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End Stage Parkinson's Disease Symptoms
Parkinson’s disease is not fatal and does not shorten the average life expectancy of the patient, according to the National Institute of Neurological Disorders and Stroke. As the disease progresses, however, secondary complications may lead to death. Neurologists measure progression of the disease by using the Unified Parkinson’s Disease Rating Scale, which describes various symptoms, all of which may not be present to the same degree. A patient who receives the highest score on the scale will be someone who is completely disabled and helpless. Some patients live for 15 years following diagnosis and never reach this point, say Dr. William Weiner and colleagues in their book "Parkinson's Disease: A Complete Guide for Patients and Families. 2"
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Movement and Balance Difficulties
The National Institute of Neurological Disorders and Stroke lists the four primary symptoms of Parkinson’s disease: tremor, rigidity, slowness of movement and impaired balance. These symptoms worsen until the person has a complete absence of facial expression, cannot speak and cannot stand or walk. According to Dr. Weiner and colleagues, movement problems include extreme loss of balance and freezing while walking, which result in the patient falling frequently.
Cognitive and Behavioral Problems
Signs & Symptoms of End Stage Parkinson's
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The patient may experience any of a variety of mental issues such as:
- confusion
- memory loss
- hallucinations
- delusions
- depression
- anxiety
According to Dr. Weiner and colleagues, confusion and memory problems, known as dementia, develop in one out of every four to five Parkinson’s patients at a level severe enough to interfere with daily activities.
Nervous System Impairments
The autonomic nervous system controls unconscious functions such as breathing, blood pressure, digestion and urination. In the end stage of Parkinson’s disease a patient becomes incontinent, constipated and subject to a drop in blood pressure when going from a seated position to standing, which may result in fainting, according to Dr. Weiner and colleagues.
Drooling and Difficulty Swallowing
Final Stages of Huntington's Disease
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In Parkinson’s disease the swallowing reflex deteriorates, which can lead to choking when eating or drinking. The patient will not swallow saliva frequently. As saliva pools in the mouth, the patient may drool and choke. Caregivers may need to feed some end stage Parkinson's patients through a tube inserted in the stomach through the abdomen.
- In Parkinson’s disease the swallowing reflex deteriorates, which can lead to choking when eating or drinking.
- As saliva pools in the mouth, the patient may drool and choke.
Medication Problems and Drug-Induced Symptoms
According to the National Institute of Neurological Disorders and Stroke, as Parkinson’s disease progresses the response of the patient to medication becomes less predictable. The medication may wear off faster and no longer control symptoms adequately. The patient may need more frequent doses. As the drug dose increases so do the side effects, including dyskinesia, an uncontrollable, involuntary writhing movement, which may disable the patient as much as the original Parkinson’s symptoms do.
- According to the National Institute of Neurological Disorders and Stroke, as Parkinson’s disease progresses the response of the patient to medication becomes less predictable.
- As the drug dose increases so do the side effects, including dyskinesia, an uncontrollable, involuntary writhing movement, which may disable the patient as much as the original Parkinson’s symptoms do.
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References
- Functional and Stereotactic Neurosurgery Center of Massachusetts General Hospital/Havard Medical School: Hoehn and Yahr Staging of Parkinson's Disease
- “Parkinson’s Disease: A Complete Guide for Patients and Families" (2nd Edition); William J. Weiner, Lisa M. Shulman, and Anthony E. Lang; 2007
- Letanneux, A, Danna, J, Velay, JL, Viallet, F, Pinto, S. From micrographia to Parkinson’s disease dysgraphia. Mov Disord. 2014;29:1467-1475. doi:10.1002/mds.25990
- Ylikoski A, Martikainen K, Sieminski M, Partinen M. Sleeping difficulties and health-related quality of life in Parkinson's disease. Acta Neurol Scand. 2017;135(4):459-468. doi:10.1111/ane.12620
- Diederich NJ, Fénelon G, Stebbins G, Goetz CG. Hallucinations in Parkinson disease. Nat Rev Neurol. 2009;5(6):331-42. doi:10.1038/nrneurol.2009.62
- Ozturk EA, Gundogdu I, Kocer B, Comoglu S, Cakci A. Chronic pain in Parkinson's disease: Frequency, characteristics, independent factors, and relationship with health-related quality of life. Journal of Back and Musculoskeletal Rehabilitation. 2016; 30(1):101-108. doi:10.3233/BMR-160720
- Pagonabarraga J, Kulisevsky J. Apathy in Parkinson's disease. Int Rev Neurobiol. 2017;133:657-678. doi:10.1016/bs.irn.2017.05.025
- Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.62
Writer Bio
Based in Toronto, Ruth Warre has been writing about the brain and neurological diseases since 2007. Her work has been published in several scientific journals such as "Neuroscience" and the "Journal of Neurophysiology." She holds a Ph.D. in neuroscience from the University of Bristol in the U.K.