The symptoms of Parkinson’s disease usually develop very slowly and are often assumed to be part of the normal process of ageing. At the beginning, they seem to occur on only one side of the body. Ultimately, however, both sides are usually affected.
Most noticeable is the trembling of the hands, which shake in a ‘pin-rolling’ tremor as if the person is rolling something between his fingers and thumb. It is most evident when the arm is inactive, for the shaking usually stops as soon as movement begins — when reaching for a cup, for example.
The muscles with the disease become unusually stiff. In the early stages it causes aching shoulders and discomfort first thing in the morning, after hours of rest. The face is also less mobile than usual, which gives the person a ‘dead-pan’ expression.
Walking is also very difficult. After a hesitant start, a person with Parkinson’s disease moves forward quickly in a shuffling manner. He takes small steps and leans forward in a stoop. This difficulty in walking can sometimes lead to severe falls if the usual automatic reaction of using the hands to break the fall is also impaired — as is often the case.
Initially the intellect is not affected, but after some years the patient may gradually lose the ability to perform higher mental tasks. In this advanced stage of the disease every physical movement becomes increasingly difficult. Yet, curiously, many instances have been recorded of a person with Parkinson’s disease being impelled to act very quickly — running away from a fire, for example.
The disease is accompanied by a drop in blood pressure when the patient stands up, which results in fainting, and by slurred and distorted speech, caused by damage to the relevant muscles.
Progressive symptoms
• Limbs become stiff, causing aching joints
• Face becomes immobile
• Limbs stiffen further, starting movements difficult
• Gait becomes small-stepped and stooping
• Reduction in sweating or increased occurrence of greasy face, due to abnormal working of sweat glands
• Feelings of taiçltness accompany standing
• Walking becomes difficult because of stiffness
• Hands tremble almost constantly when inactive
• Fingers increasingly affected by slight tremor