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| {{mergeto|Parkinson's disease}} | |||
| Mood disturbances: | Mood disturbances: | ||
| *]: occurs in 40-80% of cases; 20% of depression cases are major depressive disorder; severity and persistence of depression is positively associated with executive dysfunction and dementia; | *]: occurs in 40-80% of cases; 20% of depression cases are major depressive disorder; severity and persistence of depression is positively associated with executive dysfunction and dementia; | ||
Revision as of 17:14, 26 August 2006
 | It has been suggested that this article be merged into Parkinson's disease. (Discuss) |
Mood disturbances:
- depression: occurs in 40-80% of cases; 20% of depression cases are major depressive disorder; severity and persistence of depression is positively associated with executive dysfunction and dementia;
- anxiety or panic attacks
Note: 70% of individuals with Parkinson's disease diagnosed with pre-existing depression go on to develop anxiety; 90% of Parkinson's disease patients with pre-existing anxiety subsequently develop depression); - apathy or abulia: abulia translates from Greek as the absence or negative of will; apathy is an absence of feeling or desire
Cognitive disturbances:
- slowed reaction time; both voluntary and involuntary motor responses are significantly slowed.
- executive dysfunction, characterized by difficulties in: differential allocation of attention, impulse control, set shifting, prioritizing, evaluating the salience of ambient data, interpeting social cues, and subjective time awareness. This complex is present to some degree in most Parkinson's patients; it may progress to:
- dementia: a later development in approximately 20-40% of all patients, typically starting with slowing of thought and progressing to difficulties with abstract thought, memory, and behavioral regulation.
- memory loss; procedural memory is more impaired than declarative memory. Prompting elicits improved recall.
- medication effects: some of the above cognitive disturbances are improved by dopaminergic medications, while others are actually worsened
- Excessive daytime somnolence;
- Initial, intermediate, and terminal insomnia;
- Disturbances in REM sleep: disturbingly vivid dreams, and REM Sleep Disorder, characterized by acting out of dream content;
Sensation disturbances:
- impaired visual contrast sensitivity, spatial reasoning, colour discrimination, convergence insufficiency (characterized by double vision) and oculomotor control
- dizziness and fainting; usually attributable orthostatic hypotension, a failure of the autonomous nervous system to adjust blood pressure in response to changes in body position
- impaired proprioception (the awareness of bodily position in three-dimensional space)
- loss of sense of smell (anosmia),
- pain: neuropathic, muscle, joints, and tendons, attributable to tension, dystonia, rigidity, joint stiffness, and injuries associated with attempts at accommodation
Autonomic disturbances:
- oily skin and seborrheic dermatitis;
- urinary incontinence, typically in later disease progression
- constipation and gastricdysmotility: severe enough to endanger comfort and even health
- altered sexual function: characterized by profound impairment of sexual arousal, behavior, orgasm, and drive is found in mid and late parkinson disease. Current data addresses male sexual function almost exclusively.