Neurological Awareness
What is Parkinson's Disease? What Are Its Symptoms?
Imagine someone slowly trying to open their hands in a room where the first rays of sunlight are just filtering through the curtains in the early morning. Each new day becomes a bit harder; buttoning a shirt, drinking tea without spilling, trying to hide your trembling hands when hugging loved ones... Parkinson's disease is a neurological disorder that can change not only movements but the whole daily life, quietly yet profoundly. For both patients and their families, it is a journey built on patience, understanding, and scientific knowledge.
Parkinson's Disease: Definition and Key Facts
Parkinson's disease is a chronic, progressive, and neurodegenerative disorder of the central nervous system. Although it is most common in middle-aged and older people, it can occur at any age. Since it was first described by Dr. James Parkinson in 1817, it has affected millions worldwide.
The main cause of Parkinson's disease is the loss of dopamine-producing neurons in a brain region called the "substantia nigra." Dopamine is a critical chemical messenger required for planning and controlling movements. A lack of dopamine leads to impaired voluntary movements.
According to the World Health Organization, more than 10 million people worldwide live with Parkinson's disease.
Frequency and Risk Factors of Parkinson's
Parkinson's disease typically begins after age 60.
The risk increases with age, but it can rarely occur in younger individuals (Young-onset Parkinson's).
It is estimated that there are about 100,000 Parkinson's patients in Turkey.
It is slightly more common in men than in women.
Both genetic and environmental factors play a role.
Who is Most at Risk?
Age: Individuals over 60
Family history: Those with close relatives with Parkinson's
Environmental factors: Long-term exposure to pesticides and certain chemicals (not a definite cause)
Gender: Men carry a slightly higher risk compared to women.
Main Symptoms of Parkinson's Disease
The most prominent symptoms of Parkinson's disease are divided into "motor" and "non-motor" categories. The most recognized findings are movement-related, but the disease also affects mental and emotional processes.
Motor Symptoms
Tremor (Tremor): Usually first appears in the hand, sometimes in the jaw or legs when "at rest." The tremor often diminishes when the person moves.
Muscle stiffness (Rigidity): Muscles become more rigid and stiff than normal in the arms and legs, sometimes the neck; movements become slow and difficult.
Slowness of movement (Bradykinesia): Slowness and difficulty in daily tasks. This can be the most troublesome symptom of Parkinson's and may result in things like smaller handwriting (micrographia).
Balance and posture disturbances: Can lead to falls and unsteady walking.
Non-Motor (Neuromotor) Symptoms
Sleep disorders: Complaints such as insomnia, nightmares, or restless legs syndrome.
Loss of smell (Anosmia): Can often appear years before motor symptoms.
Depression and anxiety: Seen in 40-50% of Parkinson's patients.
Constipation: Common due to a slowed digestive system.
Cognitive impairment: Issues with attention, memory, and sometimes effects severe enough to lead to dementia.
Parkinson's disease symptoms usually progress slowly and may be mild in the early stages. Many people mistake early tremors for "fatigue" or just signs of "aging." This can delay the diagnosis.
Disease Progression and Course
The progression of Parkinson's disease can vary significantly between individuals. With treatment, symptoms can be alleviated for years. However, the disease typically worsens gradually over time. Experts use the Hoehn & Yahr staging system to define the disease from stages 1 to 5:
Stage | Brief Description |
|---|---|
1 | Mild symptoms on only one side of the body (e.g., slight tremor or slowness) |
2 | Symptom on both sides but balance remains intact |
3 | Impaired balance, some activities require help |
4 | Can walk independently but with serious limitations |
5 | Severely dependent, often uses wheelchair |
Remember: The course of Parkinson’s disease varies greatly from person to person; some people may stay at a mild stage for 10 years, while others show faster progression. With proper care and treatment, the quality of life can be improved.
How is Parkinson's Disease Diagnosed?
The diagnostic process can be one of the most difficult moments for patients. Prolonged uncertainty, complex symptoms, and misunderstandings may delay the diagnosis. There is no definitive laboratory or blood test for Parkinson’s disease. Diagnosis is mostly based on medical history, examination, and sometimes imaging tests.
Neurological examination: Assessment of movement, tremor, gait, and muscle tone.
History taking: Detailed questioning of when symptoms started and how they have progressed.
Magnetic resonance (MR) or other imaging: Used to rule out other causes (tumor, stroke, etc.).
Dopamine transporter imaging (DaTscan): May be used for a specific diagnosis; not required in every case.
Note: The best way to be sure if someone has Parkinson's is evaluation by an experienced neurologist.
What Are the Early Signs of Parkinson's?
There are "silent" signals that may occur before the motor symptoms of Parkinson’s disease. These are often overlooked and attributed to aging. However, recognizing them allows better management of the disease.
Loss of smell: Can occur in up to 80% of people with Parkinson’s years before motor symptoms.
Constipation: Slowed bowel movement may precede the disease.
