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How to spot the early signs of Parkinson’s Disease

Evening Standard logo Evening Standard 12/04/2018 Laura Hampson

a blurry photo of an animal © Provided by Evening Standard Limited In the UK, one in every 500 people are affected by Parkinson’s disease.

While the cause of Parkinson’s is not yet known, it is a progressive and chronic neurological disease that typically affects those aged over 55 and is caused by a build-up of clumps of a protein called alpha synuclein in brain cells and lack of the neurotransmitter dopamine in certain parts of the brain.

This is what leads to problems with movement – meaning everyday activities like writing, walking and talking can be impacted.

Spotting the early signs of Parkinson’s can be difficult, as symptoms vary between individuals, so we’ve spoken to Dr Paul Jarman, Consultant Neurologist at The National Hospital for Neurology and Neurosurgery and the Wellington Hospital to see what you need to look out for.

What Are the early signs of Parkinson’s?

Dr Jarman told the Standard: “There is no one defining symptom or sign of Parkinson’s, but rather a combination of warning signs and symptoms, which each individual can experience differently.

“The classic symptoms that typically bring people to medical attention relate to abnormalities of movement: particularly shaking (tremor), slowness and stiffness.”

Tremors, meaning a slight shake in fingers, hands or legs (typically on one side of the body) is a common early sign of Parkinson’s disease.

Another common sign is a change in handwriting, if it becomes small and untidy, or difficulty with buttons or using a computer mouse.

However prior to this these signs you may experience early Prodromal symptoms.

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As Dr Jarmon explained: “There are often subtle non-specific symptoms that precede the onset of the movement related symptoms, often by 7 years or more. These ‘non-motor’ symptoms are not necessarily recognised as being early symptoms of Parkinson’s disease.”

Things to be aware of are:

  • Reduction or loss of sense of smell.
  • Constipation.
  • Aches and pains.
  • REM sleep behaviour disorder.
  • Depression and anxiety
  • Cognitive symptoms like a mild slowness of mental processing speed, concentration and lack of motivation.

Parkinson’s develops gradually, so it can sometimes be years before symptoms develop enough to see a doctor.

© Provided by Evening Standard Limited How is Parkinson’s diagnosed?

Dr Jarmon explained: “If you seek advice from your GP and they suspect you might have Parkinson’s, you should be referred to a Parkinson’s specialist, usually a neurologist or geriatrician. There is no specific test for Parkinson’s, it is a clinical diagnosis based on your medical history, a review of your symptoms, and a neurological and physical examination. You might be asked to write, walk and make fast repetitive movements of fingers or hands so the specialist can look for signs of Parkinson’s.

"The classic symptoms relate to abnormalities of movement: particularly shaking (tremor), slowness and stiffness"
Dr Paul Jarman

“Your doctor may also order tests, such as MRI scans, to rule out other conditions that may be causing your symptoms. Sometimes where the diagnosis of Parkinson’s is not certain, a specialised scan to image the dopamine cells in the brain called a DaTscan may be requested.”

What medication can you take to manage Parkinson’s?

While Parkinson’s currently has no cure, it can be effectively treated with medication.

“Medications used to treat Parkinson’s help increase the levels of dopamine in the brain,” Dr Jarmon said. “Physical activity and regular aerobic exercise are considered to be important in managing Parkinson’s symptoms.

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“Medication used in PD needs to be gradually adjusted over time as the condition progresses and dopamine levels in the brain reduce. Advanced forms of treatment such as deep brain stimulation are sometimes required after a number of years of treatment if medication becomes less effective over time in controlling the symptoms.

“There is a lot of research ongoing to develop new treatments for PD including stem cell therapy, fetal cell transplantation, gene therapy and new treatment approaches to ‘dissolve’ the abnormal protein clumps in nerve cells in the brain using antibody treatments. ‘Repurposing’ of existing medications for other conditions to see if they help Parkinson’s is also a promising area of research.”

If you notice any of these symptoms, make an appointment with your GP.

The Wellington Hospital is part of HCA Healthcare UK which is the country's largest provider of privately funded care.

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