arkinson’s Disease (PD) is a neurological condition where there is lack of an important chemical in the brain called dopamine that is due to the degeneration of brain cells that produce it. Here we list down 8 things you should know about this condition. Tremors are a prominent but not an exclusive feature to Parkinson’s disease. PD patients will have their tremors at rest, are more pronounced when they are anxious or stressed, and may affect all the limbs and neck, one side worse than the other. ¬† PD patients have a characteristic poker face. They have devoid facial expression and may appear to have a blank stare. A common symptom seen in patients with PD is a change in their handwriting. The letters in a word progressively becomes smaller, and the words in a sentence become spaced much closer to each other. Though many factors may contribute to changes in handwriting, in PD, often this is due to slowness and reduction in movement known as bradykinesia and hypokinesia respectively. This slowing down in movement may also be observed in other activities such as bathing, partaking food, walking, and other daily routine. When patients with PD walk, they have difficulty maneuvering through narrow and tight spaces and would tend to shuffle. They also have difficulty turning around and would do so en bloc. When they are asked to walk, they would appear hesitant on initiation. They take smaller strides, with their feet barely clearing the floor and on occasions would seemingly get stuck known as freezing. An associated condition to PD is REM Behaviour Disorder. This is a condition where the patients act out their dreams. The dreams are described to be very vivid and too real. This is one of the conditions that may appear before the motor problems manifest in PD. Other conditions that may be observed even before the motor symptoms appear include constipation, depression, and the inability to smell known as anosmia. More commonly, Parkinson’s Disease is sporadic or randomly appearing condition. Only about 10% of patient with PD had inherited this disease. Although there is still no treatment for Parkinson’s Disease, there are available medications to improve the symptoms and provide better function and quality of life. The main principle of these medicines is to replace Dopamine in the brain. April is Parkinson’s Disease awareness month. The tulip is the universal symbol of Parkinson’s Disease as well as the silver ribbon. To celebrate and campaign for awareness, wear a silver ribbon or a tulip pin on your coat or shirt.

Anthony N. Piano, MD, FPNA

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