Parkinson’s disease (PD) is a neurodegenerative disease that results in the premature death of a group of neurons located in a region of the brain stem called the substantia nigra. The function of these neurons is to control that the movement we make is done correctly and that certain motor activities, such as walking, are performed automatically without the need to think about what we have to do to walk.
According to specialists in Neurology, Parkinson’s disease is more frequent as we get older, especially from the 60s and 70s, although in some cases the onset is advanced to the late forties or early fifties.
Symptoms of Parkinson’s disease
The symptoms of Parkinson’s disease appear when 80% of the neurons of the substantia nigra disappear. Until that happens there is a phase that can be called prodromal, in which symptoms and signs appear that can already indicate the onset of the disease.
The first symptoms of Parkinson’s disease are usually a difficulty to get up from low chairs, with falling backwards when trying to do so. Decrease of the brachiation in one of the upper extremities when walking, dragging of the feet, shorter steps, tendency to move the body forward when walking, difficulty to turn when walking, etc. In addition, the family may also notice a decrease in the frequency of blinking and a more expressionless face. Occasionally, pain in a shoulder may appear due to increased stiffness in the upper extremity.
Initially, these symptoms affect one side of the body more than the other, i.e. there is a clear asymmetry. When the symptoms are bilateral from the beginning, we will have to look for other causes, such as the intake of drugs or other signs of other neurodegenerative diseases, which will not respond to treatment for Parkinson’s disease.
Prodromal symptoms may appear years before the onset of the previous symptoms and, at present, we cannot predict whether these prodromal symptoms will eventually lead to this disease. The most frequent are going to be a persistent constipation, a persistent depressive condition and a sleep disorder called REM sleep-associated behavior disorder. In the latter disorder, if we can only move our eyes and respiratory muscles when we are dreaming during our night’s rest, these patients “act out” their dreams with movements and even walk out of bed.
Parkinson’s should be treated when the symptoms alter the patient’s quality of life, the longer the delay in the use of levodopa the better, and the sooner other drugs can be used that will also alleviate the symptoms.