Sudden movements during dreams: Such as shouting or fighting in sleep...
Depression and anxiety: Rarely, may be the first signals of Parkinson’s disease.
One or more symptoms alone do not indicate Parkinson's. However, if someone has a noticeable loss of smell along with a tremor starting in their left hand, it may be helpful to see a neurologist.
Parkinson's and Emotional Expression: Living With the Disease
It’s not only the body's mechanical functioning, but also emotions, that deeply affect and are affected by the disease. Many patients, despite increasing difficulty in movement, are most afraid of losing independence, appearing "different" in society, or becoming a burden to their loved ones.
On some days, your hands tremble as you hold a teacup; on other days, a storm brews inside. Parkinson’s doesn’t just slow down the muscles; sometimes it reshapes hopes, relationships, and dreams into a new format.
Numerous studies show that depression rates among Parkinson’s patients are as high as 40-50% (source). This shows that emotional support should be a priority for society, families, and the healthcare system.
What Other Diseases Can Parkinson's Symptoms Be Confused With?
Parkinson's disease leads to a group of symptoms called "parkinsonism;" however, not every parkinsonism points to Parkinson's disease. There are other diseases or conditions that can present with similar symptoms:
Essential tremor: Tremor typically occurs while moving. This distinguishes it from Parkinson's.
Slowing due to advanced age
Multiple system atrophy and progressive supranuclear palsy
Drug-induced parkinsonism
This is why expert consultation is crucial for diagnosis.
What Causes Parkinson’s Disease?
The exact reason why dopamine-producing cells in the brain are lost is unknown. However, ongoing research is focusing on these factors:
Genetics: About 10-15% of Parkinson's cases have a hereditary (familial/genetic) link.
Environmental factors: Some pesticides, heavy metals, and toxins may increase risk.
Aging: Growing older is considered the strongest risk factor.
Still, for many patients no clear cause can be found and it is considered "multifactorial." Healthy lifestyles, regular physical activity, and stress management may have protective effects.
Managing Parkinson’s Symptoms
Although Parkinson’s disease is progressive, early diagnosis and regular follow-up can significantly reduce its impact on daily living. With medications and physical and emotional support, people can remain independent for years.
Basic Approaches to Manage Symptoms
Regular medication: Drugs that mimic or enhance dopamine can significantly reduce symptoms.
Exercise and physical therapy: Can reduce muscle stiffness, strengthen balance, and increase independent movement.
Mental health support: Psychological counseling for dealing with depression and anxiety.
Nutrition: A fiber-rich, well-hydrated, and balanced diet helps relieve constipation.
Family and social support: Patient motivation is closely linked to the capacity of caregivers.
Treatment Options in Advanced Stages
Surgery (Deep Brain Stimulation – DBS): May help manage movement symptoms in severe cases.
Teamwork: Close collaboration among neurologists, physiotherapists, psychologists, and dietitians is important.
How Do Parkinson's Symptoms Affect Daily Life?
The symptoms of the disease can make even the simplest everyday activities challenging. From buttoning a shirt to brushing teeth or a morning walk, many routines in Parkinson’s require extra planning and patience.
Slowness of movement (bradykinesia): Movement from one room to another inside the house slows down.
Tremor: Writing and eating become difficult due to trembling hands.
Impaired balance: There is an increased risk of falls and fractures.
Changes in speech and facial expression: Facial expressions may diminish. Speech may become monotone or difficult to understand.
Sometimes the most touching moment is quietly sharing a cup of tea with a loved one. The value of small gestures, a smile, and a patient touch becomes much deeper when living with Parkinson’s.
For Families: The Emotional Burden and Support in Parkinson’s
Many caregivers experience a significant emotional burden as they watch their loved one’s disease progress. While striving to provide proper care, they also struggle with uncertainty, exhaustion, and sadness.
“Laughing together, crying together. Redefining love and patience with every new symptom.”
Talk to each other: Both patient and caregiver should openly share their feelings.
Join support groups: Knowing you’re not alone gives strength.
Take time for yourself: Caregivers also need support and rest.
Common Misconceptions About Parkinson's Disease
Parkinson’s is not just a “disease of the elderly.” It can be seen in younger people too.
It presents not only with tremor but also with walking, balance, and psychological symptoms.
With early diagnosis, quality of life can be preserved for years.
It is not solely a genetic disease; environmental factors play a role as well.
Parkinson’s: A Story of Hope, Science, and Humanity
Parkinson’s disease is one of the most unique areas where medicine meets empathy. As science advances, new drugs and treatments increase the chances and hopes of people living with Parkinson’s. But perhaps most important of all is not just medical support; but being understood, seen, and heard…
If one day you notice a fine tremor in your hands or see unexpected slowness of movement in a loved one, having these signals assessed by a specialist in a timely manner is extremely valuable. Both patients and their families should know that you are not alone with Parkinson’s. We will make this journey together, strengthened by science and compassion.
References
Bir Sonraki Okuma
