Fact Sheets

10 Signos Tempranos

Este folleto describe las diez síntomas que pueden ser indicadores tempranas de la enfermedad de Parkinson. Cada síntoma explica qué es "normal". Si usted tiene más que una síntoma, es aconsejable visitar a su doctor.

Puede resultar difícil saber si usted o un ser querido tiene la enfermedad de Parkinson (EP). La EP es un trastorno neurodegenerativo que afecta principalmente las neuronas que producen dopamina (“dopaminérgicas”) en un área específica del cerebro denominada la “sustancia negra”. En general, los síntomas se manifiestan lentamente durante años y su evolución a menudo varía de una persona a otra, debido a la diversidad de la enfermedad.

A continuación, se muestra una lista de los 10 signos tempranos de la enfermedad de Parkinson.

Ninguno de estos signos por sí solo significa que debe preocuparse por tener la EP; sin embargo, si nota usted más de un signo, debe considerar consultar con su médico.

Temblores

¿Ha notado un leve temblor o agitación de los dedos de las manos, las manos o la barbilla? Frecuentemente, un temblor, mientras está en reposo, es un signo temprano de la EP.

¿Qué es lo normal?

La agitación puede ser normal después de hacer mucho ejercicio, si está estresado o si ha sufrido una lesión. La agitación también puede ser causada por un medicamento que tome.

Escritura pequeña

¿Su escritura es mucho más pequeña de lo que solía ser? Es posible que note que el tamaño de sus letras es más pequeño y que las palabras se amontonan. Un cambio en la escritura puede ser un signo de la enfermedad de Parkinson que se denomina “micrografía”.

¿Qué es lo normal?

En ocasiones, la escritura puede cambiar a medida que se envejece, si tiene rigidez en las manos o los dedos, o si tiene visión escasa.

Estreñimiento

¿Tiene problemas diariamente para evacuar sin sufrir estreñimiento? El estreñimiento puede ser un signo temprano de la EP y debe hablar con su médico.

¿Qué es lo normal?

Si no consume suficiente agua o fibra, puede tener problemas a la hora de ir al baño. Además, algunos medicamentos, especialmente los analgésicos, provocan estreñimiento. Si no hay otro motivo, como la dieta o algún medicamento que le provoquen problemas para evacuar, debe hablar con su médico.

Pérdida del olfato

¿Ha notado que ya no huele tan bien determinadas comidas? Si siente que le cuesta más oler determinadas comidas, como bananas, pepinillos en vinagre al eneldo o licor, debe preguntarle a su médico sobre la EP.

¿Qué es lo normal?

El sentido del olfato puede cambiar a causa de resfrío, gripe o congestión nasal, pero debe recuperarse cuando mejore.

Problemas para dormir

¿Se agita mucho en la cama o tiene sueños vívidos mientras duerme? En ocasiones, su cónyuge lo notará o querrá irse a otra cama. Los movimientos repentinos durante el sueño pueden ser un signo de la EP.

¿Qué es lo normal?

Es normal que todos tengamos una noche en la que demos vueltas en vez de dormir. De la misma forma, las sacudidas rápidas del cuerpo al dormirse o al tener un sueño liviano son frecuentes y, a menudo, normales.

Mareos o desmayos

¿Nota que a menudo se marea al levantarse? La sensación de mareos o desmayos puede ser un signo de presión arterial baja y puede vincularse con la EP.

¿Qué es lo normal?

Todas las personas han pasado por la situación de marearse al pararse; sin embargo, si esto sucede habitualmente, debe consultar al médico.

Encorvarse

¿No se está parando tan derecho como solía hacerlo? Si usted o sus familiares o amigos notan que parece estar encorvándose o inclinándose al pararse, podría ser un signo de la EP.

¿Qué es lo normal?

Si siente dolor por una lesión o si está enfermo, esto podría hacer que se pare de manera encorvada. Además, un problema óseo puede hacer que se encorve.

