Monday, 23 November 2015

The 5 Stages of Parkinson’s disease

On August 11, 2014, the world woke up to the shocking news that the famous comedian and actor Robin Williams of Mrs. Doubtfire fame (the movie that inspired the making of Avvai Shanmugi) had passed away. Robin Williams had been afflicted with Parkinson’s disease, a degenerative disease that affects the nervous system. Apart from restrictive mobility, depression is one of the hallmarks of this disease.

The signs and symptoms commonly exhibited by someone afflicted with Parkinson’s are discernible as follows:

  • Lack of coordinated movement
  • Uncontrolled shaking or tremors exhibited by parts of the body (head, hands, etc)
  • Stiffness of the limbs
  • Slow movement
  • Standing up and balancing
  • Difficulty in speaking lucidly

These signs may differ from person to person, but as this brain disorder progresses, it only worsens through the stages. The progression of Parkinson’s has been mapped into 5 stages, which are:

Stage I: A person in this stage may show some mild symptoms, which are not alarming, and which do not prevent them from carrying out their daily tasks, nor does it affect their lifestyle. The tremors and difficulty in movement are very minimal and are usually restricted to one side of the body. These signs are so minimal that they can often be missed. When diagnosed and treated at this stage with medications, it does work to minimize the symptoms.

Stage II: This is considered the moderate stage and the symptoms become noticeable. Changes in facial expressions may begin to occur, and the trembling, tremors and stiffness in the muscles will be very perceptible. There is no impairment of balance, but stiffness in the muscles does elongate the time taken to complete tasks. Also at this stage, Parkinson’s affects both sides of the body and may cause speech difficulty. Progression from stage I to II can happen in months or may take years, and depends on each individual.

Stage III: This is still considered the mild stage and the symptoms are still the same as were in Stage II, but with the added symptoms of loss of balance and decreased reflexes. The chances of falling frequently are greater at this stage. Moreover, the patient will now find it more difficult to complete their daily tasks. Medication and occupational therapy can help decrease the symptoms now.

Stage IV: Dependency on others increases at this stage, as movement becomes very difficult indeed. The patient may be able to stand up without aid, but may require an assistive aid such as a walker to move. Performing daily tasks also becomes even more difficult, and the patient can no longer live alone.

Stage V: This is the final and most advanced debilitating stage in Parkinson’s disease. The stiffness is in an advanced stage, and upon standing, sometimes causes freezing of the muscles. The patient will require being in a wheelchair and may often be unable to stand without falling.

Therefore, the patient will require round-the-clock assistance. Furthermore, the patient will experience hallucinations and be occasionally delusional. The side-effects of medications at this stage counterbalance the benefits.
Age groups prone to Parkinson’s disease

The early stages of Parkinson’s set in usually around 62 years of age. Parkinson’s is also known to occur in people of younger age groups - 50 and below. Being affected by Parkinson’s below the age of 50 years is known as ‘young-onset Parkinson’s disease’.


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