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Parkinson's Disease – Cedars-Sinai

Every Parkinson's patient experiences a combination of three motor symptoms, which typically worsen over time at a pace that varies from person to person. For most people, symptoms begin on one side of the body and later spread to the other side.

Classic symptoms of Parkinson's disease may include:

Tremor is usually the first symptom people notice, and unlike other tremors, these tremors are typically present when the patient is at rest. Emotional and physical stress tends to make the tremor worse. Sleep, complete relaxation and intentional movement or action usually reduce or stop the tremor. It is important to remember, however, that as many as 30 percent or more of people with Parkinson's disease do not experience tremors.

The muscles of the legs, face, neck or other parts of the body may become unusually stiff or rigid. Another common early sign of the disease is a reduced swing of the arm on one side when the person is walking.

In addition to the four classic motor symptoms, Parkinson's disease can cause a variety of other disabilities as the disease progresses:

Finally, people with Parkinson's disease may experience one or more symptoms that typically do not affect their movements. The most typical nonmotor symptoms of Parkinson's disease include:

A person with Parkinson's disease may slowly become more dependent, fearful, indecisive and passive. The person may talk less often, withdraw from people and be inactive unless encouraged to move about. Depression is very common with this disease and can be caused by chemical changes in the brain. Symptoms of depression often improve with proper treatment.

The causes for most forms of Parkinson's disease are unknown. Some evidence indicates that inherited (genetic) factors may predispose some people to develop Parkinson's disease; however, the majority of people with Parkinson's don't have a known gene abnormality. Research has indicated that there may be a connection between Parkinson's and environmental toxins that damage dopamine-producing nerves.

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Parkinson's Disease - Cedars-Sinai

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Parkinson's Disease

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10 Early Warning Signs of Parkinson's Disease | National …

It can be hard to tell if you have Parkinson's disease.

Here are the 10 signs you might have the disease. No single one of these signs means that you shouldworry. But if you have morethan one symptom you should make an appointment to talk to yourdoctor.

Have you noticed a slight shaking or tremor in your finger, thumb, hand, chin or lip? Does your leg shake when you sit down or relax? Twitching or shaking of limbs is a common early sign of Parkinson's disease.

Shaking can be normal after lots of exercise or if you have been injured. Shaking could also be caused by a medicine you take.

Has your handwriting suddenly gotten much smaller than in it was in the past? You may notice the way you write words on a page has changed, such as letter sizes are smaller and the words are crowded together. A sudden change in handwriting is often a sign of Parkinson's disease.

Sometimes writing can change as you get older, if you have stiff hands or fingers or poor vision, but this happens over time and not suddenly.

Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about Parkinson's disease.

Your sense of smell can be changed by a cold, flu or a stuffy nose, but it should come back after you are better.

Do you thrash around in bed or kick and punch while you are deeply asleep? You might notice that you started falling out of bed while asleep. Sometimes, your spouse will notice, or will want to move to another bed. Sudden movements during sleep may be a sign of Parkinson's disease.

It is normal for everyone to have a night when they 'toss and turn' instead of sleeping.

Do you feel stiff in your body, arms or legs? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson's disease. You might notice that your arms don't swing when you walk, or maybe other people have said you look stiff. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem 'stuck to the floor.'

If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.

Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of Parkinson's disease and you should talk to your doctor.

If you do not have enough water or fiber in your body, it can cause problems in the bathroom. Alsosome medicine will cause constipation. If there is no other reason such as diet or medicine that would cause you to have trouble moving your bowels, you should speak with your doctor.

Have other people told you that your voice is very soft when you speak in a normal tone, or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson's disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.

A chest cold or other virus can cause your voice to sound different, but you should go back to sounding the same when you get over your cough or cold.

Have you been told that you have a serious, depressed or mad look on your face more often, even when you are not in a bad mood? This serious-looking face is called masking. Also, if you or other people notice that you have a blank stare or do not blink your eyes very often, you should ask your doctor about Parkinson's disease.

Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.

Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be signs of low blood pressure and can be linked to Parkinson's disease.

Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.

Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson's disease.

If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

For more information, visit our Treatment page.

Watch and share this public service announcement featuring U.S. Senator Cory Booker that discusses the early warning signs of Parkinson's disease.

Made possible through the generous support of the Medtronic Foundation and thousands of people with Parkinson's and their families.

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Parkinsons Disease Information from

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:

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.

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Parkinson's Disease Dementia | Signs, Symptoms, & Diagnosis

About Parkinson's disease dementia

The brain changes caused by Parkinson's disease begin in a region that plays a key role in movement. As Parkinson's brain changes gradually spread, they often begin to affect mental functions, including memory and the ability to pay attention, make sound judgments and plan the steps needed to complete a task.

The key brain changes linked to Parkinson's disease and Parkinson's disease dementia are abnormal microscopic deposits composed chiefly of alpha-synuclein, a protein that's found widely in the brain but whose normal function isn't yet known. The deposits are called "Lewy bodies".

Lewy bodies are also found in several other brain disorders, including dementia with Lewy bodies (DLB). Evidence suggests that dementia with Lewy bodies, Parkinson's disease and Parkinson's disease dementia may be linked to the same underlying abnormalities in brain processing of alpha-synuclein.

Another complicating factor is that many people with both dementia with Lewy bodies and Parkinson's disease dementia also have plaques and tangles hallmark brain changes linked to Alzheimer's disease.

Parkinson's disease is a fairly common neurological disorder in older adults, estimated to affect nearly 2 percent of those older than age 65. The National Parkinson Foundation estimates that 1 million Americans have Parkinson's disease. It is estimated that 50 to 80 percent of those with Parkinson's disease eventually experience Parkinson's disease dementia. Sign up for our enews to receive updates about Alzheimers and dementia care and research.

Learn more: Dementia with Lewy Bodies, Mixed Dementia

What percentage of people with Parkinson's develop dementia?

An estimated 50 to 80 percent of those with Parkinson's eventually experience dementia as their disease progresses. The average time from onset of Parkinson's to developing dementia is about 10 years.

Parkinson's disease dementia is a decline in thinking and reasoning that develops in someone diagnosed with Parkinson's disease at least a year earlier. Common symptoms include:

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As with other types of dementia there is no single test or any combination of tests that conclusively determines that a person has Parkinson's disease dementia.

Many experts now believe that Parkinson's disease dementia and dementia with Lewy bodies are two different expressions of the same underlying problems with brain processing of the protein alpha-synuclein. But most experts recommend continuing to diagnose dementia with Lewy bodies and Parkinson's dementia as separate disorders.

Guidelines for diagnosing Parkinson's disease dementia and dementia with Lewy bodies are:

Brain Imaging

Since individuals with Parkinson's are at high risk for dementia as their disease progresses, doctors monitor those with Parkinson's closely for signs of thinking changes. When someone with Parkinson's develops thinking changes, doctors often order magnetic resonance imaging (MRI) of the brain to rule out tumors, structural changes and evidence for vascular disease.

Certain factors at the time of Parkinson's diagnosis may increase future dementia risk, including older age, greater severity of motor symptoms, and having mild cognitive impairment (MCI).

Additional risk factors may include:

There are no treatments to slow or stop the brain cell damage caused by Parkinson's disease dementia. Current strategies focus on helping symptoms.

If your treatment plan includes medications, it's important to work closely with your physician to identify the drugs that work best for you and the most effective doses. Treatment considerations involving medications include the following issues:

Find a clinical trial

More than 100 research studies pertaining to Alzheimer's and other dementias are underway. Alzheimer's Association TrialMatch lets you search these trials quickly and easily. Find a trial.

Like other types of dementia that destroy brain cells, Parkinson's disease and Parkinson's disease dementia get worse over time and speed of progression can vary.

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Parkinson's Disease Dementia | Signs, Symptoms, & Diagnosis

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