What is Parkinson’s disease?

  Parkinson’s disease is also known as “tremor palsy”, Parkinson’s disease or Parkinson’s disease. Parkinson’s disease is a degenerative disease of the nervous system that commonly occurs in middle-aged and older people, mostly after the age of 60. The main manifestations are slow movements, tremors in the hands, feet or other parts of the body, and loss of flexibility and stiffness. The first systematic description of the disease was made by the British physician Jemima Parkinson, who at that time did not know what category the disease should be classified as and called it “tremor paralysis.  Parkinson’s disease is the fourth most common neurodegenerative disease in the elderly, affecting 1 percent of people aged ≥65 years and 0.4 percent of people aged >40 years. The disease can also develop in childhood or adolescence. The disease has been observed more carefully, and it was found that in addition to tremor, there are other symptoms such as muscle stiffness and smaller and smaller writing, but the strength of the muscles of the limbs is not impaired, so it was not considered appropriate to call it paralysis, so it was suggested that the disease be named “Parkinson’s disease”.  In 50% to 80% of cases, the onset of the disease is insidious, and the first symptom is usually a resting “pill-twisting” tremor of 4 to 8 Hz in one hand. This tremor is most pronounced when the limb is at rest, decreases when the limb is performing activities, and disappears during sleep; emotional stress or fatigue can aggravate the tremor. Usually the tremor is most severe in the hands, arms and legs, and the order of symptoms is earliest in the hands and latest in the legs, with tremor in the jaw, tongue, forehead and eyelids, but vocalization is not affected.  Many patients show only rigidity; no tremor appears, and the rigidity becomes progressively more severe, with movements becoming slower and slower (slow movements), less and less frequent (too few movements), and more and more difficult to initiate (lack of movements). The stiffness combined with the lack of movement may contribute to muscle soreness and fatigue. Expressionless face, masked face, open mouth, decreased blinking, which may be confused with depression. Forward bending of the body posture.  The patient finds it difficult to open the gait; the gait is sluggish, the gait distance is reduced, both upper limbs are in a fixed flexed position at the waist, and there is no natural swing of both upper limbs when walking. The gait may appear to be unintentionally accelerated, with the patient shifting to a running gait (festination) in order to avoid a fall. Due to the loss of postural reflexes, the patient’s body weight may be shifted and a propulsion or retropulsion may occur. Hypermobility combined with impaired control of distal muscles can lead to micrographia and increasing difficulty in performing activities of daily living. Dementia is present in approximately 50% of cases, and depression is also common.