Problemas para moverse o caminar

¿Siente rigidez en el cuerpo, los brazos o las piernas? ¿Otras personas han notado que uno de sus brazos o ambos ya no se balancean de la forma en que solían hacerlo al caminar? En ocasiones, la rigidez desaparece al moverse. De lo contrario, puede ser un signo de la EP. Un signo temprano puede ser rigidez o dolor en los hombros o las caderas. A veces las personas dicen que sus pies parecen “pegados al piso”.

¿Qué es lo normal?

Si se lesionó el brazo u hombro, es posible que no pueda usarlo tan bien hasta que haya sanado; también otra enfermedad, como la artritis, podría causar el mismo síntoma.

Reducción de la expresión

¿Le han dicho que tiene una mirada de seriedad, depresión o enojo, incluso cuando no está de mal humor? Esto a menudo se llama “enmascaramiento facial”. Si es así, debe hablar con su médico sobre la EP.

¿Qué es lo normal?

Algunos medicamentos pueden hacer que tenga una mirada de seriedad o fijación; sin embargo, volverá a su expresión anterior cuando deje de tomar los medicamentos.

Voz baja o suave

¿Le han dicho otras personas que su voz es muy suave o ronca? Si se produjo un cambio en su voz, debe consultar con su médico sobre si puede ser a causa de la EP. En ocasiones, puede pensar que otras personas están perdiendo la audición, cuando, en realidad, usted está hablando con una voz más suave.

¿Qué es lo normal?

Un resfrío u otro virus pueden hacer que la voz suene diferente, pero debe volver al mismo sonido anterior al resfrío o a la tos.

¿Qué puede hacer si tiene la EP?

Es posible tener una gran calidad de vida si tiene la EP. Es fundamental trabajar con su médico y hacer las terapias recomendadas para tratar los síntomas correctamente.

  • Elaborar un plan con su médico para mantenerse sano.

Podría incluir lo siguiente:

– Una derivación a un neurólogo, un médico que se especializa en el cerebro, o a un especialista en trastornos del movimiento, un neurólogo con una mayor formación en la EP.

– Atención de un terapeuta ocupacional, fisioterapeuta o terapeuta del habla.

– Reunirse con un trabajador social médico para hablar sobre la forma en que la enfermedad de Parkinson afectará su vida.

  • Comenzar un programa de ejercicio regular para controlar los síntomas y mantener el bienestar.
  • Hablar con familiares y amigos que puedan darle el apoyo que necesite.

La Parkinson’s Foundation está a su disposición para ayudarle

Comuníquese con la línea de ayuda de la Parkinson’s Foundation para obtener respuestas a sus preguntas, ya sea en inglés o en español. Dotada de personal especializado en información sobre la enfermedad de Parkinson, la Línea de Ayuda es gratuita y está a su disposición para ayudarlos, a usted y a sus seres queridos, de todas las maneras posibles, entre ellas:

  • Información actual sobre la enfermedad de Parkinson
  • Apoyo emocional
  • Derivaciones a profesionales de la atención médica y recursos comunitarios

También hay disponibles diversas publicaciones gratuitas. Puede comunicarse con esta línea llamando al 1.800.4PD.INFO (1-800-473-4636); opción 3 para español  o escribiendo a Helpline@Parkinson.org.

¿No está listo para hablar con alguien sobre la EP? Visite Parkinson.org para obtener información de confianza.

Para ordenar una copia física, visite nuestra tienda.

Videos & Webinars

Expert Briefing: Medication: What’s New?

Medication options for Parkinson’s disease (PD) are constantly evolving and vary for each individual. Choosing medications depends on many variables; including motor fluctuations, symptom variability and other existing health issues. In this webinar, Dr. Rajesh Pahwa shares new treatment options to be on the lookout for within the next two years and explains who would be the best candidates for these new therapies available.

