Parkinson's disease

Early symptoms of Parkinson's disease

The early symptoms of Parkinson’s disease might not seem bad enough for the person experiencing them to think of asking anyone about them. Most people don't know much about Parkinson’s, and what they do know may be a poor guide to the early stages of the disease. 

Some symptoms which people experience before a definite diagnosis are very vague and non-specific. For instance several people described quite long periods when they noticed that they were increasingly exhausted, or noticed that they had become physically or mentally slower, or felt somewhat depressed. Jean was told she probably had chronic fatigue syndrome and to this day does not know whether she did indeed have this as well as early Parkinson’s disease. Elaine also convinced herself that her exhaustion was caused by other things and didn't to connect this with other symptoms as they happened. Brian noticed that he was becoming increasingly exhausted so he cut down his activities and, at the age of 63, accepted his symptoms could be due to ageing. Stephen did the same at the age of only 43.

People who were very physically active and especially used to how their bodies functioned became aware of a problem when running or in the gym. Rafa started having problems when his leg wouldn’t move properly after a couple of miles running; "You know what to do, you know you can do it, but the leg doesn’t want to cooperate".

Quite often the next step towards diagnosis would be that someone else, a friend or family member, would comment on a symptom which the person showing it had not noticed. Shuffling was commonly noticed and often treated as a bit of a joke. Relatives noticed Fred’s shuffling and mentioned it to his wife who didn’t tell him until a doctor friend commented on the trouble he seemed to be having walking. When a friend noticed that Sharon was walking strangely she did her best to ignore it until further symptoms appeared.

Another symptom others noticed is the rigidity of expression (lack of movement) in a person's face - described as the mask. The mask becomes the person's normal expression - a default position. But it can be over-ridden during social contact, particularly in response to a joke but also when the person in question looks at their own face in a mirror. This would explain why many people have failed to recognise the symptom in themselves. Fred's consultant asked him whether he had always been so ‘po faced’ and he had no idea whether he had or not. Philip described how his GP had looked at him, and noticed that his face had lost some mobility and that the muscles in his face seemed slightly rigid, and so referred him to a neurologist.

A husband/wife or partner may get the wrong idea about the mask, thinking that their partner has become unresponsive. until it has been explained to them.

Change in handwriting is a common early symptom which people notice themselves. Brian had various symptoms, his right side was stiff, he was limping and walking with difficulty. He began to worry that he might have multiple sclerosis (MS) or a wasting disease. But most peculiar was the fact that his writing had got smaller and for some reason he found it particularly difficult to make w’s. Jean described how her handwriting would start out big and then get smaller until it was hardly anything. Tom’s first clue that something was wrong was when he was writing a postcard to a friend and found himself suddenly brought to a halt in the middle of writing a name and could not complete it. Helen’s GP (see Getting the diagnosis of Parkinson's disease) guessed her problem when she told him that she was having problems putting a key in the lock or using her computer mouse.
 
Judie noticed that it was difficult to drive or change gear. Kevin found it difficult to control the toothbrush to brush his teeth. David developed a tendency to fall over when running and then became unable to tap in time to music so he decided that it really was time to see a doctor. Angela noticed pains in her shoulder, hip and knees and Ann started to find it hard to do the ironing.
 
Tremors are one symptom which many people associate with Parkinson’s disease. Rex noticed an ongoing tremor in his right hand and his GP immediately referred him to a neurologist. Elisabeth on the other hand described a sensation of having one hot and one cold leg, and sitting on a beach watching her leg shaking, but not knowing what this might mean. When Judie developed a tremor in one hand her GP obviously guessed what it probably meant and referred her to a neurologist, but she continued to think it was due to a trapped nerve.

Many of the people we interviewed had been to their GPs about unexplained symptoms only to be given a variety of alternative explanations. Sometimes this was frustrating because they felt that they knew something was really wrong. Geraldine's GP told that the change in her handwriting at the age of 42 was caused by carpal tunnel syndrome related to her menopause.
The symptoms in Parkinson’s disease may begin slowly, spread over several years. They may not always be present. Mari remembered that she used to be cross when Humphrey failed to appreciate the scent of a flower she was pointing out to him or the smell of the food she had cooked. It was not until after he had died that she discovered that this was a symptom associated with Parkinson’s disease. While some people didn't mention what they saw as 'trivial' symptoms to their doctor for fear of being labelled a hypochondriac, others thought their symptoms might all be explained by advancing age or other things in their lives.
 
A few guessed that their symptoms might be signs of a serious disorder and even made their own diagnosis of Parkinson's disease before consulting a doctor.

Last reviewed May 2017
Last updated May 2017

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