing or blinking.

This also interferes with the mobility of the gut, which can bring the famous constipation. In addition, constipation can also be aggravated by the medications used in the treatment.

The care in this case is the same as for any type of constipation: changes in food, such as fiber and water. "The most important thing here is the doctor's look, because if the Parkinsonian patient reports this difficulty, the doctor can help more effectively," says neurologist Henrique Ballallai.

Sleep Disorders

A person with Parkinson's may having a series of sleep disorders such as insomnia (early or late at night), restless legs syndrome, nocturia (need to pee at night often), sleep apnea, etc. As a consequence, the patient does not sleep well . "And when we think about the causes of these problems, especially in insomnia, there is the possibility that the motor symptoms themselves are responsible for the awakening or micro-awakening ( those that are not noticeable, but cut the sleep cycle) throughout the night.

"Many times the tremors or the night immobility associated with an uncomfortable position can lead to the interruption of the sleep", clarifies the expert. In these cases, medicines that improve the motor part also help sleep.

Dementia

Parkinson's disease is linked to the reduction of dopamine, the brain's chemical that nerve cells use to help control muscle movements. Parkinson's occurs when the nerve cells in the brain that produce this substance are slowly and progressively destroyed. These cells are deposited in the substantia nigra.

However, it is now known that this condition also affects other neurons, so the symptoms of dementia occur in more advanced conditions.

"This degeneration occurs mainly in the outer part of the brain, the cerebral cortex, "explains Ballalai.

Thus, with the advancement of the condition, Parkinson's may exhibit hallucinations, forgetfulness and even loss of autonomy. Many times, however, as the patient is old, this characteristic of Parkinson's is confused with other types of dementias, such as Alzheimer's.

Depression and anxiety

Dopamine (or, in this case, its absence) does not only interfere with the movements of the patient. It, like serotonin, is linked to our mood. Low levels of dopamine in the body can cause symptoms of depression, anxiety, pessimism and irrationality. "These are the problems that initially take the patient's welfare even more," says the neurologist Rezende do Carmo.

In these cases it is important to follow a specialized treatment, which can ask for antidepressant medications and even follow a psychiatrist.

Urinary incontinence and erectile dysfunction

In cases where Parkinson's affects the autonomic nervous system, the patient's urologic functions may be impaired. "This system regulates the entry of blood into the penis and the functioning of the bladder sphincter, among other functions." When it is impaired, it can lead to problems such as urinary incontinence and erectile dysfunction, "says Ballalai.


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