We are talking about “Parkinsonian triad”.
Parkinson’s disease destroys dopamine neurons in the brain (those which in particular control movements). Some signs appear before the diagnosis is established, they are “precursors”. Little characteristic, they generally do not take away from the future diagnosis but are reported by the patients afterwards. “Parkinson’s disease can be not very symptomatic at first but as soon as it evolves, the patient develops the associated symptoms“Underlines Dr. Stéphanie Cantiniaux, neurologist and specialist in Parkinson’s disease. And add that “Symptoms do not differ according to sex but according to the stage of evolution, form or age“. So “The forms that start later, at an advanced age see the Axio signs to settle earlier and cause walking problems more quickly. In a younger patient, the duration of evolution of the disease and the signs is slower “ Note the neurologist.
At first, the “Parkinsonian triad” must alert
Three symptoms characteristic of Parkinson’s disease are used to make the diagnosis. To qualify them, we speak of “Parkinsonian triad”. These are:
- trembling
- slowness to perform gestures and movements (kinesis)
- Rigidity/stiffness of members or “extra-pyramidal syndrome”
“Patients do not necessarily present the 3 signs at the same time, some will never even tremble. In general, they present at least 2. the most characteristic and most embarrassing sign being the slowness of alternating gestures“Note Dr. Cantiniaux, neurologist. The symptoms of the Parkinsonian triad can touch only one side of the body. Apart from these signs, patients encounter digestive disorders such as constipation, nausea or the feeling of being Broken.Other symptoms may also appear, even if they are more atypical, such as the dystonia of a member or face with for example an apraxia of the eyes (difficulties in opening the eyelids)continues the neurologist. There are also significant fluctuations in blood pressure which can cause neurovegetative dystonia (stomach emptying disorders). “
The disease evolves in 3 phases:
► First phase or “honeymoon”: it is the stage where the diagnosis being established, a treatment is prescribed at the dose which allows the patient to be asymptomatic or almost (very light signs because well controlled). The patient lives normally. This phase lasts from 18 months to 6 years.
► Second phase: this is the stage of motor and non-motor fluctuations, that is to say that the symptoms of the triad return and lead the neurologist to increase treatment and split it over the day. Symptoms still respond to treatment but will be less well balanced, they will be fluctuating during the day. This stage can last for 10, 15, 20 years. The more time passes, the more symptoms worsen and new ones appear (walking disorders, falls, speech and concentration disorders).
► Third stage: this is the most disabling stage of the disease, the symptoms no longer respond to treatment and the patient develop axio signs with severe walking, speech, swallowing, memory disorders .
What are the psychological symptoms of Parkinson’s disease?
Parkinson’s disease patients are in dopamine deficiency, the hormone that controls body movements and participates in good mental condition. “”This is why during the evolution of the disease, patients will be depressed more or less deeply and may present behavioral modifications. There is also a apathy, a disinterest in what is happening around and a loss of motivation“Note our expert.
Does Parkinson’s disease cause pain?
“The main pains are those called neuropathic in connection with Parkinsonian syndrome“Specifies Dr. Cantiniaux. Neuropathic pain concerns an area innervated by a nerve. The nerve trying to recover tends to become hyperexcitable which leads to burn -type pain or on the contrary of pain sensations painful, impression of compression, sensations electrical discharges, cramps …
What are the advanced symptoms?
“At an advanced stage, we meet severe cognitive disorders (memory in particular) in around 30% of patients with delusional ideas (Parkinsonian dementia) and hallucinations favored by medicines” replies our interlocutor.
Thank you to Dr Stéphanie Cantiniaux, neurologist and specialist in Parkinson’s disease.
