symptoms of parkinsons disease : What Is It?

Parkinson's disease is one of a larger group of neurological conditions called motor system disorders. Historians have found evidence of the disease as far back as 5000 B.C. It was first described as "the shaking palsy" in 1817 by British doctor James Parkinson. Because of Parkinson's early work in identifying symptoms, the disease came to bear his name.

In the normal brain, some nerve cells produce the chemical dopamine, which transmits signals within the brain to produce smooth movement of muscles. In Parkinson's patients, 80 percent or more of these dopamine-producing cells are damaged, dead, or otherwise degenerated. This causes the nerve cells to fire wildly, leaving patients unable to control their movements. Symptoms usually show up in one or more of four ways:

tremor, or trembling in hands, arms, legs, jaw, and face
rigidity, or stiffness of limbs and trunk
bradykinesia, or slowness of movement
postural instability or impaired balance and coordination.
This diagram of the brain shows several structures related to Parkinson's disease. Basal ganglia affect normal movement and walking; substantia nigra are types of basal ganglia that produce the neurotransmitter dopamine, which sends messages that control muscles. The globus pallidus is part of a larger structure connected to the substantia nigra affecting movement, balance and walking. The thalamus serves as a relay station for brain impulses, and the cerebellum affects muscle coordination.
Though full-blown Parkinson's can be crippling or disabling, experts say early symptoms of the disease may be so subtle and gradual that patients sometimes ignore them or attribute them to the effects of aging. At first, patients may feel overly tired, "down in the dumps," or a little shaky. Their speech may become soft and they may become irritable for no reason. Movements may be stiff, unsteady, or unusually slow.

Joe Dulaney says he was in "perfect health" nine years ago when his wife noticed that he had stopped swinging his right arm when he walked. Soon, simple tasks such as brushing his teeth and combing his hair became major ordeals. His right hand was always ice cold and he produced small, jerky letters when he wrote.

Dulaney's doctor diagnosed the problem as arthritis and prescribed drugs to treat it. But symptoms worsened. Dulaney's voice dwindled to a slight whisper. Leg cramps, dry mouth, severe constipation, itchy eyes, and trouble turning over in bed tormented him. "My wrists were rigid and my fingers were not flexible, so I couldn't even button my shirt," he says. Still, another doctor seconded the arthritis diagnosis and prescribed different drugs.

Finally fed up because his deteriorating condition prevented him from doing simple tasks such as turning newspaper pages, putting money in his wallet, and replacing a light bulb, Dulaney checked himself into a local hospital, arriving in such a weakened state he couldn't walk.

Though a Parkinson's diagnosis rarely comes quickly, the three doctors who examined Dulaney at the hospital agreed within minutes that his classic symptoms indicated Parkinson's. The doctors gave him the Parkinson's drug levodopa, marketed as Larodopa and in generic forms, and the effect was nearly immediate.

"In one hour or so I was walking the halls. I took a shower by myself and did one push-up to show off," says Dulaney. It was, for the moment, as if the disease had somehow vanished. But Dulaney says he soon became "fully aware" that because Parkinson's is progressive, he could manage some symptoms with drugs, but the disease wasn't about to go away.

by John Henkel