Understanding Weakness in Parkinson’s disease

It is common for Parkinson’s Disease patients to feel weak. They frequently describe their legs as feeling, “like they’re made out of lead,” “like they’re in concrete.” But they will also feel weak all over, or describe weakness in their hands or arms. In fact, when Parkinson’s Disease patients are tested for strength they are normal but they do fatigue easier. That is, with repeated muscle contractions they do lose force, so it is more difficult for a Parkinson’s Disease patient to do repetitive tasks.

When patients think about weakness in Parkinson’s Disease they should recall that the original name for this disease was, “The Shaking Palsy.” “Shaking” refers to the tremor, of course, but “palsy” means weakness. James Parkinson called his monograph on the disease, “The Shaking Palsy.” Thus Parkinson, himself, called this disorder “weakness and tremor,” but substituted the technical terminology of his day. The coding book used for billing insurance companies calls Parkinson’s Disease “Paralysis agitans,” meaning paralysis (complete weakness) with tremor (agitans meaning tremor, or agitated).

Although patients feel the weakness in their limbs, the problem is in the brain. Studies have shown that the actual, objectively measurable muscle weakness that occurs with repeated tasks improves with treatment of the dopamine deficit in the brain with Parkinson’s Disease medications.

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