Parkinsons Disease is a chronic, progressive, neuromuscular condition. It is caused by changes in the basal ganglia of the brain, which manifest as disturbances of motor function distinguished by the slowing and weakening of voluntary movement, including those expressing emotion.
Parkinsons Disease displays three principal characteristics, or symptoms: rigidity, brakykinesia and tremor.
Rigidity
Rigidity is caused by increased muscle tone. It often affects one hand initially, progressing to one side of the body, then the other side, and finally the neck and trunk. Rigidity become more pronounced as the condition progresses and it also increases with anxiety and concentration. If the facial muscles are affected the individual develops a mask-like, fixed expression with staring eyes; to the lay person, this may be the most striking symptom of Parkinsons Disease. In addition, handwriting may become very small and tremulous.
Bradykinesia
Bradykinesia is a slowness and poverty of voluntary movement. This slowness results from muscle weakness and fatigue and is, perhaps, the most disabling feature of the disease. Difficulty in initiating movement will frequently cause a delay between a stimulus, such as a request to sit down, and the subsequent response. The mobility problems caused by bradykinesia include difficulties in rising from a bed or chair and in getting into or out of the bath. An interesting feature is the fact that once movement is initiated the person has less difficulty climbing a flight of stairs than walking on level ground.
Tremor
Tremor is present when the person is at rest, though not when they are asleep. It is inhibited by movement (which differs from the tremor in multiple sclerosis, where tremor starts with the intention to move). It begins on one side and spreads to both sides over time.
Sensory Loss and the intellect
In spite of the above symptoms there is no sensory loss associated with Parkinsons. The person who has the disease may often be cold because the immobility enforced by the condition makes the circulation system less responsive to temperature changes. Parkinsons Disease does not normally affect the intellect, but it can slow mental processes. In addition studies have shown that approximately a third of elderly people with the disease have some form of dementia. Other effects may include depression, which is caused by the undermining of self-confidence brought on by the effects of the condition.
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