Cancer Types

People have conducted more detailed observations on the disease and found that in addition to tremors, there are other symptoms such as muscle stiffness and smaller writing. However, the strength of the muscles in the limbs has not been damaged, and it is not appropriate to call it paralysis. Therefore, it is recommended to name the disease "Parkinson's disease". Quiescent tremor is often the earliest manifestation of the disease, usually starting from the distal end of one side of the upper limb, mainly with the thumb, index finger, and middle finger, manifested as finger movements like rubbing balls or counting money. Then it gradually extends to the same and opposite limbs, and in the later stage, it can affect the lower jaw, lips, tongue, and head. In the early stages of the disease, patients do not pay much attention to tremors, often appearing when their fingers or limbs are in a special position, and disappearing when changing positions. In the future, it will only appear when the limbs are stationary, such as when watching TV or talking to others, the limbs suddenly experience involuntary trembling, and the trembling decreases or stops when changing positions or movements, so it is called static tremor, which is the main characteristic of Parkinson's disease tremor. Tremor intensifies when the patient is emotionally excited or mentally tense, and can completely disappear during sleep. Another characteristic of tremor is its rhythmicity, with a frequency of 4-7 vibrations per second. This feature can also help us distinguish between other diseases, such as those caused by chorea, cerebellar disorders, and hyperthyroidism. Muscle stiffness: Patients with Parkinson's disease usually lose flexibility in their limbs and body, becoming very stiff. The early stages of the lesion often begin with one limb. In the early stage, I feel a certain limb's movement is not flexible, there is a sense of stiffness, and it gradually worsens, resulting in delayed movement and even difficulties in performing some daily life movements. If you pick up the patient's arm or leg and help them move their joints, you will clearly feel their limbs stiff and it is difficult to move their joints, like folding a lead tube back and forth. If the affected limb experiences tremors at the same time, there will be intermittent pauses, similar to the feeling when two interlocking gears rotate. In the early stages of motor delay, due to the rigidity of the upper arm and finger muscles, patients often cannot perform delicate movements in their upper limbs, such as untiing shoelaces, buttoning, etc., which become much slower than before or cannot be completed smoothly at all. Writing has gradually become difficult, with curved handwriting that becomes smaller and smaller, which is referred to as "lowercase syndrome" in medicine. Facial muscle movement decreases, patients rarely blink, their eyes rotate less, and their expressions are stiff, as if wearing a mask, medically known as a "masked face". When walking, it is difficult to start. Once taking a step, the body leans forward, the center of gravity moves forward, and the step becomes smaller and faster, unable to stop in a timely manner, known as the 'panic gait'. During movement, the coordinated swing of the affected upper limb decreases or even disappears; It is difficult to turn around and requires several consecutive small steps to turn around. Due to movement disorders in the muscles of the mouth, tongue, jaw, and pharynx, the patient is unable to swallow saliva naturally, resulting in excessive salivation. The speech decreases, and the pronunciation is also low and monotonous. In severe cases, it can lead to eating, drinking, and coughing. In the late stage of the illness, the patient cannot stand on their own after sitting down, cannot roll over on their own after lying in bed, and cannot take care of themselves in daily life. Although the patient's entire body muscles are affected and the muscle tension is increased, the flexor muscle tension is higher when stationary than the extensor muscle. Therefore, the patient presents with special postures such as head forward tilt, trunk slightly bent, upper arm adduction, elbow joint bending, wrist slightly extended, palmar joint bending and interphalangeal joint straightening, thumb facing palm, and slight bending of hip and knee joints. Many patients experience pain, although it may not be severe enough to require painkillers, it can sometimes be very distressing. The manifestations of pain are multifaceted, including shoulder and neck pain, headache, and low back pain. The most common symptoms are soreness in the arms or legs, and local muscle stiffness is the main cause. Supplementing levodopa has a good therapeutic effect on the pain caused by muscle stiffness in Parkinson's disease. Most patients experience relief with the relief of muscle stiffness when the medication takes effect. However, in the later stages of medication, a few patients may experience spasmodic pain in the lower limbs, especially the toes, during the peak period of levodopa action. This situation is often difficult to handle because it is clearly a side effect of levodopa. Reducing the dosage can often alleviate the symptoms