Do You Know the Early Warning Signs of Parkinson’s Disease?

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Symptoms of the later stages of Parkinson’s disease, such as tremors and constant motion, are easy to recognize. Yet early warning signs of the disease aren’t as well known, and most cases aren’t diagnosed until patients are well past the beginning stages of Parkinson’s.

Small changes in your behavior and movement can signify Parkinson’s disease and help you know to see a doctor before it progresses. The earlier you begin treatment, the better your chances for improved quality of life over the long term.

Dr. Habib Khan, a skilled neurologist practicing in Casa Grande, Arizona, has extensive experience diagnosing and treating Parkinson’s disease, a disorder of the central nervous system. Here, he shares some of the early warning signs of Parkinson’s disease.

1. Loss of smell

Parkinson’s begins by attacking the medulla located at the base of the brain stem. The result is loss of smell, or hyposmia, one of the earliest occurring and most common signs of Parkinson’s. Not all instances of hyposmia are related to Parkinson’s. If you are experiencing loss of smell, schedule an evaluation with Dr. Khan.

2. Constipation

Constipation is another early symptom associated with Parkinson’s disease. Research indicates about 25% of those with Parkinson’s report constipation before the onset of other symptoms. Constipation can arise for many reasons, but when coupled with other symptoms, it can be an indication of Parkinson’s disease.

3. Small tremors

In the early stages of Parkinson’s disease, tremors are very small, resembling minor shaking. While tremors after vigorous exercise or from certain medications are normal, shaking of the hands, legs, or chin might indicate Parkinson’s. Doctors look for “tremors at rest” — tremors that occur when your body part is still but go away when you move.

4. Trouble sleeping

Everyone experiences trouble sleeping at times. With Parkinson’s, trouble sleeping happens nightly. You may experience uncontrollable movements — like thrashing, kicking, or flailing — or sleep apnea, REM sleep behavioral disorder, and nightmares.  

Dr. Khan is experienced with both neurologic and sleep disorders. He can evaluate your sleep pattern using the latest in sleep study medicine in a comforting environment to ensure a proper diagnosis.

5. Difficulty balancing

Parkinson’s disease affects nerve cells in the brain called basal ganglia. These nerves control your balance and flexibility. As a result, people with Parkinson’s have difficulty balancing.

Doctors test this with the pull test: pulling your shoulders back until you lose balance and then counting the number of steps you need to regain balance. Healthy people regain their balance after only one or two steps. Needing more steps may be an early warning sign of Parkinson’s.

6. Small, cramped handwriting

Have you noticed that the way you write has changed? If your written letters and numbers have become smaller and more crowded, it may be micrographia, a warning sign of Parkinson’s disease. Handwriting can change for other reasons, too — such as age, vision changes, or injury. Dr. Khan can determine if this is normal or cause for concern.

7. Stiffness and slow movement

In the initial stages of Parkinson’s disease, you may notice that starting movement becomes challenging or that your arm swing when walking has changed. Parkinson’s disease causes muscles to become rigid and stiff, making movement more difficult.

Stiffness and slowness can occur for many reasons. If symptoms don’t improve with movement, they may be an indication of Parkinson’s.

8. Voice changes

Have you started to think everyone else is losing their hearing? Do friends and family constantly tell you to speak up? It could be a sign of Parkinson’s disease. Many people with Parkinson’s disease develop changes in their voice. This includes a very soft or hoarse voice or fading volume as speaking continues.

9. Facial masking

Difficulty controlling muscles due to Parkinson’s disease is especially evident in the small muscles in your face. People with Parkinson’s often experience facial masking — changes in facial expression resulting in a serious or blank look — or trouble blinking.

If someone tells you that you’ve appeared more serious than normal, even during humorous conversations, or if you’re blinking less frequently, schedule an appointment with Dr. Khan.

10. Poor posture

People in the early stages of Parkinson's disease may develop increasingly poor posture. This change occurs as muscles become more rigid. Other conditions, such as weight gain and loss of muscle tone, can also lead to poor posture. It’s important to share your concerns with your doctor so these may be ruled out.

If you suspect Parkinson’s disease, don’t delay seeking medical help. Early treatment helps relieve symptoms, delays the disease’s progression, and enhances your quality of life. Dr. Khan may also recommend lifestyle changes, such as an improved diet and exercise, to improve overall wellness. Schedule your evaluation today at Arizona Institute of Neurology and Polysomnography.

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