The Struggles Behind Parkinson's disease

Symptoms and diagnosis

Neurology 2

By Neurosurgery Singapore

What is Parkinson’s disease?

Parkinson’s disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.

In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over time.


Although Parkinson’s disease can’t be cured, medications might significantly improve your symptoms. Occasionally, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

What are some symptoms of Parkinson’s disease?

Parkinson’s disease signs and symptoms can be different for everyone. Early signs may be mild and go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides.

Parkinson’s signs and symptoms may include:

  • Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may a rub your thumb and forefinger back-and-forth, known as a pill-rolling tremor. Your hand may tremor when it’s at rest.
  • Slowed movement (bradykinesia). Over time, Parkinson’s disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk.
  • Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.
  • Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson’s disease.
  • Loss of automatic movements. You may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
  • Speech changes. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.
  • Writing changes. It may become hard to write, and your writing may appear small.

“In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to symptoms of Parkinson’s disease.”

What types of diagnosis?

  • The doctor may order the following tests:

    Blood test: This can help to rule out other conditions, such as abnormal thyroid hormone levels or liver damage.

    MRI or CT scan: A scan can check for signs of a stroke or brain tumor. If there are no signs of a stroke or brain tumor, most MRI or CT scans of people with PD will appear normal. A person with a normal brain scan but symptoms of PD may have PD.

    Positron emission tomography (PET) scan: This is an imaging test that can sometimes detect low levels of dopamine in the brain. PET scans are expensive, and not all hospitals offer them, so this option is not always available.

    Single-photon emission computerized tomography (SPECT) scan: This is also called a dopamine transporter (DAT) scan.

    Whatever the results of the scan, the doctor will primarily consider the person’s signs and symptoms when making a diagnosis.

Living with Parkinson’s disease 

Hearing that you or another person has PD can be a life-changing event. Support from your health workers, friends, and family will be important.

It can help to find out as much information as you can about what causes PD, what to expect, what kind of support is available, and what kind of treatment your insurance will cover.

Communicating with your doctor and those around you is also likely to be important.

You may find it helpful to get in touch with a local or online community group for people with PD and their loved ones. A doctor will be able to advise you on this.

Call us for a consultation

Call our Specialists!