What are the motor symptoms of Parkinson’s disease what characterizes each?

Parkinson’s disease mainly includes four main signs: 1, static tremor: tremor is often the earliest manifestation of the onset of the disease, usually starting from the distal part of one side of the upper limb, with the thumb, forefinger and middle finger as the main manifestation of the fingers like rubbing pills or counting banknotes as the same as the movement. Then it gradually extends to the lower limbs on the same side and the opposite side of the limbs, and in the late stage, it can spread to the jaw, lips, tongue and head. In the early stage of the disease, the patient is not too concerned about the tremor, often when the finger or limb is in a particular position, and disappears when the position is changed. Later on, the tremor develops only when the limbs are stationary, for example, when watching TV or talking with others, the limbs suddenly show involuntary tremor, and the tremor decreases or stops when the position is changed or when there is movement, so it is called stationary tremor, which is the most important feature of Parkinson’s disease tremor. The tremor is aggravated when the patient is agitated or nervous, and may disappear completely during sleep. Another characteristic of tremor is its rhythmic nature, the frequency of vibration is 4-7 times per second. This feature can also help us to distinguish other diseases, such as those caused by chorea, cerebellar disorders, and hyperthyroidism. 2, muscle ankylosis: Parkinson’s disease patients’ limbs and bodies usually lose flexibility and become very stiff. The early stage of the disease starts from one side of the limbs. Initially, a limb feels inflexible and stiff, and gradually aggravated, there is a slow movement, and even difficult to do some daily life actions. If you pick up the patient’s arm or leg and help him move his joints, you will obviously feel that his limbs are stiff and it is very difficult to move his joints, like folding a lead pipe back and forth. If the affected limb has tremor at the same time, there is an intermittent sense of stagnation, like the feeling of two occluded gears rotating. 3, motor retardation: in the early stage, due to the upper arm muscles and finger muscles of the ankylosis, the patient’s upper limbs often can not make fine movements, such as untie shoelaces, buttons and other actions have become much slower than before, or can not be successfully completed at all. Writing also gradually becomes difficult, and the handwriting is curved and becomes smaller and smaller, which is known as “micrographia” in medicine. Facial muscle movement is reduced, the patient seldom blinks, the rotation of the eyes is also reduced, and the expression is dull, as if wearing a mask, which is medically known as “mask face”. When walking, it is difficult to start, and once started, the body leans forward, the center of gravity is shifted forward, the pace is small but faster and faster, and can’t stop in time, i.e. “panic gait”. The coordinated swing of the upper limb on the affected side decreases or even disappears during the march; it is difficult to turn around, and it takes several consecutive small mincing steps to turn around. Due to the motor disorders of the mouth, tongue, jaw and pharyngeal muscles, the patient is unable to swallow saliva naturally, resulting in profuse salivation. Speech is reduced and the voice is low and monotonous. In severe cases, this can lead to choking on food and water. In the advanced stage of the disease, patients cannot stand up by themselves after sitting down, cannot turn over by themselves after lying down, and cannot take care of themselves in daily life. 4, posture balance disorder: although the patient’s whole body muscles can be involved, muscle tension increases, but at rest the flexor muscle tension is higher than the extensor muscle, so the patient has a special posture: head tilt forward, trunk slightly flexed, the upper arm inward, elbow joint bending, wrist slightly extended, the finger metacarpophalangeal joints are bent and the interphalangeal joints are straightened, the thumb is to the palm, the hip and the knee joints are mildly flexed. In addition to these main symptoms, the patient may also experience phytoneurotic dysfunction, such as increased secretion of saliva and sebaceous glands, increased or decreased sweat secretion, difficulty in urinating and defecating, and upright hypotension. In a few patients, psychiatric symptoms such as dementia or depression may be present.