Lesser Known Symptoms of Parkinson's Disease

The speaker introduces the topic of Parkinson's disease, highlighting both motor and non-motor symptoms. Motor symptoms include tremors, slowness, stiffness, and balance issues, while non-motor symptoms, which are less visible but equally impactful, include autonomic dysfunction, cognitive and psychiatric issues, and sleep disorders. The importance of addressing non-motor symptoms early is emphasized to maintain quality of life.

The speaker discusses autonomic dysfunction, particularly drooling, which affects 10% of Parkinson's patients. Drooling is caused by impaired swallowing efficiency and reduced facial movement. Treatments include medication adjustments, atropine drops, and botulinum toxin injections. Swallowing issues, which can lead to choking and aspiration pneumonia, are also covered, with recommendations for speech therapy, posture adjustments, and specific eating techniques to prevent complications.

The speaker addresses other autonomic dysfunctions like body temperature regulation and excessive sweating, which often coincide with medication wear-off periods. Constipation is highlighted as a common issue, affecting 75% of patients. Recommendations include hydration, fiber intake, and consistent use of over-the-counter medications like Miralax. The importance of maintaining regular bowel movements for effective medication absorption is emphasized.

Bladder issues, including urinary urgency, frequency, and nocturia, are common in Parkinson's patients and can disrupt sleep. The speaker advises avoiding caffeine and managing fluid intake. Sexual dysfunction, including decreased libido and erectile dysfunction, is discussed, along with potential treatments. The importance of addressing these issues with healthcare providers is stressed.

Orthostatic hypotension, a drop in blood pressure upon standing, affects many Parkinson's patients. Symptoms include lightheadedness, fatigue, and cognitive slowing. The speaker advises monitoring blood pressure at home, staying hydrated, increasing salt intake, and using compression socks. The importance of preventing falls and fractures due to low blood pressure is highlighted.

Parkinson's-related pain, often neuropathic, is discussed, with treatment options including medication adjustments and lifestyle changes. Cognitive changes, which can lead to dementia, are also covered. Early symptoms include difficulties with multitasking and processing speed. Dementia in Parkinson's is characterized by slow thought processes, memory issues, and visual-spatial difficulties.

The speaker addresses mood-related non-motor symptoms, including apathy and depression. Apathy is described as a lack of motivation, while depression often presents as anxiety in Parkinson's patients. Treatment options include antidepressants and mood stabilizers. The importance of addressing these symptoms to improve quality of life is emphasized.

Restless leg syndrome and REM behavior disorder are common sleep issues in Parkinson's patients. Restless leg syndrome involves an uncomfortable sensation and a need to move the legs, often related to low iron levels. REM behavior disorder, where patients act out their dreams, can lead to injuries and poor sleep quality. Treatment options include medication and sleep studies.

The speaker continues discussing sleep disorders, emphasizing the importance of good sleep quality to prevent cognitive decline and other complications. REM behavior disorder is highlighted as a significant issue that precedes Parkinson's diagnosis in many cases. The speaker recommends melatonin and clonazepam for treatment and stresses the need for sleep studies if symptoms persist.

The speaker briefly introduces new medications and treatments for Parkinson's, such as pretory, a combination of immediate and extended-release Sinemet, and new options for hallucinations and orthostatic hypotension. The speaker also mentions upcoming treatments and the importance of staying informed about new developments in Parkinson's care.