of painful spasms, but at the same time, the symptoms of Parkinson's disease cannot be effectively alleviated. In this situation, doctors often reduce the amount of levodopa used each time, but increase the frequency of administration, or increase the dosage of dopamine receptor agonists. If it doesn't work, you can try local injection of botulinum toxin, which can have a relieving effect. Patients with Parkinson's disease may also experience abnormal warm or cold symptoms in certain parts of the body, with more patients experiencing abnormal warm sensations. This abnormal temperature sensation often occurs in the hands and feet. Some patients may experience abnormal sensations on one side of the body or within the body, such as discomfort in the stomach or lower abdomen. Abnormal fever is common among patients, and some parts of the body may even experience a burning sensation. An elderly woman who has been suffering from Parkinson's disease for more than ten years has severe burning sensation in her lower back. When the medication fails, the burning sensation becomes more severe, but when adjusting the patient's medication to effectively control the condition, the symptoms will also be improved. This abnormal sensation is still a symptom of Parkinson's disease itself. The treatment of this symptom with anesthetic drugs is ineffective and lacks specific therapies. Usually, the treatment of Parkinson's disease can improve this symptom, and sometimes adding a drug called carbamazepine can have some effects. Dysphagia can occur in the late stages of Parkinson's disease. Nowadays, in addition to the swallowing disorders caused by Parkinson's disease itself, there are some swallowing disorders caused by surgery in various regions, which are more severe than the former, and anti Parkinson's disease treatment is ineffective for it. The reason is swallowing paralysis caused by bilateral pallidotomy or other surgical methods, which is an organic damage that is difficult to recover. There are no good methods for this situation except for functional exercise and gradual recovery. Speech disorder is a common symptom in Parkinson's disease patients, characterized by unclear language, flat tone of speech, lack of cadence, monotonous rhythm, and so on. Other symptoms may include autonomic nervous system dysfunction, such as increased secretion of saliva and sebaceous glands, increased or decreased sweat secretion, difficulty in urination and urination, and orthostatic hypotension. A few patients may have psychiatric symptoms such as dementia or depression. In addition to the symptoms mentioned above, Parkinson's disease patients also have the following special symptoms: the forehead of Parkinson's disease patients is always shiny with oil. Many patients with Parkinson's disease often experience drooling due to drooling, and in severe cases, others need to hold a handkerchief and constantly wipe it off. The study found that the patient's saliva secretion did not increase, but rather due to the difficulty of swallowing reflex in Parkinson's patients, the decrease in automatic swallowing action caused saliva to accumulate in the oral cavity. As the amount of accumulation increased, saliva would automatically flow out. Therefore, patients should regularly and consciously swallow saliva to reduce drooling. For young patients, the use of anticholinergic drugs such as antan can inhibit the secretion of saliva. Bladder irritation symptoms: Some Parkinson's disease patients often go to the restroom several times a day, especially at night, which leads to insomnia. Urination is sometimes uncontrollable, and coupled with the patient's slow movement, it can easily lead to wet pants. Patients with Parkinson's disease may sometimes experience lower limb swelling, mainly in the feet, and in severe cases, it can affect the lower legs. Usually on the lower limb where the obstacle first appears. Patients with significant motor delay are more likely to see foot swelling. It usually decreases or disappears after sleep at night, but gradually becomes severe during the day. The reason for this is due to the lack of activity in Parkinson's disease patients, who are unable to squeeze venous blood into the heart through leg activity and muscle contraction, causing venous blood to accumulate in the venous vessels, causing tissue fluid to seep out and causing swelling in the feet and ankle joints. In severe cases, symptomatic treatment methods can be taken, such as using diuretic drugs. When sleeping at night, you can raise your feet to facilitate venous reflux and reduce edema. The occurrence of the above situation is often related to poor symptom control of Parkinson's disease. Anti Parkinson's disease treatment not only alleviates symptoms of Parkinson's disease, but also improves bladder symptoms. It is worth mentioning that the dopamine receptor agonist Xieliang has a good effect on improving bladder symptoms in Parkinson's disease patients. If the symptoms do not improve through anti Parkinson's disease treatment, consideration should be given to whether there are other diseases, such as inflammation of the urinary system and prostate enlargement in male patients. Urologists can check and take targeted treatment.