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Introduction to Parkinson's Disease
Early Presentation of Parkinson's Disease
Bradykinesia tends to affect fine motor movement more than gross motor movement, as well as repetitive movement. Thus, the patient notices difficulty in activities that require dexterity such as fastening buttons, or in tasks requiring repetitive hand motions such as brushing teeth.
In the face, bradykinesia may manifest itself as a decrease in facial expression and/or eye blinking. Some patients experience slowness in the muscles involved in swallowing, leading to a buildup of saliva which could cause choking.
Postural Instability
Postural instability is a general term that involves gait changes and an impaired sense of balance. It is noticeable when the patient with Parkinson's disease moves or turns abruptly which may cause them to lose their balance and fall. Gait changes include asymmetric slowness, shuffling, and reduced arm swinging. Some patients lean forward or backward also causing them to fall easily especially if they are bumped. For some patients, especially older adults, postural instability may be a later presenting symptom of Parkinson's disease.
