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Everything You Need to Know About Parkinson’s (Part 1)

Dr. Zahid Rustam

2 min read

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Parkinson’s Disease (PD) is a slowly progressing neurodegenerative condition identifiable via increasing movement difficulty and tremors. Commonly affecting individuals over 50, Parkinson’s is not a fatal condition in itself; with many diagnosed individuals living healthily up to the general human lifespan.

How It Happens?

Dopamine is the key motion controlling chemical produced by neurons (nerve cells) in a specific area of the brain known as the ‘Substantia nigra’. However, the gradual death or damage of these neurons in certain individuals results in decreased dopamine production The  decrease is marked by slowness in movements, impaired balance and tremors in muscles.


While the exact cause is unknown, the following factors are often associated with a positive Parkinson’s diagnosis:

  • Environmental Factors: Certain genetic mutations may predispose particular individuals to PD. However, such individuals must have multiple family members with Parkinson’s to be diagnosed positive.
  • Environmental Factors: Prolonged exposure to herbicides and pesticides mildly increases the risk of Parkinson’s. However, this too is a variable factor; not all individuals exposed to similar toxins over a similar time span may develop the condition.


Noticeable symptoms usually don’t appear until later stages, when almost 80% of the neurons in the substantia nigra have either died or become impaired. However, some might notice mild versions of the following symptoms early on-usually on one side of the body:

  • Tremors in one hand or fingers when at rest, or the involuntary rubbing of the thumb and fore-finger (pill-rolling tremor).
  • Sudden feet dragging and difficulty performing simple actions such as getting out of a chair or taking long strides (Bradykinesia).
  • Reduced range of motion due to suddenly stiff and painful muscles.
  • A monotonous speech pattern, slurred speech, hesitation before talking, and speaking abnormally softly.
  • Difficulty in differentiating between, or identifying certain odours (Anosmia).
  • A stooped posture and balancing issues, such as falling over when making sudden turns.
  • Difficulty writing and Micrographia, i.e. abnormally small and/or crowded handwriting.
  • Serious, depressed, or angry facial expressions despite a normal mood (Facial Masking).
  • Uncharacteristic depression or anxiety.
  • Unexplained energy loss and fatigue.
  • Pain in specific areas or throughout the body.


Since Parkinson’s is a progressive condition, doctors rate patients based on the severity of their symptoms using a modified version of the 1967 ‘Hoehn and Yahr Scale’. Originally ranging from 0-5 i.e. 0=no signs and 5=advanced Parkinson’s, it has since been modified to a scale of 1-5, with 1 and 2 for early-stage, 2 and 3 for mid-stage, and 4 and 5 for advanced-stage Parkinson’s. Another scale  is the ‘Unified Parkinson’s Disease Rating Scale (UPDRS), which encompasses both motor and non-motor symptoms.

  • Stage 1: Mild and unnoticeable symptoms on one side of the body that do not interfere with daily activities.
  • Stage 2: Mild-to-moderate symptoms on both sides of the body, with slight difficulty in performing daily tasks.
  • Stage 3: Visibly slow movements and frequent falls due to balancing difficulties.  
  • Stage 4: Severe and disabling symptoms, extreme muscle rigidity, and limited walking that may require assistance.
  • Stage 5: Hallucinations, delusions, and extreme leg stiffness requiring a wheelchair to move around, along with constant care.

Young-Onset Parkinson’s Disease (YOPD):

In some instances, Parkinson’s-related symptoms may appear in individuals younger than 50, while even rarer cases have been observed in children and teenagers, also known as ‘Juvenile Parkinsonism’. While both are primarily due to the PD-specific genetic mutations, those diagnosed with YOPD have a comparatively longer survival rate. However, the symptoms and side-effects of Parkinson’s and its relevant medication are much more frequent and severe in YOPD patients as compared to those over 50 with PD.

No two patients with Parkinson’s progress at the same pace; certain symptoms may be experienced earlier, later on, or not at all, depending upon the individual. If you experience any of the above symptoms, consult with your doctor immediately, You can also book an appointment with a top Neurologist in Lahore, Karachi and Rawalpindi through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your neural concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Zahid Rustam
Dr. Zahid Rustam - Author "Dr. Zahid Rustam completed his MBBS from Army Medical College and pursued his further education in the UK and USA. Recently Dr. Zahid has Earned qualification of FIPP WIP USA which is the only recognized Post-graduation degree in Interventional pain practice. He is one of only 06 physicians in Pakistan to earn this degree.

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