Presenter

Rajesh Pahwa, MD
Laverne and Joyce Rider Professor of Neurology
Chief, Parkinson and Movement Disorder Division
Director, Parkinson’s Foundation Center of Excellence
University of Kansas Medical Center

Videos & Webinars

Expert Briefing: Mental Health and PD

Parkinson's disease (PD) is complicated by a number of comorbid psychiatric symptoms that often overlap with the motor and other physical aspects of PD or may be caused by PD medications used to treat motor symptoms (e.g., impulse control disorders and dopamine agonists). In this webinar, Dr. Marsh will focus on the overlap of motor, cognitive, and psychiatric aspects of PD. Additionally, she will describe the features of comorbid psychiatric disturbances, including depression, anxiety and psychosis along with general approaches to treatment.

Learning Objectives: At the conclusion of this webinar, the participants will:

  1. Understand the relationships between motor, cognitive and psychiatric dysfunction in PD over the course of the disease.
  2. Understand the common psychiatric diagnoses seen in patients with PD.
  3. Be familiar with appropriate treatments for neuropsychiatric disturbances in PD.

Download Slides

Presenter

Laura Marsh, MD
Professor of Psychiatry and Neurology, Baylor College of Medicine
Director, Mental Health Care Line
Michael E. DeBakey VA Medical Center

Videos & Webinars

Expert Briefing: Non-motor Symptoms: What’s New?

In this webinar, Dr. Pfeiffer will focus on the detection and effective treatment of non-motor symptoms other than traditional PD medications. He will address how non-motor symptoms, such as impaired sense of smell, sleep behavior changes, constipation and depression may be present years before the classic motor features of PD appear. You will take away specific recommendations on how to cope and live optimally with these non-motor symptoms.

Learning Objectives: At the conclusion of this webinar, the participants will:

  1. Recognize that non-motor symptoms, such as impaired olfaction, REM sleep behavior disorder, pain, constipation and depression may be present years before the classic motor features of PD appear.
  2. Understand that non-motor features frequently become the most troublesome features of PD as it advances.
  3. Be aware that treatment other than traditional PD medications may be needed for non-motor features of PD.

Download Slides

Presenter

Ronald Pfeiffer, MD
Oregon Health and Sciences University
OHSU Parkinson Center
Parkinson’s Foundation Center of Excellence

Videos & Webinars

Expert Briefing: Vision Changes

Download Slides

Presenter

Dan Gold, DO
Assistant Professor of Neurology, Ophthalmology, Neurosurgery, Otolanryngology,
- Head and Neck Surgery, Emergency Medicine
The Johns Hopkins University School of Medicine

Videos & Webinars

Exploring Non-Motor Symptoms: Neuropathy, Fatigue, GI Issues

Non-motor symptoms of Parkinson's disease can be as disabling as the problems one may experience with their movement. While some non-motor symptoms are commonly related to PD, others do not always have a clear connection. In this collaborative presentation, the ambiguous topics of fatigue, neuropathy, and gastrointestinal issues and how they may relate to medications, Parkinson’s disease, and/or aging will be discussed. Evidenced-based treatments for these non-motor symptoms are addressed as well.

Presenters

Steven Swank, PharmD, BCACP, University of Kansas Medical Center
Ellen Walter, APRN-CNP, Cleveland Clinic
Kelly Weinschreider, Aware in Care Ambassador

Podcasts

Episode 145: Treating Depression

Parkinson’s disease (PD) depression may be a biological part of the disease itself, resulting from PD-related changes in brain chemistry. Untreated depression and other mood disorders can have a greater impact on well-being than even common motor symptoms.

Depression affects at least 50 percent of people with PD sometime in the course of their disease, but it is often under-recognized and, therefore, under-treated, even though effective treatments exist, both pharmacologic and nonpharmacologic. Treating depression can be a significant way to improve quality of life. 

Veronica Bruno, MD, MPH, a neurologist specializing in movement disorders at the University of Calgary in Alberta, Canada, a Parkinson’s Foundation Center of Excellence, discusses depression, the problem of under-diagnosis, and the benefits of recognition and treatment.

