With Parkinson’s, the tragedy is not so much the disease itself, but the fact that it often goes unrecognised and, therefore, untreated, which causes the disease to progress to disabling levels. What’s tricky is besides failing to recognise it early we confuse the symptoms with the normal process of ageing. In the absence of medical intervention, the disorder progresses steadily. And that is a pity, because timely treatment can slow its advance.
“Early diagnosis and appropriate intervention can give a person with Parkinson’s many decades of healthy life,” says Dr. V. Sathish Kumar, senior consultant neurophysician, Fortis Malar. “If there is no intervention, he might end up bedridden 7-10 years after its onset,” warns Dr. D. S. Halprashanth, consultant neurologist and specialist in Parkinson’s and epilepsy, Global Health City.
Common among the 60 plus
The disorder is more commonly seen in the 60 plus age group, though a few people show signs of it even in their fifties and forties. As per western statistics, about five in a 1000 persons in their 60s have Parkinson’s, with the incidence becoming more common in older age groups. “In rare cases, a head injury or brain infection can trigger symptoms of Parkinson’s in the young. But they too are administered the same treatment as that given for Parkinson’s,” says Dr. Sathish.
Since Parkinson’s is a degenerative disorder of the brain that affects the relay of messages from the brain to various muscles of the body, it could affect a wide range of functions and give rise to a spectrum of seemingly unrelated symptoms. “Difficulty in identifying different smells is one of the earliest indicators, but it may not be seen in everyone with Parkinson’s. Slowness, tremors and stiffness of one limb or one side of the body are the three major early symptoms,” says Dr. Sathish.
Slows down life
Parkinson’s slows down life — from bodily movement, gestures and speech to facial expressions and blinking of the eyes in many. One side of the body might start getting rigid. For instance, the spouse of a person with Parkinson’s is likely to say, “My husband doesn’t swing one hand much while walking.” Then, there is the shuffling walk that’s so common among people with Parkinson’s. Such people may experience difficulty when they start or stop walking or even while turning along the way; they may find it hard to execute routine movements like getting up from a chair. The rigidity eventually spreads. A person with Parkinson’s might have a lot to say, but finds he is unable to speak; he might want to reach for something, but his hands will not obey his mind’s bidding; coordinated and fine movements like buttoning up his dress get difficult, handwriting gets cramped and smaller; there is less balance, and the person slips or falls more often. There might be resting tremors — tremors that occur in the fingers, hands and arms when these body parts are at rest; the arch of the back becomes rigid; the body muscles get tense. The person’s speech might become monotonous with less variation in pitch and tone. He may experience memory loss, assorted aches, tiredness, constipation, difficulty in swallowing, welling up of saliva in the mouth, difficulty in sleeping because of being unable to turn….
There are no confirmatory tests such as scans or blood tests for Parkinson’s. However, neurologists can arrive at a diagnosis from studying the patient’s symptoms and after a neurological examination. “But the affected person himself is unlikely to recognise these changes and is likely to brush them aside. Therefore, recognition of these changes by family and friends is crucial,” observes Dr. Halprashanth.
