Next in our series of blogs on Parkinson’s disease, Movement Disorder Neurologist, Dr Paul Silberstein, explains the motor features of Parkinson’s disease.
Parkinson’s disease (PD) is a neurologic disorder characterised by slowness of movement, stiffness, tremor and gait or walking impairment. The condition is typically asymmetric – that is, it affects one side of the body more than the other.
Slowness of movement, termed bradykinesia, is the hallmark of the condition. Bradykinesia often manifests initially with smaller handwriting or an impaired ability to attend to fine motor tasks such as doing up buttons. Sometimes it is recognised by relatives or friends as reduced arm swing when walking
The muscular rigidity associated with Parkinson’s disease, manifests as a feeling of stiffness. Typically, stiffness will first be evident in one limb, more commonly an arm.
Tremor is common in Parkinson’s disease, but, contrary to general opinion, tremor is not a universal finding in PD. Overall, approximately 75% of people with PD will experience tremor at some stage. PD Tremor is more common in the upper limbs than lower limbs, typically occurs at rest, such as when seated quietly, and resolves at least transiently with movement of the affected limb. Tremor can be made worse with stress or anxiety and can vary spontaneously in severity over minutes or hours.
Walking and balance impairment can occur either early, or after many years of Parkinson’s disease.
Motor, or physical difficulties related to PD typically respond well to medication and exercise therapy. Most patients treated with medications and exercise achieve consistent control of physical symptoms of PD for many years after the initial diagnosis.
Motor symptom control can become less consistent over years, or even more than a decade after the diagnosis of PD. Here a second tier of therapies including surgical treatment can be very effective in re-achieving consistent physical symptom control and improving quality of life.