Parkinson's disease (PD) is a progressive, neurodegenerative disorder of aging that affects both motor and cognitive function. The etiology of PD is mostly unknown, but it likely involves both genetic and environmental factors.

Recognizing early symptoms of Parkinson's

Nonmotor symptoms:

Nonmotor symptoms are common in early Parkinson disease. The identification of non-motor symptoms is key to early detection of PD. Recognition of the combination of nonmotor and motor symptoms can promote early diagnosis and thus early intervention, which often results in a better quality of life.

The most commonly experienced nonmotor (early) symptoms in patients with early Parkinson disease included the following^:

·       Gastrointestinal difficulties like constipation and slowed movement of food from the stomach into the intestines (gastroparesis)

·       Reduced sense of smell (hyposmia)

·       Excessive saliva

·       Sleep problems, including insomnia, REM sleep behavior disorder, restless legs syndrome and excessive daytime sleepiness

·       Sexual dysfunction, like erectile dysfunction in men, poor lubrication in women, or difficulty achieving orgasm in both men and women

·       Mood disorders, like depression or anxiety

·       Forgetfulness

·       Urinary urgency

·       Fatigue

Onset of motor signs includes the following:

• Typically asymmetric
• The most common initial finding is a resting tremor in an upper extremity
• Over time, patients experience progressive bradykinesia, rigidity, and gait difficulty
• Axial posture becomes progressively flexed and strides become shorter
• Postural instability (balance impairment) is a late phenomenon

Diagnosis

Clinical diagnosis requires the presence of 2 of 4 cardinal signs:

• Resting tremor
• Rigidity
• Bradykinesia
• Postural instability
• 
  

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