Released: February 7, 2023

Audiobooks

Sleep: A Mind Guide to Parkinson's Disease

Consider this your practical guide for achieving good sleep health. This book addresses healthy sleep, sleep changes due to aging and sleep problems due to Parkinson’s, as well as diagnosis, treatment and coping strategies.

LISTEN NOW

Raise Awareness

PD Dementia: An Important Conversation

Nurse resting her hand on the shoulder of her patient

Many people with Parkinson’s disease (PD) experience some degree of cognitive change, such as slowness of memory, changes in thinking, trouble focusing or difficulty finding words. Dementia is a permanent cognitive change that interferes with daily activities and quality of life. Identifying thinking changes early and discussing them with your doctor are the first steps in treating or ruling out PD-related dementia.

This article is based on a Parkinson’s Foundation Expert Briefing Let’s Talk About Dementia presented by Dr. James Leverenz, Director, Lou Ruvo Center for Brain Health at Cleveland Clinic, a Parkinson’s Foundation Center of Excellence.

Slowed movement, tremor and stiffness are some of the visible movement signs of Parkinson's disease. Though not visible, the impact of non-movement symptoms can be even more challenging for people with PD and their loved ones — this includes issues with thinking and memory. While PD-related cognitive change can be mild, between 60 to 80% of people living with PD for 15 years or more can experience disease-related dementia. Awareness of thinking changes can ensure early treatment.

Lewy Body Dementias

In Parkinson’s, the protein alpha-synuclein misfolds and forms clusters in the brain called Lewy bodies. These sticky clusters upset normal brain function. Lewy bodies are strongly linked to PD and dementia.

Nearly 1.5 million Americans are impacted by Lewy body dementias, including those living with:

  • Parkinson’s disease dementia (PDD): diagnosed when significant cognitive decline occurs in someone living with Parkinson’s movement symptoms for a year or more (usually several years).
  • Dementia with Lewy bodies (DLB): diagnosed when cognitive decline occurs before or at the same time as motor symptoms.

Almost 50% of people with Alzheimer's disease also have some Lewy body brain abnormalities. These are frequently seen in both people who live with sporadic and familial forms of Alzheimer's. When these changes go beyond a part of the brain called the amygdala, people often have some of the same symptoms as people living with dementia with Lewy bodies , frequently developing Parkinson's-like motor symptoms. This is known as the Lewy body variant of Alzheimer disease.

Some researchers theorize that Alzheimer's disease may drive clumping of Lewy bodies. New therapies designed to slow Alzheimer's progression could also hold possibility to slow Lewy body development — another reason for the importance of an early and correct diagnosis, and early treatment.

Dementia Signs and Symptoms

In addition to memory, thinking and behavior changes, other symptoms include:

Despite many shared symptoms across Lewy body dementia diseases, people often store and recall information differently, depending on which cognitive disorder they are living with.

Adding and retaining new memories is often difficult for people living with Alzheimer's disease. It may be challenging for someone with Alzheimer's to remember a question or conversation just minutes after, or they may have forgotten events from the previous day. Encoding new information can be an issue. However, if a person experiencing PD thinking changes struggles retrieving a memory, they can often pull it up with a clue or a reminder.

This means people with PD dementia can store memories. Rather than primary encoding difficulty, they often experience retrieval challenges — an executive dysfunction similar to difficulty multitasking or staying on track during conversations.

People with Alzheimer’s disease tend to have less awareness that they are hallucinating. A person with PD dementia or dementia with Lewy bodies can more often recognize that they are experiencing hallucinations. It’s important for the care provider to ask the person experiencing changes “Do you see things?” People with PD-related dementia will often acknowledge that they do see things, are aware the hallucinations are not real and are not bothered by what they see.

Diagnosing Lewy Body Dementias

Ensuring the person living with thinking changes receives the correct diagnosis is important. When diagnosing dementia, a doctor, neurologist or other healthcare expert will look for the ability to retrieve retained memories, early executive dysfunction or multitasking difficulties.

A review of symptoms, medications, medical history and more are also key to an accurate diagnosis. Your doctor will also rule out other medical illnesses — urinary tract infections or pneumonia can be related to sudden confusion and agitation.

Work with your doctor to identify any medications that might impact symptoms. Some medicines can cause or worsen confusion and hallucinations, including:

  • Certain dopamine-boosting medications that ease movement at lower doses but may worsen thinking problems at higher doses
  • Old antipsychotics, such as haloperidol, and anticholinergic (acetylcholine-blocking)
  • Medications, such as trihexyphenydil, sometimes used to treat tremor

Therapies

Medications used in Alzheimer’s disease have benefits in PD dementia, including rivastigmine, donepezil and galantamine. Selective serotonin reuptake inhibitors (SSRIs), used for depression, may also be beneficial.

For people with Parkinson’s experiencing rapid eye movement (REM) sleep behavior disorder, your doctor might recommend the over-the-counter sleep aid melatonin. Clonazepam is frequently used if melatonin is not effective, although it can cause confusion, daytime sleepiness and other side effects.

Cognitive remediation, provided by a neuropsychologist or speech-language pathologist, focuses on strengthening cognition.

Behavior management modifies activities and environments to improve abilities and independence. It includes creating a daily routine, decluttering living spaces, increasing lighting and using assistive tools to reduce confusion.

Exercise, physical activity and social connection can also benefit cognitive health.

On the Horizon

Research is currently underway to better understand dementia and discover disease-specific therapies. Diagnosing and treating the earliest stages of thinking change can ensure early lifestyle adjustments and the best chance for responsive therapy.

Understanding the biological differences behind the development and onset of all Lewy body dementias will be essential to future disease-specific therapies.

Scientists are currently working to standardize testing of blood and body fluids to reveal amassed Lewy body alpha-synuclein. This could serve as an early detection tool for neurodegenerative disorders related to the protein, such as PD.

Biomarkers for the Lewy Body Dementias, a National Institutes of Health-funded study, recently awarded more than $10 million to the Cleveland Clinic to expand the national Dementia with Lewy Bodies Consortium. A collaboration with several Parkinson’s Foundation Centers of Excellence and others, the coalition accelerates research to improve diagnosis and treatment of dementia with Lewy bodies, including Parkinson’s disease dementia.

People who experience rapid eye movement (REM) sleep behavior disorder (RBD) are at risk for developing Lewy body dementias. This risk factor might be another potential early diagnosis clue or cue to begin preventative future preventative therapies as they become available.

Learn More

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and dementia by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) or visiting Parkinson’s Foundation resources below.

Podcasts

Episode 144: How to Cope with Blood Pressure Fluctuations

Parkinson’s disease (PD) affects several automatically regulated bodily functions, such as digestion, bowel activity, sweating, and blood pressure control, together known as autonomic functions. Low blood pressure, or hypotension, is common in PD, and high blood pressure (hypertension) can also occur. They may be a result of the disease itself or be caused by some of the medications to treat it. Hypotension, in particular, can be dangerous, leading to dizziness, fainting, falls, and fractures.

Up to 60% of people with PD may experience orthostatic hypotension at some point, which is a drop in blood pressure within three minutes of changing to a more upright position, that is, from sitting to standing or from a lying position to sitting or standing. 

In this episode, Jeni Bednarek, RN, BSN, ACRP-CP, nurse team coordinator and associate director of education of the Parkinson Center of Oregon in the Parkinson’s Center and Movement Disorders Program of the Oregon Health and Science University in Portland, a Parkinson’s Foundation Center of Excellence, discusses several ways for individuals with PD to cope with blood pressure problems, including pharmacologic and non-pharmacologic methods, as well as working with their health care providers to reach a good blood pressure balance.

Released: January 24, 2023

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