Parkinsonism constitutes a number of conditions which have the following similar features:
- Slowing of activities
- Stiffness/Rigidity of body
- Postural instability (Tendency to fall)
If 2 out of the above 4 symptoms are present then the condition is Termed Parkinsonism.
Parkinsonism is a syndrome which has several similar but distinct conditions within it such as Parkinson’s disease, Vascular Parkinson’s, Parkinson’s plus syndromes (Multiple System Atrophy, Progressive Supranuclear Palsy, Normal Pressure Hydrocephalus. This can be compared to the example of Motor vehicles given below:
MOTOR VEHICLES (PARKINSONISM)
- BUSES (PARKINSON’S PLUS)
- TRUCKS (DRUG INDUCED PARKINSON’S)
- SCOOTERS (VASCULAR PARKINSON’S)
- VANS (NPH)
- CARS (PARKINSON’S DISEASE)
The common early symptoms of Parkinson’s include:
- Excessive salivation
- Shoulder pain – often misdiagnosed as frozen shoulder
- Vivid dreams and dream-enacting behavior called REM sleep behavior disorder (RBD)
- Slurred indistinct, low volume speech
- Handwriting becoming smaller
- Stooping of posture when walking, sitting
- Expressionless face - often confused with depression.
It is important to recognize the symptoms of Parkinsonism early make the correct diagnosis and start treatment early. It is even more important to diagnose Mimic condition such as essential tremors which are often mistaken as Parkinson’s disease.
Treatment results in relief and resolution of symptoms to a great extent.
For advanced cases new therapeutic modalities such as Deep Brain can be considered.