Clinical Manifestations of Parkinson's Disease

Parkinson's Disease clinical Manifestations
1. Motoric symptoms

a. Tremor
       Symptoms of Parkinson's disease often escapes ordinary sight, and seen as a normal thing in the elderly. One characteristic of Parkinson's disease is a hand tremor (shaking) when at rest. However, if the person is asked to do something, the vibe was not seen again. That's called resting tremor, which also lost during sleep.

       Tremors are the fingers, tremors metacarpophalang rough on the joints, sometimes tremor such as counting coins (pill rolling). In the hand joints flexion-extension or pronation-supination, the foot is flexion-extension, head is flexion-extension or head,  mouth open-shut, tongue hanging out-drawn. Tremor is disappearing recess time and intensity of emotion aroused (resting / alternating tremor).

        Tremor does not only occur on the hands or feet, but can also occur on the eyelids

eyes and eyeballs, lips, tongue and fingers (such as people counting money). All that occurs at rest / unknowingly. In fact, the head of the patient could be swayed if not doing the activity (unconsciously). That is, if realized, could stop tremors. At first tremors only occur on one side, but the more severe the disease, tremors can occur on both sides.

b. Rigidity / stiffness

      Another sign is the stiffness (rigidity). If the fist tremor driven (by others) is slowly upwards resting on the wrist, there is any resistance such as through a toothed wheel that moves a terpatah-patah/putus-putus. In addition to the hands and feet, stiffness it can also occur in the neck. Due to the stiffness, the movements become smooth again like break-dancing. Rigid motions made people will walk with a bent posture. To maintain the center of gravity to keep from falling, the pace became faster but short. The existence hypertony the extensor and flexor muscles hipertoni whole movement, this is due to the increased activity of alpha motorneuron, no cogwheel phenomenon.

c. Akinesia / Bradykinesia

       Both of the above symptoms are usually still less attention so mark akinesia / bradykinesia appeared. The movement of people into slow-paced. In the daily work can be seen in the writings / signatures become smaller, hard wearing, and dragged into a short step. Awareness is still good, so people can become depressed (stress) due to the disease. The face became expressionless. Wink and a glance of the eye is reduced, a small voice, swallowing reflex is reduced, resulting in frequent salivation.

       Voluntary movements become slower so it reduced the associative movement, such as poor to get up from a chair, hard start walking, slowly taking an object, when talking motion tongue and lips to be slow. Bradykinesia resulted in reduced expression of the face and expression and decreased spontaneous movements, such as facial masks, eye blink is reduced, the reduced motion swallowed so hard often out of the mouth.

d. Suddenly Stop or Hesitant to Stepping

       Another symptom is freezing, which stops in place when going to start moving, walking, or a U-turn, and start hesitation, are hesitant to start moving. It may also happen frequent urination, and constipation. Patients being slow thinking and

depression. Loss of postural reflexes due to the failure of integration and the neural maze and propioseptive fraction impulses from the eye, at the level of the thalamus and the basal ganglia that would interfere with the body's alertness position. This situation resulted in the patient easily fall.

e. Mycrographia

Handwriting gradually became smaller and closer, in some cases this an early warning sign.

f. The pace and style of the street (attitude Parkinson)

Walking with baby steps and getting a rapid shift (marche a petit pas), locally advanced head flexed to the chest, shoulders bent forward, back arched when running.

g. Talk monotonous

This is because the bradykinesia and rigidity of respiratory muscles, vocal cords, larynx muscles, so when talking or saying words that monotonous with subtle volume (whisper) that slow.

h. Dementia

A change in mental status during the course of their illness with cognitive deficits.

i. Behavioral disorders

Gradually become dependent (dependent on others), easily frightened, attitude

less assertive, depression. How to think and respond to questions later (bradyphrenia) usually still able to provide the correct answer, the origin given enough time.

j. Other Symptoms

Both eyes blinking heavily on pengetukan above the bridge of his nose (Myerson sign, being positive)

Clinical Symptoms and Signs of Parkinson's Disease

2. Non-motor symptoms
a. Autonomic dysfunction
-  Excessive sweating, excessive saliva, sphincter disorders, especially incontinence and orthostatic hypotension
- oily skin and seborrheic dermatitis
- spending a lot of urine
- changed sexual function disorders, characterized by weakening of desire
sexual behaviors, orgasm.
b. Mood disorders, patients often experience depression
c. Cognitive disturbances, slow response to stimuli
d. Sleep disorders, patients have difficulty sleeping (insomnia)
e. Impaired sensation
-  weak visual contrast sensitivity, spatial reasoning, color discrimination
- sufferers often experience fainting, generally caused by hypotension orthostatic, failure autonomous neuro system to make adjustments Blood pressure response to changes in body position
- reduction or loss of senses of smell sensitivity (mycrosmia or anosmia).


RELATED ARTICLES

•    Parkinson Disease
•    Pathophysiology of Parkinson's Disease
•    Diagnosis of Parkinson's Disease
•    Medical Treatment and Therapy of Parkinson's Disease


Medical Books about Parkinson's Disease: